Table 1.
Summary of recent available clinical evidence of phthalate esters effects on sperm parameters and reproductive hormones.
| Paper | Year | N subjects | EDCs investigated | Subjects with EDCs >LOD | Population | Sperm Parameters | Hormones |
|---|---|---|---|---|---|---|---|
| Joensen et al. [78] | 2012 | 881 | urinary MEP, MnBP, MiBP, MBzP, MEHP, MEHHP, MEOHP, MECPP, MOP, MCPP, MiNP, MHiNP, MOiNP, MCiOP | MOP 2.5%; others 79.6–100% | general population | semen parameters were not significantly associated with the urine concentrations of various phthalate esters | urinary MEHP was associated with total and free testosterone, but not with gonadotropins |
| Han et al. [79] | 2014 | 232 | MBP, MEP, MEHP, MBzP, phthalic acid | MBzP 8.9%; MEHP 58.9%; MEP 77.6%; others 100% | men with unknown fertility attending a fertility center | weak association between MBP and sperm concentration (OR 1.97; 95%CI 0.97–4.04); no associations with sperm DNA integrity | no correlations between phthalates and serum hormones after adjustments for confounders |
| Lenters et al. [80] | 2014 | 602 | DEHP, MEHHP, 5OH-MEHP, MEOHP, 5oxo-MEHP, MECPP, 5cx-MEPP, DiNP, MHiNP, 7OH-MMeOP, MOiNP, 7oxo-MMeOP, MOiCP, PFAS, PFOS, PFOA, PFHxS, PFNA, PFDA, PFUnDA, PFDoDA, cadmium, lead, mercury, PCB153, p,p’-DDE, HCB | phtalates 39–100%; metals 100%; perfluoroalkylic acids 29–100%; organochlorines 93–100%; | male partners of pregnant women | no associations between phthalates and sperm parameters; PCB-153 negatively associated with sperm motility | DiNP metabolites negatively associated with testosterone |
| Wang et al. [81] | 2015 | 687 | semen plasma MMP, MEP, MBP, MBzP, MEHP, MEHHP, MEOHP and MOP |
MOP 13%; MBzP 29%; MMP 35%; others 67–100% | men with unknown fertility, attending a fertility clinic | negative associations with semen volume semen volume (MBP, MEHP, MEHHP, MEOHP), sperm kinetics parameters (MBzP, MEHP), normal forms (MBzP) | no associations with reproductive hormones |
| Axelsson et al. [82] | 2015 | 314 | urinary and serum MEHP, MECPP, MEHHP, MEOHP, MCiOP, MHiNP, MOiNP, MBP, MBzP, MEP | >97% | general population | DHEP metabolites and MECPP in particular were negatively associated with sperm motility; MEHP was positively associated with HDS. | N/A |
| Wang et al. [83] | 2016 | 1040 (483 reproductive hormones; 509 DNA integrity; 467 sperm apoptosis) | MMP, MEP, MBP, MBzP, MEHP, MEHHP, MEOHP, MEHP urinari | >90% | men with unknown fertility, attending a fertility clinic | MEHP, MEHHP, MEOHP: association with increased DNA fragmentation and apoptosis | MEHP: negative association with Estradiol, total and free Testosterone. |
| Thurston et al. [84] | 2016 | 420 | urinary MEHP, MEHHP, MEOHP, MECPP, MBP, MiBP, MCPP, MBzP, MEP | 77–100% | partners of pregnant women | MiBP: positive association with motility; MBzP: positive association with total sperm count | N/A |
| Liu et al. [85] | 2017 | 139 infertile vs. 150 fertile | urinary MMP, MEP, MBP, MBzP, MEHP, MEHHP, MEOHP | MMP 3.5%; MBzP 50.9%; others >99% | infertile vs. fertile subjects | MEHHP was significantly riduced in cases vs. fertile controls | N/A |
| Chen et al. [86] | 2017 | 796 | urinary MMP, MEP, MiBP, MnBP, MCHP, MCPP, MnOP, MEHHP, MECPP, MEOHP, MEHP, MBzP, MiNP | MCHP 2.5%; MiNP 17.3%; MnOP 32.5%; MBzP 35.6%; others >88% | general population | negative associations with sperm volume (MiBP, MEHP), concentration (MEP), motility (MEP, MnBP, MCPP, MnOP), normal forms (MEHP, MnOP, MBzP) | negative associations with estradiol (MnOP, MEHHP, MECPP, MEOHP), testosterone (MMP, MiBP, MnBP, MEOHP); positive associations with gonadotropins (MBzP) |
| Al-Saleh et al. [87] | 2019 | 599 | MEP, MiBP, MnBP, MBzP, MECPP, MEHHP, MEOHP, MEHP | MBzP: 26.1%; others: >96% | infertile | MECPP, MEHHP, MEOHP and calculated ΣDEHP: positive association with sperm concentration; calculated excreted %MEHP: negative association with sperm concentration | MiBP and MEHHP were inversely associated with testosterone and FSH, respectively. Estradiol was positively associated with MEP. %MEHP was positively associated with gonadotropins (FSH, LH) |
Abbreviations: monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), monoisobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECCP), mono-n-octyl phthalate (MOP), mono-(3-carboxypropyl) phthalate (MCPP), monoisononyl phthalate (MINP), mono(hydroxyisononyl) phthalate (MHiNP), mono(oxoisononyl) phthalate (MOiNP), mono(carboxyisooctyl) phthalate (MCiOP), mono-(2-ethyl-5-carboxypentyl) phthalate (5cx-MEPP), mono-(4-methyl-7-hydroxy-octyl)phthalate (7OH-MMeOP), mono(4-methyl-7-carboxyheptyl) phthalate (MOiCP), polyfluoroalkyl acids (PFAS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorhexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA) and perfluorododecanoic acid (PFDoDA), polychlorinated biphenyls (PCB), dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB).