Adverse Effects of Pesticides on the Ovary: Evidence from Epidemiological and Toxicological Studies

Pesticides are widely used in agriculture, public health, and residences to control pests and insects. The safety of exposure to pesticides has raised concerns due to their presence in the environment and their potential effects on human health. The ovary is the major female reproductive organ and is considered a potential target organ for pesticide toxicity. This comprehensive Review examines the adverse effects of pesticide exposure on the ovary based on evidence from human biomonitoring, epidemiological studies, and toxicological studies. Epidemiological studies have shown that pesticide exposures are associated with early/delayed menarche, menstrual cycle disorders, early menopause, long time to pregnancy, polycystic ovary syndrome, primary ovarian insufficiency, infertility, and implantation failure in women. Both in vivo and in vitro studies have shown that exposure to pesticides disrupts the estrous cycle, reduces the follicle pool, alters hormone levels, and impairs oocyte maturation. Mechanisms of action of pesticides on ovarian function include effects on steroid receptors, hormone synthesis, oxidative stress, inflammation, epigenetic modifications, and signaling pathways. Gaps in knowledge and further research needs include prospective cohort studies with adequate sample sizes to elucidate the effects of different classes of pesticides (especially emerging insecticides, herbicides and fungicides) and mixture exposures on ovarian health, the development of effective toxicological models that can approximate or simulate realistic human exposure scenarios, and the translation of toxicological findings into measurable indicators that can be used in human health risk assessment. In summary, this Review aims to improve the understanding of the risk to women’s reproductive health from exposures to pesticides and to provide insights into strategies for preventing and managing reproductive health risks.