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Year 2026 · Volume 6 · Issue 5
Review Article
Environmental Pollution and the Female Genital Microbiome: Implications for Reproductive Health
Akanksha Pandey1
Pooja Singh Gaur2
Sushil Chaturvedi3
Jyoti Prakash4
Rachna Chaturvedi5
1 Queen Mary Hospital KGMU Lucknow, Uttar Pradesh, India. 2 Department of Respiratory Medicine, KGMU Lucknow, Uttar Pradesh, India. 3 Department of Pulmonary Medicine, Saraswati Medical College Uttar Pradesh, India. 4 5 Amity Institute of Biotechnology, Amity University Lucknow, Uttar Pradesh, India.
Published Online: September-October 2026
Pages: 488-494
Cite this article
↗ https://www.doi.org/10.59256/ijrtmr.20260605055References
1. Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SSK, McCulle SL, et al. Vaginal microbiome of reproductive-age women. Proceedings
of the National Academy of Sciences of the United States of America. 2011;108(Suppl 1):4680–4687.
2. Petrova MI, Reid G, Vaneechoutte M, Lebeer S. Lactobacillus in the human vagina: why, how, which ones, and what is next? Trends in
Microbiology. 2015;23(6):345–352.
3. Witkin SS, Linhares IM. Why do lactobacilli dominate the human vaginal microbiota? BJOG: An International Journal of Obstetrics and
Gynaecology. 2017;124(4):606–611.
4. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. American Journal of Obstetrics
and Gynecology. 2013;209(6):505–523.
5. Koedooder R, Singer M, Schoenmakers S, Savelkoul PHM, Morré SA, de Jonge JD, et al. The vaginal microbiome as a predictor of
preterm birth and assisted reproductive technology outcome. Human Reproduction Update. 2019;25(6):720–735.
6. The impact of endocrine disruptors on the female genital tract microbiome: a narrative review. 2025. The available literature identifies
BPA, phthalates, and parabens as important candidates but emphasizes that robust human evidence remains limited.
7. Nunn KL, Forney LJ. Unraveling the dynamics of the human vaginal microbiome. Yale Journal of Biology and Medicine. 2016;89(3):331–
337.
8. Hickey RJ, Zhou X, Pierson JD, Ravel J, Forney LJ. Understanding vaginal microbiome complexity from an ecological perspective.
Nature Reviews Microbiology. 2012;10(10):743–753.
9. Host, microbial, and environmental drivers of vaginal microbiota composition. Fertility and Sterility. 2026. Recent synthesis emphasizes
the interaction of host physiology, microbial factors, immune responses, metabolism, and lifestyle in determining vaginal microbial
composition.
10. Environmental factors affecting female fertility. 2024. Review of environmental exposures and endocrine-disrupting chemicals, including
heavy metals, plasticizers, pesticides, industrial chemicals, and other contaminants, in relation to female fertility.
11. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, Hauser R, Prins GS, Soto AM, et al. Endocrine-disrupting chemicals: an Endocrine
Society scientific statement. Endocrine Reviews. 2009;30(4):293–342.
12. Kafshgiri SK, Farkhondeh T, Miri-Moghaddam E. Glyphosate effects on the female reproductive systems: a systematic review. Reviews
on Environmental Health. 2021;37(4):487–500.
13. Conforti A, Mascia M, Cioffi G, De Angelis C, Coppola G, De Rosa P, et al. Air pollution and female fertility: a systematic review of
literature. Reproductive Biology and Endocrinology. 2018;16:117.
14. Carré J, Gatimel N, Moreau J, Parinaud J, Léandri R. Does air pollution play a role in infertility? A systematic review. Environmental
Health. 2017;16:82.
15. Mandalou L, Aghebati-Maleki A, Mardi A, Yousefi M, Aghebati-Maleki L. Associations of air pollution exposure with anti-Müllerian
hormone as an ovarian reserve biomarker: a systematic review. Journal of Gynecology Obstetrics and Human Reproduction.
2026;55(4):103127.
16. Impact of microplastics on female reproductive health: insights from animal and human experimental studies: a systematic review.
Archives of Gynecology and Obstetrics. 2025. The review identified experimental evidence of effects on ovarian function, hormone levels,
fertility, embryo development, and offspring health, while noting variability in study quality.
17. Ali-Hassanzadeh M, Arefinia N, Ghoreshi ZAS, Askarpour H, Mashayekhi-Sardoo H. The effects of exposure to microplastics on female
reproductive health and pregnancy outcomes: a systematic review and meta-analysis. Reproductive Toxicology. 2025;135:108932.
18. Hyman S, Kahn LG, Cowell W. Microplastics and reproductive health: implications for human health and areas for future research.
Human Reproduction. 2026;41(7):1040–1049.
19. The reproductive tract microbiome and female fertility: dysbiosis, disease links, and emerging therapeutic strategies. Fertility and Sterility.
2026. Recent evidence links reproductive-tract microbial composition with fertility while emphasizing the need for standardized methods
and stronger interventional evidence.
20. Vaginal microbiota in assisted reproduction: determinants, dynamics, and impact on clinical outcomes. 2026. Current evidence supports
an association between vaginal microbial composition and ART outcomes but also identifies substantial methodological and causal
uncertainties.
21. Vaginal microbiome: considerations for reproductive health. 2022. Review describing the protective functions of Lactobacillus and
associations between vaginal microbial composition and reproductive disorders.
22. Vaginal microbiome profiles and reproductive outcomes: implications for natural conception and assisted reproduction. 2026. Recent
review discussing associations among Lactobacillus-associated profiles, dysbiosis, implantation, pregnancy, and ART outcomes while
emphasizing that clinical application remains investigational.
