Persistent organic pollutants and couple fecundability: a systematic review.
Level 3 - non-randomized controlled study
Systematic review of observational studies
PubMed 33147335 · doi:10.1093/humupd/dmaa037
What was done
A systematic review of literature published between January 2007 and August 2019 across MEDLINE, EMBASE, Global Health, DART/TOXLINE, and POPLINE. The authors evaluated empirical human studies assessing exposure to organochlorine (OC) pesticides, brominated flame retardants, polychlorinated organic compounds, or per- and polyfluoroalkyl substances (PFAS) in relation to time to pregnancy (TTP) or fecundability. Screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale and fecundability-specific metrics were completed in duplicate.
What was found
The search identified 4,573 articles, yielding 28 papers from 19 unique studies. Four studies measured TTP prospectively, three assessed prenatal exposure, three evaluated both partners, and one evaluated males only. Wide variation in exposure characterisation precluded quantitative meta-analysis; no pooled numerical estimates are reported. Qualitative synthesis found the strongest support for an association between female exposure to polychlorinated biphenyls (PCBs) and longer TTP, with additional support for female exposure to polybrominated diphenyl ethers (PBDEs) and PFAS. Little or no support was found for female exposure to OC pesticides or male exposure to any POP class.
Why it matters
This review synthesises evidence showing that female exposure to certain persistent endocrine disruptors may reduce fecundability, highlighting reproductive risks from both legacy pollutants and emerging replacement chemicals.
Limits
Substantial heterogeneity in exposure assessment methods prevented quantitative meta-analysis. Most included studies were retrospective (only four prospective), introducing potential recall and selection bias. Data on male partner exposures were extremely sparse (only four studies evaluated males).
Cited by
- supports PFAS compounds (forever chemicals) are linked to hormone disruption, gut microbiome disruption, and fertility issues.
- supports PFAS chemicals are linked to health issues including hormone disruption, gut microbiome disruption, and fertility issues.