Endocrine Disruption and Reproductive Health in Latin America and the Caribbean: A Systematic Review of Microplastics

), and Mexican groundwater (18.3 particles/L). Overall, 82% of assessed sites were classified as "Dirty" to "Extremely Dirty." Animal studies reported that microplastics exposure was associated with reproductive toxicity, including reduced sperm concentration and motility, ovarian fibrosis, and polycystic ovary syndrome (PCOS)-like phenotypes. Human biomarker studies found elevated urinary bisphenol A (BPA) levels in pregnant women from Caribbean countries, correlating with altered gonadotropin ratios. Dietary intake, particularly from seafood and beverages, was identified as a primary exposure pathway, while inhalable particles in urban air posed additional risks. No LAC country has established enforceable microplastics thresholds for drinking water or standardized biomonitoring protocols. This systematic review suggests that microplastics pollution is prevalent in LAC environments and is associated with adverse reproductive outcomes in animal models. Preliminary human data indicate potential exposure-related endocrine effects, though causal inference is limited by the absence of direct microplastic exposure measurements and reliance on cross-sectional EDC biomarker studies. The findings underscore the need for expanded biomonitoring, harmonized research methodologies, and region-specific policy development to better understand and address potential public health implications.