Molecular Mechanisms of Air Pollution–Induced Reproductive Toxicity: Oxidative Stress, Endocrine Disruption and Epigenetic Alterations

Widespread declines in fertility and the rising burden of reproductive disorders have increased the search for environmental determinants of reproductive health. Ambient air pollution is now recognized as a critical contributor to reproductive deterioration. Beyond its established respiratory effects, pollutants such as PM2.5, polycyclic aromatic hydrocarbons, nitrogen oxides, and heavy metals exert profound biological effects on reproductive systems.

This systematic review synthesizes mechanistic evidence published between 2015 and 2025 to elucidate how air pollution influences reproductive health through oxidative stress, endocrine disruption, and epigenetic reprogramming. Studies were systematically retrieved from PubMed and Scopus, focusing on experimental and epidemiological data.

Previous evidence has demonstrated that exposure to pollutants causes an overproduction of reactive oxygen species, leading to mitochondrial dysfunction, lipid peroxidation and genomic instability in germ cells. Air pollutants also induce endocrine disruption by disturbing the hypothalamic–pituitary–gonadal axis, leading to hormonal imbalances that impact gametogenesis and reproductive function. Importantly, emerging data suggest that epigenetic mechanisms, such as aberrant DNA methylation and changes in microRNA expression, are responsible for persistent and possibly transgenerational effects of exposure.

These pathways act not in isolation but as an integrated network driving reproductive toxicity. Despite significant advances, important gaps remain in long-term human studies, dose-response relationships, and sex-specific mechanisms. Addressing these challenges will be vital for designing targeted interventions and informing policies to reduce the reproductive health burden associated with air pollution.

Air pollution, Reproductive toxicity, Oxidative stress, Endocrine disruption, Epigenetic changes.

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