Potentially Toxic Elements and Male Reproductive Toxicity: Mechanisms, Implications, and Protective Strategies: A Narrative Review.

The male reproductive system is highly vulnerable to environmental toxicants, particularly potentially toxic elements (PTEs), which represent a growing public health concern worldwide. Increasing evidence indicates that these elements impair male reproductive function through interconnected mechanisms including oxidative stress, endocrine disruption, inflammation, apoptosis, and DNA damage, resulting in impaired spermatogenesis and infertility. This review summarizes the current understanding of the major PTEs associated with male reproductive toxicity and highlights the underlying cellular and molecular mechanisms responsible for testicular injury. In addition, it discusses emerging protective and therapeutic strategies, including antioxidants, phytochemicals, nutraceuticals, chelating agents and lifestyle-based interventions that have shown potential in mitigating PTE-induced reproductive damage. A comprehensive understanding of these mechanisms and protective approaches may facilitate the development of effective preventive and therapeutic strategies to preserve male reproductive health in populations exposed to PTEs.