Dr. Rose Ngandalo

🌸 Open Your TTC CompanionThe Invisible Threat to Your Fertility: Endocrine disruptors and environmental toxins
Let me ask you something that might feel uncomfortable.

You're eating well. You're moving your body. You're sleeping better and managing your stress. You're taking your supplements. And yet something still feels off. Cycles remain irregular. Sperm quality hasn't shifted as expected. IVF outcomes are disappointing despite good-looking embryos.

What if part of the answer isn't in what you're doing, but in what you're being exposed to every single day, without knowing it?

This is the conversation I feel most urgently needs to happen in reproductive medicine right now. Environmental toxins specifically a class of chemicals known as endocrine-disrupting chemicals (EDCs) are quietly interfering with the hormonal machinery of fertility in both men and women. They are in our food packaging, our cookware, our cosmetics, our water supply, our clothing, and our furniture. They are, in many cases, already inside us.

The science on this is no longer preliminary. It is substantial, concerning, and demands our attention.

What are endocrine disruptors and why should fertility patients care?

Endocrine-disrupting chemicals are exogenous compounds made outside the body that interfere with the endocrine system by mimicking, blocking, or altering the action of your own hormones particularly estrogens, androgens, and thyroid hormones.

They do not need to be present in large quantities to cause harm. Many EDCs act at extraordinarily low concentrations sometimes lower than the levels your body uses its own hormones. This is one of the features that makes them so difficult to regulate and so clinically relevant: the dose-response relationship is not linear. Small, chronic, continuous exposures can cause significant biological disruption over time.

A 2024 systematic review published in PMC examining a decade of human epidemiological evidence on EDC exposure and fertility outcomes confirmed that the most commonly studied EDCs (BPA, BPA analogs, phthalates, parabens, PFAS, and persistent organic pollutants) are all associated with adverse reproductive outcomes in both males and females of reproductive age.

The key EDCs relevant to fertility fall into these main categories:
Bisphenol A (BPA) and its analogs found in plastics, food can linings, thermal receipt paper
Phthalates found in soft plastics, personal care products, fragrances, food packaging.

PFAS (per- and polyfluoroalkyl substances) found in non-stick cookware, waterproof clothing, food packaging, drinking water

Pesticides and herbicides found in non-organic produce, tap water in agricultural areas
Heavy metals (cadmium, lead, mercury) found in contaminated water, certain fish, old paint, air pollution

Microplastics now found virtually everywhere, including inside the human body

Let's look at each through a reproductive lens for both women and men.

BPA: The Plastic chemical living in your body right now

Bisphenol A is one of the most produced industrial chemicals in the world. Despite growing regulation in some regions, it remains pervasive and its replacements (BPS, BPF) appear to carry similar risks.

BPA is a potent xenoestrogen a chemical that binds to estrogen receptors in the body and triggers estrogenic effects. This directly disrupts the hormonal environment required for fertility.

For Women

Human cohort and IVF studies consistently associate elevated BPA exposure with diminished ovarian reserve, impaired oocyte quality, and reduced fecundability. Elevated urinary BPA concentrations have been linked to reduced anti-Müllerian hormone (AMH) levels the primary marker of ovarian reserve and lower antral follicle counts in IVF patients.

BPA also disrupts endometrial receptivity, potentially impeding implantation even when a good quality embryo is present a factor that may explain some cases of unexplained implantation failure.

For Men

A 2024 systematic review and meta-analysis published in PMC ; drawing on 18 epidemiological studies found that urinary BPA concentration was significantly and negatively correlated with sperm concentration and total sperm count. BPA binds to estrogen-related receptor gamma and suppresses androgen receptors in the testes, increasing the risk of male infertility through impaired spermatogenesis.

What is particularly alarming is evidence that fetal BPA exposure programmes reproductive dysfunction in male offspring altering testicular physiology and bioenergetics in ways that may not manifest until adulthood. This is not just about your fertility today; it is about the environment you were gestated in, and the one you may be creating for future generations.

Where BPA hides:
Plastic food containers and water bottles (look for "BPA-free" but note the caveats above)
The lining of tinned foods and drinks
Thermal paper receipts absorbed through skin on contact
Plastic wrap and food packaging

Phthalates: The hidden hormone disruptors in your bathroom cabinet

Phthalates are plasticisers used to make plastics soft and flexible and they are also found extensively in fragranced personal care products (where they act as fixatives). They are among the most ubiquitous EDCs in the human body, detected in virtually 100% of the population studied in biomonitoring surveys.

