The Role of Mycotoxins in Reproductive health: Mechanisms, Evidence, and Clinical Implications

Importance Infertility is a global health issue with multiple causes, including environmental factors. Mycotoxins—secondary metabolites produced by fungi—are increasingly recognized as potential contributors to reproductive dysfunction. Objective This review explores the impact of mycotoxins on reproductive health, examining their role in fertility impairment through mechanisms such as hormone disruption, gametogenesis impairment, and uterine toxicity. Evidence Review Mycotoxins are widespread in food and the environment, posing health risks that extend beyond known carcinogenic and immunotoxin effects. Exposure to mycotoxins such as ochratoxin A (OTA) and zearalenone (ZEA) has been linked to epigenetic alterations, endocrine disruption, and direct cellular damage in reproductive tissues. These findings are supported by epidemiological data, animal models, and experimental research, emphasizing regional variations in exposure due to differences in agricultural practices and food contamination. Findings Mycotoxin exposure is associated with adverse reproductive outcomes, including reduced sperm quality, menstrual irregularities, and increased miscarriage risk. The biological mechanisms involve oxidative stress, hormone dysregulation, and direct toxicity to gametes and reproductive organs. Conclusion and Relevance Reducing mycotoxin exposure through dietary precautions, improved food safety regulations, and environmental controls may help protect reproductive health. Further research is needed to clarify exposure thresholds and develop targeted interventions.