23. The role of probiotics in restoring and maintaining vaginal microbiome health: a review. 2026. Review of microbiome-directed
interventions and the continuing need for standardized strains, dosing, and clinical protocols.
24. Vaginal Microbiome: Environmental, Biological, and Racial Influences on Gynecological Health Across the Lifespan. American Journal
of Reproductive Immunology. 2024. Review emphasizing the effects of environmental, biological, hormonal, and lifestyle factors on
vaginal microbial communities.
of the National Academy of Sciences of the United States of America. 2011;108(Suppl 1):4680–4687.
2. Petrova MI, Reid G, Vaneechoutte M, Lebeer S. Lactobacillus in the human vagina: why, how, which ones, and what is next? Trends in
Microbiology. 2015;23(6):345–352.
3. Witkin SS, Linhares IM. Why do lactobacilli dominate the human vaginal microbiota? BJOG: An International Journal of Obstetrics and
Gynaecology. 2017;124(4):606–611.
4. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. American Journal of Obstetrics
and Gynecology. 2013;209(6):505–523.
5. Koedooder R, Singer M, Schoenmakers S, Savelkoul PHM, Morré SA, de Jonge JD, et al. The vaginal microbiome as a predictor of
preterm birth and assisted reproductive technology outcome. Human Reproduction Update. 2019;25(6):720–735.
6. The impact of endocrine disruptors on the female genital tract microbiome: a narrative review. 2025. The available literature identifies
BPA, phthalates, and parabens as important candidates but emphasizes that robust human evidence remains limited.
7. Nunn KL, Forney LJ. Unraveling the dynamics of the human vaginal microbiome. Yale Journal of Biology and Medicine. 2016;89(3):331–
337.
8. Hickey RJ, Zhou X, Pierson JD, Ravel J, Forney LJ. Understanding vaginal microbiome complexity from an ecological perspective.
Nature Reviews Microbiology. 2012;10(10):743–753.
9. Host, microbial, and environmental drivers of vaginal microbiota composition. Fertility and Sterility. 2026. Recent synthesis emphasizes
the interaction of host physiology, microbial factors, immune responses, metabolism, and lifestyle in determining vaginal microbial
composition.
10. Environmental factors affecting female fertility. 2024. Review of environmental exposures and endocrine-disrupting chemicals, including
heavy metals, plasticizers, pesticides, industrial chemicals, and other contaminants, in relation to female fertility.
11. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, Hauser R, Prins GS, Soto AM, et al. Endocrine-disrupting chemicals: an Endocrine
Society scientific statement. Endocrine Reviews. 2009;30(4):293–342.
12. Kafshgiri SK, Farkhondeh T, Miri-Moghaddam E. Glyphosate effects on the female reproductive systems: a systematic review. Reviews
on Environmental Health. 2021;37(4):487–500.
13. Conforti A, Mascia M, Cioffi G, De Angelis C, Coppola G, De Rosa P, et al. Air pollution and female fertility: a systematic review of
literature. Reproductive Biology and Endocrinology. 2018;16:117.
14. Carré J, Gatimel N, Moreau J, Parinaud J, Léandri R. Does air pollution play a role in infertility? A systematic review. Environmental
Health. 2017;16:82.
15. Mandalou L, Aghebati-Maleki A, Mardi A, Yousefi M, Aghebati-Maleki L. Associations of air pollution exposure with anti-Müllerian
hormone as an ovarian reserve biomarker: a systematic review. Journal of Gynecology Obstetrics and Human Reproduction.
2026;55(4):103127.
16. Impact of microplastics on female reproductive health: insights from animal and human experimental studies: a systematic review.
Archives of Gynecology and Obstetrics. 2025. The review identified experimental evidence of effects on ovarian function, hormone levels,
fertility, embryo development, and offspring health, while noting variability in study quality.
17. Ali-Hassanzadeh M, Arefinia N, Ghoreshi ZAS, Askarpour H, Mashayekhi-Sardoo H. The effects of exposure to microplastics on female
reproductive health and pregnancy outcomes: a systematic review and meta-analysis. Reproductive Toxicology. 2025;135:108932.
18. Hyman S, Kahn LG, Cowell W. Microplastics and reproductive health: implications for human health and areas for future research.
Human Reproduction. 2026;41(7):1040–1049.
19. The reproductive tract microbiome and female fertility: dysbiosis, disease links, and emerging therapeutic strategies. Fertility and Sterility.
2026. Recent evidence links reproductive-tract microbial composition with fertility while emphasizing the need for standardized methods
and stronger interventional evidence.
20. Vaginal microbiota in assisted reproduction: determinants, dynamics, and impact on clinical outcomes. 2026. Current evidence supports
an association between vaginal microbial composition and ART outcomes but also identifies substantial methodological and causal
uncertainties.
21. Vaginal microbiome: considerations for reproductive health. 2022. Review describing the protective functions of Lactobacillus and
associations between vaginal microbial composition and reproductive disorders.
22. Vaginal microbiome profiles and reproductive outcomes: implications for natural conception and assisted reproduction. 2026. Recent
review discussing associations among Lactobacillus-associated profiles, dysbiosis, implantation, pregnancy, and ART outcomes while
emphasizing that clinical application remains investigational.
23. The role of probiotics in restoring and maintaining vaginal microbiome health: a review. 2026. Review of microbiome-directed
interventions and the continuing need for standardized strains, dosing, and clinical protocols.
24. Vaginal Microbiome: Environmental, Biological, and Racial Influences on Gynecological Health Across the Lifespan. American Journal
of Reproductive Immunology. 2024. Review emphasizing the effects of environmental, biological, hormonal, and lifestyle factors on
vaginal microbial communities.
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