HEAVY METAL TOXICITY VERSUS TRACE ELEMENT PROTECTION IN WOMEN'S REPRODUCTIVE HEALTH - A SYSTEMATIC REVIEW.

[BACKGROUND] Environmental exposures are increasingly linked to reproductive dysfunctions such as endometriosis, ovarian insufficiency, and polycystic ovary syndrome (PCOS). Through endocrine disruption, oxidative stress, and epigenetic pathways, heavy metals (such as cadmium [Cd], lead [Pb], mercury [Hg], and arsenic [As]) and trace elements (such as zinc [Zn], copper [Cu], and selenium [Se]) may affect female fertility. Nevertheless, there are still few integrated assessments that address their combined consequences. The goal is to perform a critical evaluation and systematic analysis of epidemiological data about the link between reproductive health issues in women of reproductive age and exposure to heavy metals and trace elements.

[METHODS] A comprehensive literature search was carried out in PubMed, Scopus, Google Scholar, and Web of Science to locate articles published between 2010 and 2024. Included were observational human studies that looked at correlations between metal exposure and the reproductive results of females. The study's quality was assessed using the Newcastle-Ottawa Scale (NOS), and the review process adhered to PRISMA guidelines.

[FINDINGS] A total of twenty-three studies were included in the review: eleven case-control studies, eight cross-sectional studies, three cohort studies, and one analytical study. Cd, Pb, As, Hg, Cu, and Zn were the most frequently evaluated elements; these were usually detected in biological samples such blood, serum, or follicular fluid. While low Zn and Se levels were linked to endometrial diseases and a reduced ovarian reserve, elevated levels of Cd, Pb, and As were linked to an increased risk of PCOS and endometriosis. Inflammation and endocrine dysregulation were inversely correlated with protective trace elements, especially zinc and selenium. 17 studies had a high-quality rating (NOS score ≥7).

[CONCLUSIONS] One important and controllable risk factor for the reproductive health of women is exposure to hazardous metals. It seems that preserving reproductive function depends on striking a balance between harmful and necessary components. To elucidate dose-response connections, synergistic effects, and possible therapeutic options, further prospective and mechanistic research is required.