The overall human fertility rate is dropping down every year over the world for a number of different reasons. Causes can be general, such as environment or lifestyle, or specific, such as genetic and disease. We propose that the use of disposable diapers for newborns and infants may result in reproductive harm in adulthood. More than 70 years ago, a disposable synthetic waterproof baby diaper was developed. Modern diapers have the same original and simple design, which contains one unit of disposable material wrapped around the perineum to collect urine and feces. This design results in an increase in internal area temperatures of 2-4°C, which can be detrimental to the function and development of reproductive cells. Moreover, the standard diaper template promotes the free passage of feces, including fecal bacteria, to the genitals, which can lead to urogenital infection also affecting reproductive cells. During the first year of life and later, the number of somatic and germinal cells increases by mitosis. It has been reported that proliferative cells are vulnerable to heat stress, which causes testicular cells to undergo apoptosis. A well-known childhood pathology, cryptorchidism, when one or both testicles do not descend into the scrotum after birth, and remain at different levels of the inguinal canal, subsequently causes infertility if the testicles do not descend into the scrotum. The one of the main reasons is the disruption of the transition from gonocytes to spermatogonia under the body-heat, which leads to spermatogenic arrest. There is no sufficient data on the effect of increased scrotal temperature in infancy on reproductive functions after puberty and we assume that reproductive functions in adulthood may be directly influenced by events in infancy. Additional aspect is a possible effect of diapers on brain gender development. Gender-related brain differentiation begins early in development, whereas gender-related behaviors and sexual orientation emerge later. In males, the first six months of life are characterized by a transient surge in testosterone (“mini-puberty”), coinciding with sharp brain growth. Elevated scrotal temperature may to impair reproductive cells function, raising the theoretical possibility that neonatal thermal exposure could affect testicular testosterone production during “mini-puberty” and as that may theoretically modulate endocrine signaling and thereby influence brain-gender development. In conventional diapers, feces diffuse into the front compartment of the diaper and thereby provide easy access for fecal flora (in most cases E. coli and E. faecalis) to the genitals and urethral tract. Urinary tract infection (UTI) is one of the most common bacterial infections in infants under 1 year of age. The relationship of this pathology in neonate and infertility in adulthood has also not yet been verified. Summarizing the available information today, it can be assumed that diaper use during infancy may have a negative impact on fertility later, after puberty. There is a major need for additional studies to better identify the role of diapers in reproductive and gender health.

TBA