A hidden crisis: the threat of environment to reproductive health

The escalating prevalence of infertility globally is increasingly linked to environmental hormone exposure, particularly endocrine-disrupting chemicals (EDCs) such as phthalates, bisphenol A (BPA), pesticides, and industrial pollutants. These ubiquitous contaminants, permeating ecosystems through air, water, food chains, and commercial goods, interfere with hormonal regulation via multifactorial mechanisms, including receptor agonism/antagonism, hypothalamic-pituitary-gonadal axis dysregulation, oxidative stress induction, and DNA methylation alterations. EDCs impair gamete quality and elevate congenital reproductive risks in both sexes. EDCs alter hormonal balance, reduce fertility, and induce germline epigenetic changes, potentially causing transgenerational reproductive harm. Critical exposure periods - embryonic development, adolescence, and adulthood - exacerbate risks, with transgenerational epigenetic effects raising concerns for offspring health. High-risk populations, including industrial workers and agricultural laborers, face disproportionate exposure. Clinical interventions such as hormone replacement therapy and assisted reproductive technologies offer limited solutions, underscoring the need for preventive strategies. Future research must address the combined effects of multi-chemical exposures, long-term low-dose impacts, and epigenetic inheritance. Public health policies should prioritize stricter regulation of EDCs, enhanced environmental monitoring, and public education to mitigate exposure. Individualized health management, including dietary adjustments and reduced plastic use, is crucial. Resolving this public health challenge requires synergistic efforts across toxicogenomics, clinical research, and environmental policymaking to ensure sustainable reproductive health preservation.