Associations between per- and polyfluoroalkyl substances and semen parameters: An updated systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational epidemiological studies
PubMed 42570390 · doi:10.1016/j.jhazmat.2026.143157
What was done
A systematic review and meta-analysis conducted following PRISMA guidelines (PROSPERO: CRD420251267798) searching four databases up to July 13, 2025. Studies assessing associations between per- and polyfluoroalkyl substances (PFAS) and sperm outcomes were included. The primary effect measure was the Pearson correlation coefficient (r). Evaluated outcomes included sperm concentration, semen volume, total sperm count, motility, morphology, pH, and sperm DNA fragmentation. Fourteen studies comprising 7,465 participants were included.
What was found
PFAS mixtures showed limited associations with conventional semen parameters, but demonstrated consistent inverse relationships with progressive motility (r = -0.058, 95% CI: -0.100 to -0.015) and positive associations with sperm DNA fragmentation (r = 0.141, 95% CI: 0.087 to 0.195). Individual congeners showed distinct, heterogeneous association profiles. Specific effect sizes for other conventional parameters were not reported in the abstract.
Why it matters
This review aggregates epidemiological data showing that while PFAS exposure has minimal association with standard semen metrics, it is linked to reduced motility and increased sperm DNA damage, pointing to potential subtle mechanisms of male reproductive toxicity.
Limits
All included studies were observational, which precludes causal inference. The magnitude of the observed correlations is very small (r < 0.15). Findings were heterogeneous across individual PFAS congeners, and the abstract does not report confounder control, specific exposure routes, or risk-of-bias assessments.