Endocrine-disrupting chemicals and human infertility: a scoping review of daily-life exposures and clinical implications for clinical practice

Abstract

Infertility is a growing worldwide health issue that cannot be addressed only by hereditary or behavioural causes. Growing research suggests that endocrine-disrupting chemicals (EDCs), which are pervasive environmental pollutants, are substantial contributors to poor male and female reproductive health, particularly in fast industrialising nations like India. The objective was to comprehensively map and synthesise current knowledge on the origins, mechanisms, and clinical reproductive consequences of EDC exposure, with an emphasis on the implications for infertility practice and public health policy. A scoping review was conducted using the PRISMA-ScR framework. The PubMed/MEDLINE, Scopus, and Web of Science databases were searched for systematic reviews, meta-analyses, umbrella reviews, and significant human and animal research published between January 2014 and June 2025. The Endocrine Society, World Health Organisation, and United Nations Environment Programme provided authoritative position statements. Evidence was synthesised thematically based on exposure sources, molecular pathways, and clinical consequences. EDCs, which include bisphenols, phthalates, pesticides, PFAS, and heavy metals, have been linked to poor sperm quality, testosterone shortage, ovulatory dysfunction, decreased ovarian reserve, endometriosis, poor pregnancy outcomes, and possible transgenerational impacts. Disruption of the hypothalamic-pituitary-gonadal axis, interference with hormone receptors, poor steroidogenesis, oxidative stress, mitochondrial dysfunction, and epigenetic alteration were among the mechanisms implicated. Exposure reduction treatments showed short-term reversibility of biomarker load, indicating therapeutic significance. EDCs are controllable yet underappreciated risk factors for infertility. Integrating exposure assessment, preventative counselling, biomonitoring, and regulatory tightening, particularly in India, may improve reproductive outcomes and supplement assisted reproductive technology.