Association between urinary bisphenol A concentrations and semen quality: A meta-analytic study.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 34968490 · doi:10.1016/j.bcp.2021.114896
What was done
Authors conducted a systematic review and meta-analysis searching PubMed, Scopus, and Web of Science for studies evaluating the relationship between urinary bisphenol A (BPA) concentrations and standard semen parameters. Inclusion was restricted to studies providing multivariable linear regression effect estimates (beta-coefficients and 95% CIs). The analysis pooled data from 9 studies comprising a total of 2,399 men.
What was found
Among standard semen parameters, only sperm motility showed a statistically significant inverse association with urinary BPA (pooled beta = -0.82; 95% CI: -1.51 to -0.12, p = 0.02; heterogeneity I^2 = 42.9%, p = 0.1). However, this statistical significance disappeared after adjusting for publication bias and when either of the two most heavily weighted studies was removed in sensitivity analyses. Other semen parameters showed no significant associations.
Why it matters
Despite preclinical animal models demonstrating male reproductive disruption from BPA, pooled human observational data indicate that urinary BPA exposure has a clinically negligible association with semen quality.
Limits
The analysis relied entirely on observational studies with multivariable linear regressions, which are susceptible to residual confounding and single-timepoint measurement error for urinary BPA. The primary significant outcome (sperm motility) was fragile, losing significance under sensitivity analyses and adjustment for publication bias. Total sample size across the literature remains modest (2,399 men across 9 studies).
Cited by
- partial High exposure to BPA and phthalates reduces sperm count, sperm motility, and normal sperm morphology.