In vivo gamete toxicology in the context of in vitro fertilization: a narrative review.

Abstract

IVF as a clinical method to surmount infertility has existed since the 1970s, and yet fertilization, embryo development, pregnancy, and live birth rates remain unacceptably low. Although a multitude of factors may contribute to stagnated success despite substantial advances in basic and applied IVF sciences, gamete quality is inarguably integral to IVF success rates. In this review, the authors will explore the role of environmental toxicology in impairing in vivo fertility and gamete quality prior to starting IVF that will influence downstream IVF success. In vivo contaminants of interest that may affect gamete potential in the context of IVF include heavy metals, per- and polyfluoroalkyl substances (PFAS), persistent organic pollutants (POPs), and airborne contaminants. By evaluating the current literature on reproductive toxicology and how toxic exposures may influence IVF, this review aims to provide a comprehensive reference of potential toxicological exposures for clinicians, to use in vitro and animal data to supplement correlative human studies with potential causative mechanisms, and to strengthen the case for patient assessment of toxicological risk.