Impact of fluoride exposure on reproductive health: Insights into molecular mechanisms and health implications

While the benefits of fluoride in preventing dental caries are well-established, concerns about its potential toxicity at high intake levels are rising. This review investigates the link between chronic fluoride exposure and reproductive health outcomes at the molecular level, focusing on population growth and child sex ratios in the fluorosis-affected and non-fluorosis regions. The exploration of the detrimental effects of fluoride on both male and female reproductive systems is necessary. In males, hormonal variations, alterations in spermatogenesis, capacitation, and sperm motility using molecular markers, epigenetic, transcriptomic, and proteomic data. For females, hormonal imbalances, disruptions in oocyte formation, teratogenicity (congenital disabilities), and compromised infant development due to maternal fluorosis using similar approaches. Furthermore, we explored drugs that address affected pathways, the potential benefits of vitamins and natural remedies, and lifestyle modifications to minimise adverse effects. The impact of various molecular pathways like apoptosis, autophagy, DNA damage, hormonal imbalance, inflammatory response, mitochondrial dynamics, and cell signalling pathways has been linked to reproductive toxicity induced by chronic and specific doses of fluoride. Analysing existing research and exploring potential therapeutic avenues contributes to the development of strategies to safeguard reproductive well-being in populations exposed to high fluoride levels.