Bisphenol A and di-(2-ethylhexyl) phthalate: Hidden threats to female fertility

J Obstet Gynaecol. 2025 Dec;45(1):2559727. doi: 10.1080/01443615.2025.2559727. Epub 2025 Sep 22.

Abstract

Bisphenol A and di-(2-ethylhexyl) phthalate are among the most widespread endocrine-disrupting chemicals (EDCs), widely present in consumer products and the environment. Preclinical studies have shown that these compounds and their metabolites may interfere with key reproductive processes, including folliculogenesis and steroidogenesis. However, translating these findings into clinical relevance remains challenging. Human studies have yielded conflicting results, with some suggesting associations between EDC levels and reduced ovarian reserve or poorer in vitro fertilisation outcomes, while others report no significant correlations. Differences in study design, population characteristics and exposure assessment contribute to this heterogeneity. Despite the current limitations, the topic warrants attention within reproductive medicine, particularly from a preventive perspective. While evidence remains inconclusive, raising awareness and considering lifestyle factors potentially linked to environmental exposures may be a reasonable step in clinical practice. Further studies are needed to clarify their clinical impact and to guide evidence-based reproductive care.

Keywords: Endocrine disruptors; assisted reproductive techniques; female infertility; fertilisation in vitro.

Publication types

  • Review

MeSH terms

  • Benzhydryl Compounds* / adverse effects
  • Benzhydryl Compounds* / toxicity
  • Bisphenol A Compounds
  • Diethylhexyl Phthalate* / adverse effects
  • Diethylhexyl Phthalate* / toxicity
  • Endocrine Disruptors* / adverse effects
  • Endocrine Disruptors* / toxicity
  • Environmental Exposure* / adverse effects
  • Female
  • Fertility* / drug effects
  • Humans
  • Infertility, Female* / chemically induced
  • Ovarian Reserve / drug effects
  • Phenols* / adverse effects
  • Phenols* / toxicity
  • Pregnancy

Substances

  • bisphenol A
  • Benzhydryl Compounds
  • Phenols
  • Endocrine Disruptors
  • Diethylhexyl Phthalate
  • Bisphenol A Compounds