The periodontal-female reproductive axis and infertility: a scoping review of epidemiological and mechanistic evidence.
Level 4 - case-series / case-control
Scoping review synthesising observational epidemiological studies, animal models, and in vitro data
PubMed 42210266 · doi:10.1186/s12903-026-08685-w
What was done
A scoping review was conducted following PRISMA-ScR guidelines across PubMed/MEDLINE, Scopus, Cochrane Library (CENTRAL), Web of Science, and grey literature without date restrictions. Two independent reviewers applied the Population-Concept-Context (PCC) framework to map literature on the relationship between periodontal disease and female reproductive disorders (including infertility, endometriosis, and recurrent implantation failure). A total of 22 studies were included.
What was found
The abstract reports no numeric effect sizes, risk estimates, or confidence interval figures. Eight epidemiological studies yielded heterogeneous findings. Prospective data showed a possible modest reduction in fecundability associated with periodontitis, accompanied by varying effect sizes and wide confidence intervals. Serological findings supported an association between periodontal pathogen exposure and unexplained infertility. In vitro and animal models suggested plausible biological pathways, but human clinical validation was lacking.
Why it matters
This review maps the current state of evidence regarding a potential periodontal-reproductive axis, demonstrating biological plausibility while clarifying that existing data are insufficient to infer causality or direct clinical practice.
Limits
The available human literature is strictly observational with no interventional or clinical trial data. Included studies frequently relied on self-reported periodontal status rather than objective diagnostic criteria, and mechanistic pathways remain largely unvalidated in human populations.
Cited by
- supports Periodontal disease is associated with impaired sperm quality, reduced fertility potential in women, and an increased risk of pregnancy complications such as preeclampsia and preterm birth.