Assessment of ovarian dysfunction induced by environmental toxins: a systematic review.
Level 3 - non-randomized controlled study
Systematic review of non-randomized cohort studies
PubMed 40809751 · doi:10.3389/fpubh.2025.1575418
What was done
A systematic review following PRISMA-P guidelines searched PubMed, EMBASE, Cochrane Library, and Web of Science through July 30, 2024 (PROSPERO CRD42024567744). The authors evaluated cohort studies examining the effects of chemical, airborne, and heavy metal environmental pollutants on ovarian reserve markers (anti-Müllerian hormone [AMH], antral follicle count [AFC]) and hormone levels (follicle-stimulating hormone [FSH], estradiol [E2]) in women. Study quality and evidence certainty were evaluated using the Newcastle-Ottawa Scale and GRADE framework.
What was found
The review synthesized 40 reports from 33 distinct cohort studies evaluating 20 pollutant types. Exposure to per- and polyfluoroalkyl substances (PFAS), phthalates, triclosan, polychlorinated biphenyls (PCBs), PM2.5, and SOx was associated with adverse impacts on ovarian function, particularly in women under 35 years of age. Long-term exposure to PM2.5 and PM10 was associated with decreased ovarian reserve, and heavy metals (lead, cadmium) also demonstrated reproductive toxicity. The abstract reports no numerical effect sizes or meta-analytic statistics.
Why it matters
This synthesis connects diverse classes of ubiquitous environmental toxins to diminished ovarian reserve and hormonal disruption in women of reproductive age, supporting targeted environmental health monitoring.
Limits
No quantitative pooled effect estimates, confidence intervals, or sample sizes across cohorts are reported in the abstract. Synthesis is limited by primary study weaknesses including heterogeneous exposure assessments, residual confounding, and inconsistent outcome measures across cohorts.
Cited by
- supports PFAS compounds are linked to adverse health outcomes including endocrine/hormone disruption, gut microbiome disturbance, and fertility problems.
- supports PFAS exposure is linked to major health issues including hormone disruption, gut microbiome disruption, and fertility problems.