Impact of endocrine disruptors on female fertility: an update.

Endocrine disruptors (EDs) are a heterogeneous group of natural or synthetic chemicals capable of interfering with hormonal regulation. Widely present in plastics, cosmetics, pesticides, food packaging, and household products, they contribute to constant human exposure. Compounds such as bisphenol A, phthalates, parabens, dioxins, and certain pesticides are among the most studied. Their mechanisms of action include interaction with hormone receptors, modulation of gene expression through epigenetic changes, disruption of steroidogenesis, and interference with the hypothalamic-pituitary-gonadal axis. Evidence from animal and human studies suggests that EDs may reduce ovarian reserve, impair oocyte maturation, alter ovulation and implantation, and contribute to infertility. Associations have also been observed with polycystic ovary syndrome, endometriosis, and poorer outcomes of assisted reproductive techniques. Despite these findings, human data remain largely observational, with methodological limitations such as variable exposure assessment, lack of standardized biomarkers, and the unaddressed "cocktail effect." Strengthening preventive strategies, regulatory measures, and further research is essential to better understand and mitigate the risks EDs pose to female reproductive health.