Microplastics and female infertility: reproductive toxicity and underlying mechanisms

In modern society, the progression of ovarian aging in women has accelerated, and the incidence of infertility has increased markedly with a distinct younger-onset trend. Exploring the etiology and pathogenesis of infertility has become a core research focus for clinicians. Plastic products bring tremendous convenience to modern life, while the health risks caused by plastic pollution have aroused global concern. As typical endocrine-disrupting chemicals, microplastics (MPs) can enter the human body through dietary intake, respiration, and skin contact, and accumulate in multiple organs. Accumulated MPs impair the physiological function of the female reproductive system and are closely associated with multiple gynecological disorders, including polycystic ovary syndrome, endometriosis, and premature ovarian insufficiency. After internalization, MPs trigger a series of pathological events such as epigenetic alterations, hormonal metabolism disturbance, inflammatory response, immune dysregulation, oxidative stress, and cellular damage, ultimately resulting in female reproductive impairment. The exposure routes and pathogenic mechanisms underlying MPs-induced reproductive toxicity have emerged as critical scientific issues that urgently require addressing. From an innovative perspective, this review elaborates on the mechanisms underlying the occurrence and progression of female infertility-related diseases mediated by MPs. It aims to provide novel insights for the clinical diagnosis and treatment of female infertility, offer theoretical references for pre-pregnancy counseling and reproductive health management, and supply scientific evidence for the precise prevention and control of MP pollution.