Phthalates are primarily anti-androgenic they interfere with testosterone production and signaling, in both women and men.

In Men

Phthalates interfere directly with Leydig cells by decreasing the production of StAR (Steroidogenic Acute Regulatory) protein a critical step in testosterone synthesis. This reduction hinders the transport of cholesterol into the mitochondria, disrupting testosterone production during fetal development with potentially lifelong consequences for reproductive health.

In adult men, phthalate exposure is consistently associated with reduced sperm concentration, motility, and morphology, as well as lower testosterone levels.
In Women

In women, the anti-androgenic and endocrine-disrupting activity of phthalates disrupts the HPG axis, impairs follicle development, and is associated with earlier ovarian ageing and irregular cycles. Phthalate metabolites in urine have been associated with reduced IVF success rates in multiple clinical studies.

Where phthalates hide:
Synthetic fragrances in perfumes, air fresheners, and scented candles
Conventional shampoos, conditioners, body washes, and lotions
Nail polish and nail polish remover
Soft plastic toys, shower curtains, and vinyl flooring
Food packaging particularly fatty foods wrapped in plastic
PFAS: The "Forever Chemicals" That Never Leave

Per- and polyfluoroalkyl substances (PFAS ) deserve special attention. They are called "forever chemicals" because their carbon-fluorine bonds are virtually indestructible. PFAS have a long biological half-life of 2.3 to 8.5 years in the human body, and PFAS exposure during critical developmental windows has been linked to differential impacts on male and female pubertal development, reproductive physiology, and epigenetic modifications including DNA methylation changes with potential transgenerational implications.

For Women

In females, PFAS inhibit the hypothalamic–pituitary–gonadal (HPG) axis, reducing FSH and LH levels and leading to suppressed androgen and estradiol production. PFAS have been found to impair folliculogenesis and cause detrimental effects on egg quality. They also disrupt progesterone-mediated endometrial function, potentially compromising implantation.

PFAS can interfere with normal reproductive and hormone signalling, directly targeting the ovary and causing serious harm to the female reproductive system.

For Men

In males, PFAS can impair sperm motility and morphology two fundamental qualities for successful fertilization. Studies also link PFAS exposure to altered testosterone levels and testicular function.

Where PFAS hide:
Non-stick cookware (Teflon and similar coatings)
Waterproof and stain-resistant clothing (Gore-Tex, treated outdoor gear)
Grease-resistant food packaging (microwave popcorn bags, fast food wrappers, pizza boxes)
Drinking water, particularly near industrial sites or military bases
Stain-resistant carpets and upholstery (Scotchgard-type treatments)
Some dental floss brands

Microplastics: Inside the ovarian follicle

Perhaps the most alarming recent development in this field is the discovery that microplastics are now being found inside the human reproductive system itself.

A 2025 PubMed study the first of its kind identified microplastics, primarily polyethylene and PVC, in the ovarian follicular fluid of 14 out of 18 women undergoing IVF treatment. Critically, higher microplastic concentrations were correlated with elevated FSH levels a potential marker of ovarian stress and diminished reserve.

Microplastics are not just passive contaminants. They carry surface-adsorbed chemicals including PFAS, phthalates, and BPA and generate oxidative stress and inflammation in the tissues they infiltrate.

In men, microplastics have now been detected in testicular tissue in multiple studies, with associations with reduced sperm count and quality. We are, quite literally, accumulating plastic inside our reproductive organs.

Pesticides, Heavy Metals, and Air Pollution
Pesticides

Organophosphate and organochlorine pesticides are well-established endocrine disruptors. Glyphosate, the world's most widely used herbicide is increasingly linked to hormonal disruption and gut microbiome damage (connecting back to our previous article). Women living in agricultural areas with higher pesticide exposure consistently show higher rates of cycle irregularity and reduced fertility in epidemiological studies.

Heavy Metals

Heavy metals including cadmium, lead, and mercury accumulate in ovarian tissue and induce oxidative stress, DNA damage, and mitochondrial dysfunction. These are the same pathways that damage egg quality discussed in our female fertility article. Mercury from large predatory fish (shark, swordfish, king mackerel, tilefish) is a particular concern for both partners during the preconception period.

