Reproductive health indicators are chosen for assessment of reproduction problems in Bulgaria by using official medical statistical information. Based on National registers a rough picture of the environmental pollution in Bulgaria is depicted by considering selected persistent organic pollutants (DDT, dioxins and furans) and some heavy metals (Pb and Cd), suspected to be reproductive toxins. Assessment was done on the basis of trends in birth and death rates, and some disruptions in reproductive functions. Significant and persistent reduction of the population, as well as a negative population growth, are established. Comparatively high male and female infertility was recorded. Prenatal and postnatal developmental problems were detected. Slight increase of the stillbirth rates and lack of statistical difference of the spontaneous abortion rates during the last years were established. Increase of mortality rate due to low birth weight and preterm delivery was noticed till 1991 with a slight reduction thereafter. Trends of reduction in the infant mortality rates were established, but still were higher than the other European countries.
Attempts to localize reproductive health problems to ‘hot spots’ of environmental pollution in Bulgaria were performed. It is concluded that the reproductive problems in Bulgaria are a combination of socio-economic, environmental and genetic factors.