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Impact of Di-2-Ethylhexyl Phthalate Metabolites on Male Reproductive Function: a Systematic Review of Human Evidence

Abstract

Purpose of Review

The purpose of this review is to systematically review the literature linking di-2-ethylhexyl phthalate (DEHP) exposure with effects on reproductive health in adult males.

Recent Findings

Thirty-three papers were included of which 28 were cross-sectional. Twenty-one papers investigated semen samples, 18 investigated reproductive hormones, and three studies investigated time to pregnancy. Studies revealed some but inconsistent indications that higher urinary DEHP metabolite levels are associated with an increase in the proportion of spermatozoa with damaged DNA and to a decrease in sperm concentration and motility. A negative association between DEHP metabolites and testosterone levels was more consistent. DEHP metabolites do not seem to be associated with a delay in time to pregnancy, but data are sparse.

Summary

The studies on DEHP exposure and reproductive biomarkers in men converge to support the hypothesis that DEHP exposure is related to impaired male reproductive function. Longitudinal studies are needed to establish if the observed associations are causal.

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Fig. 1

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgment

It is with our deepest sorrow that we inform you of the passing of our co-author, Bo A.G. Jönsson during the writing of this article.

Funding

This systematic review was part of the CLEAR collaboration funded by the European Commission 7th Framework Program FP7-ENV-2008-1 Grant no.: 226217; the Danish Research Council (10-082745); ReproHigh, the Öresund-Kattegat-Skagerrak-Program; and funded by the European Regional Development Fund. This article was furthermore a part of the ReproUnion collaborative study, co-financed by the European Union, Intereg V ÖKS.

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Correspondence to Birgit Bjerre Høyer.

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Human and Animal Rights and Informed Consent

All reported studies with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Bo A.G. Jönsson Deceased.

This article is part of the Topical Collection on Susceptibility Factors in Environmental Health

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Høyer, B.B., Lenters, V., Giwercman, A. et al. Impact of Di-2-Ethylhexyl Phthalate Metabolites on Male Reproductive Function: a Systematic Review of Human Evidence. Curr Envir Health Rpt 5, 20–33 (2018). https://doi.org/10.1007/s40572-018-0174-3

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Keywords

  • Review
  • Phthalic acids
  • Fecundity
  • Reproduction
  • Semen quality
  • Gonadal steroid hormones