Effects of Perfluorohexane Sulfonic Acid on Female Reproductive Function and Oocyte Quality

An emerging persistent organic pollutant, perfluorohexane sulfonic acid (PFHxS), has drawn considerable attention owing to its female reproductive toxicity. PFHxS penetrates the blood-follicle barrier and accumulates in follicular fluid, with a prolonged elimination half-life in humans. Mechanistically, PFHxS impairs oocyte quality through oxidative stress, mitochondrial damage, disruption of hypothalamic-pituitary-gonadal (HPG) axis signaling, meiotic spindle abnormalities, and epigenetic modifications. Animal models demonstrate that PFHxS exposure leads to follicular arrest, reduced ovulation, and intrauterine growth restriction in offspring. Human studies have associated exposure with diminished ovarian reserve, prolonged amenorrhea, and reduced high-quality embryos. Current research highlights a shift from single-compound to mixture effects and transgenerational epigenetic inheritance, yet significant gaps remain regarding chronic low-dose exposure and causal evidence in clinical populations. Future research should focus on realistic exposure models and large-scale prospective cohorts, and the existing evidence should be integrated into regulatory frameworks to safeguard reproductive health.