Persistent organic pollutants and couple fecundability: a systematic review

Area of Science:

• Environmental Health
• Reproductive Epidemiology
• Toxicology

Background:

• Persistent organic pollutants (POPs) are environmental contaminants that biomagnify and are linked to endocrine disruption.
• Adverse reproductive outcomes, including reduced fecundability (time to pregnancy, TTP), are a public health concern associated with POPs exposure.

Purpose of the Study:

• To systematically review and synthesize evidence on the association between common POPs and couple fecundability.
• To identify research gaps and limitations in the existing literature on POPs and TTP.

Main Methods:

• Systematic literature search of multiple databases (MEDLINE, EMBASE, etc.) for studies published between 2007 and 2019.
• Inclusion of empirical research examining human exposure to specific POP classes (OC pesticides, brominated flame retardants, polychlorinated organic compounds, PFAS) and TTP/fecundability.
• Quality assessment using the Newcastle-Ottawa Scale and additional bespoke metrics for fecundability studies.

Main Results:

• 28 papers from 19 studies met inclusion criteria; analyses varied, precluding meta-analysis.
• Strongest evidence links female exposure to polychlorinated biphenyls with reduced TTP.
• Some evidence suggests polybrominated diphenyl ethers and PFAS are associated with longer TTP in females; limited evidence for OC pesticides or male POP exposure.

Conclusions:

• Female exposure to certain POPs, like PCBs, may impair fecundability.
• Despite regulations, POPs persist, and replacement chemicals may pose similar risks.
• Future research should focus on newer POPs, combined exposures, human metabolism, and vulnerable populations.