Air Pollution

A 2025 narrative review on environmental pollution and female fertility included air pollution particularly fine particulate matter (PM2.5) as a measurable fertility disruptor, associated with reduced ovarian reserve and impaired IVF outcomes. Urban living with heavy traffic exposure is not neutral from a reproductive standpoint.

What You Can Realistically Do: A Practical Reduction Protocol

I want to be honest with you here: complete avoidance of EDCs is not possible in the modern world. These chemicals are too pervasive. The goal is meaningful, systematic reduction lowering your total body burden enough to make a difference to your reproductive environment.

This the total load concept: your body can handle a certain level of toxic exposure. When that threshold is exceeded through cumulative, ongoing exposure from multiple sources the system starts to show strain. Reducing from several directions simultaneously can meaningfully reduce that total load.

Here is my practical framework for couples:
In the Kitchen
Switch to glass, stainless steel, or cast iron for food storage and cooking eliminate plastic containers entirely where possible.
Never heat food in plastic even "microwave-safe" plastic leaches chemicals when heated.
Replace non-stick cookware with ceramic-coated, cast iron, or stainless steel alternatives
Buy tinned food in BPA-free cans, or better, choose fresh or glass-jarred alternatives
Filter your drinking water a high-quality carbon block or reverse osmosis filter significantly reduces PFAS, chlorine by-products, and pesticide residues
Choose organic produce for the highest-pesticide crops (the "Dirty Dozen": strawberries, spinach, kale, peaches, pears, nectarines, apples, grapes, capsicum, cherries, blueberries, green beans)

In the Bathroom
Simplify your personal care routine every product you use topically adds to your chemical load
Choose fragrance-free products wherever possible "fragrance" on an ingredient list is a blanket term that can conceal dozens of phthalates and other EDCs
Switch to natural or mineral-based deodorants, and check your toothpaste, sunscreen, and makeup for parabens and phthalates
Use apps like Think dirty or the EWG Skin Deep database to check the toxicity ratings of your current products ( free, quick, and genuinely eye-opening)

In the Home
Ventilate your home regularly indoor air quality is frequently worse than outdoor, and off-gassing from furniture, flooring, and paint contributes to EDC exposure
Remove shoes at the door; pesticides, heavy metals, and other outdoor contaminants are tracked inside on footwear
Avoid synthetic air fresheners and scented candles these are significant sources of phthalate exposure indoors
Choose fragrance-free or naturally scented laundry products ; conventional fabric softeners and dryer sheets are among the most fragrance-loaded household products

Nutrition to support detoxification

Your liver is your primary detoxification organ and supporting its Phase I and Phase II detoxification pathways actively helps clear EDC metabolites:
Cruciferous vegetables daily (broccoli, cauliflower, Brussels sprouts, kale) contain sulforaphane and DIM (diindolylmethane), which powerfully support estrogen metabolism and liver detoxification
Adequate protein amino acids are essential for Phase II detoxification conjugation reactions
Glutathione support N-acetyl cysteine (NAC) 600mg daily, alpha lipoic acid, and foods rich in Sulphur (garlic, onions, eggs) support your body's master antioxidant and detoxification molecule
Fiber supports the excretion of estrogen metabolites and EDC conjugates via the gut, reducing reabsorption
Stay well hydrated adequate water intake supports urinary excretion of water-soluble EDC metabolites

Supplements with evidence for EDC Support

Calcium D-glucarate ; inhibits beta-glucuronidase , reducing the reabsorption of estrogen and estrogen-like chemicals. Particularly relevant for women with estrogen dominance
DIM (Diindolylmethane, 100–200mg) supports healthy estrogen metabolism toward less estrogenic metabolites
Zinc; supports testosterone production and competes with heavy metals for absorption in men
Modified citrus pectin; binds heavy metals in the gut and supports their excretion

A Word on Hope and Agency

I want to close this article where I started with honesty and compassion.

Learning about environmental toxins can feel overwhelming. It can induce fear, helplessness, and a sense that the world is fundamentally unsafe. That is not my intention, and it is not a useful response to what is genuinely a modifiable risk factor.

The science shows us that EDC exposure is cumulative which means reduction is meaningful. That the body has detoxification pathways which means support is effective. That dietary, lifestyle, and environmental changes can shift biomarkers of EDC exposure within weeks which means action has measurable impact.

You are not powerless here. You are informed. And being informed is the first and most important step.