Hyperthermia-induced infertility in women: an urgent narrative review of environmental and occupational risks: a literature review

Abstract

Female infertility is a global health challenge with multifactorial causes, yet the role of exogenous hyperthermia as a significant and growing risk factor remains underappreciated in clinical practice. This narrative review synthesizes current evidence on how environmental and occupational heat exposure impairs female reproductive function, focusing on physiological mechanisms, epidemiological data, and preventive strategies. Hyperthermia exerts its detrimental effects through multiple pathways, including increased oxidative stress, disruption of the hypothalamic-pituitary-ovarian axis, and direct damage to oocyte quality and endometrial receptivity. Rising global temperatures and more frequent heatwaves, particularly in low-resource settings and among women in high-heat occupations such as agriculture, manufacturing, and food services, create a double burden of environmental and occupational heat stress with limited protective infrastructure. Current occupational safety guidelines are largely based on male physiology and fail to adequately safeguard female reproductive health. Recognizing hyperthermia as a tangible threat to fertility is critical, and there is an urgent need for female-specific research, revised occupational health standards, and clinical guidance for at-risk patients. Addressing this challenge requires coordinated efforts from gynecologists, occupational physicians, policymakers, and climate scientists to protect reproductive health in a warming world