The impact of electromagnetic fields on female fertility: a scoping review of research designs and study limitations

Background: The modern lifestyle has heightened exposure risks to various forms of electromagnetic fields (EMFs). Exposure to EMF has been shown to impair cellular homeostasis, endocrine function, reproductive function, and foetal development in animal models. To assess the reproductive risks of EMFs in human, it is crucial to examine the research methodology used, in order to provide the most reliable risk estimations. This review paper evaluates the study designs employed to investigate the impact of EMFs on female fertility and addresses the limitations of the research methodologies. Methods: This review follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Review (PRISMA-SCR) guidelines. Seven electronic databases were utilised to access recent cohort studies published between the years 2013 to 2023. Results: A total of 35 articles reporting on EMFs and fertility were analysed. Majority of the studies employed animal study design (n=16), followed by 9 observational studies, 4 case-control, 3 interventional and 3 in vitro studies. Thematic analysis identified five main themes addressing the methodological limitations; (i) operationalisation, (ii) measurement and instrumentation, (iii) contextual constraints, (iv) practical constraints, and (v) analytical constraints. Conclusion: This review identifies several key limitations on the current research methodologies that can be incorporated into future studies to support the development of empirical study designs.