Detection of levels of (C) TC, (D) FC, and (E) HDL-c in testis after BPA treatment. (A) Detection of relative accumulation of lipid droplets in testicular tissues treated with BPA, scale bar (100 μm). Lipid droplets are the primary storage sites for neutral lipids in cells. For in vivo experiments, statistical analysis was conducted using data from 6 mice. Mouse serum, TM3 cell culture supernatant, and testicular supernatant was measured using a highly sensitive ELISA detection kit according to the manufacturer’s instructions. The cells were divided into 4 groups, specifically the CON, BPA (20 μmol/L), 22-OH-Chol (30 μmol/L), and 22-OH-Chol (30 μmol/L) and BPA (20 μmol/L) co-treatment groups, with 3 replicates in each group, and were treated for 24 h. Afterwards, the cells were stained with 50 μg/mL Filipin III at room temperature for 30 min. Two other compounds used in Chinese medicine—Cistanche tubulosa and echinacoside—were also shown to have the potential to protect testis and sperm against BPA injury. Recently, several phytochemicals 88,89 and plant extracts 30,31,32,90 showed an ameliorative effect on testicular function and semen quality in human and animal models exposed to BPA. However, the limited number of studies available question the reliability of these evidence, requiring more investigation to clearly elucidate the role of vitamins in fertility protection against BPA. Interestingly, the preventive effects of vitamin E and GSH are more evident than those from vitamin C since the administration of vitamin C resulted in an incomplete recovery of the damages . Additionally, vitamin E and GSH reduced tyrosine phosphorylation in sperm, preventing premature abnormal acrosome reaction . The authors reported that these antioxidants inhibit the excessive production of ROS and increase intracellular ATP, avoiding motility loss caused by exposure to BPA . On the other hand, the co-administration of the dietary antioxidant vitamin C with BPA did not seem to result in any benefit on testicular BPA-induced oxidative damage in rats . In addition, BPA affects hormone levels through various mechanisms, including the hypothalamic-pituitary-gonadal axis in mice (50). Hinfray et al. (49) demonstrated that BPA may affect sex hormone synthesis secretion by regulating the expression of steroidogenesis-related genes (49). Numerous studies have shown that testosterone production in rodents is significantly attenuated by BPA treatment (43, 46, 47).. The evident divergence and, sometimes, opposed association between steroids and BPA in both fluids plasma and seminal suggests that their composition is significantly different . On the other hand, BPA in men with impaired fertility appears to alter hormones levels with detriment of semen parameters. No significant associations were found between any semen parameters and urinary BPA concentration .|For more than three decades, NIEHS has been a pioneer in conducting research on the health effects of endocrine disruptors. This observation leads scientists to think that endocrine-disrupting chemical exposures, even at low amounts, can alter the body’s sensitive systems and lead to health problems. If a woman has symptoms of high or low testosterone, it’s recommended that she visit a healthcare provider to get further testing and a diagnosis.|Twelve 8-week-old male Kunming mice were obtained from The 2nd Affiliated Hospital of Harbin Medical University (Harbin, China). The RCT has long been considered the only pathway that transports excess cholesterol from cells to the liver for excretion (35). Testosterone is a steroid hormone that plays an important role in physiological processes such as male growth and development, libido maintenance, and reproductive function (31). APOA1, a key protein of high-density lipoprotein (HDL), plays a crucial role in RCT and has been confirmed to have anti-atherogenic effects in the past several decades. Apolipoproteins play a key role in the transport of lipids in the body and are involved in the reverse cholesterol transport process by assisting in the transport of cholesterol, triglycerides and other lipids from one tissue or cell to another.|Interestingly, studies performed in other tissues, such heart, showed that the decrease in GPx, SOD, GST, and CAT activities in BPA exposed groups were not reverted by the administration of TAU or curcumin , which suggest a tissue/cell-dependent response. It was shown that pre-treatment with TAU suppressed BPA-induced mitochondrial OS, enhanced MMP and improved sperm viability and motility in a dose-dependent manner . TAU (2-aminoethanesulfonic acid) is a free amino acid present in several tissues that may act as an antioxidant in sperm.|Moreover, exogenous supplement of 22-hydoxycholesterol (22-OH-Chol) were used to uncover the mechanisms by which BPA increases APOA1-mediated RCT led to inhibition of testosterone synthesis in TM3 cells in the presence of BPA. Therefore, investigating the decrease in testosterone synthesis in Leydig cells from the perspective of cholesterol is advantageous. However, few studies have investigated whether BPA regulates testosterone synthesis in mouse testes by enhancing reverse cholesterol transport (RCT). This cholesterol reduction likely led to testosterone synthesis disorders in the model, indicating that BPA inhibits testosterone synthesis in mice by disrupting cholesterol transport. It was observed that serum and testicular testosterone levels were drastically reduced in BPA-treated mice. Regarding maternal BPA exposure and male reproductive function, a weak association of prenatal BPA exposure with sperm quality and testicular functions has been observed in men later in life. BPA affects the human male reproductive system by disrupting the hypothalamic-pituitary-testicular axis and altering the expression and activity of enzymes related to testicular steroidogenesis and spermatogenesis.|Whether or not low unintentional environmental BPA exposure can worsen the fertility potential in subfertile men would represent a more relevant issue, but it is difficult to be ascertained. Other endocrine-disrupting substances are ubiquitous in the environment and may coexist in the human body, leading to possible synergic effects on semen quality with BPA not necessarily playing the major role. Firstly, the cross-sectional design of the studies and the large spontaneous between- and within-subject variability of semen parameters (140) hinder any conclusion about the cause–effect relationships. As BPA is qualified as a xenoestrogen endocrine disruptor, growing concern is rising for possible harmful effects on human health, including fertility. In animal models, the in vitro treatment with different doses of BPA adversely affected sperm motility in fish (129), bovine (130), mouse (131), and chicken (132) and also impaired sperm fertilizing ability in mouse (131) and chicken (132). However, parameters of embryo development (from the fertilization of oocyte to the stage of blastocyst) were not related to the exposure to BPA (117). Also inconclusive are the findings on semen quality arising from studies that enrolled men attending fertility clinics.|During puberty in people assigned male at birth, testosterone is one of the main drivers of physical changes like muscle development, voice changes, and hair growth. A clear understanding of BPA action mechanisms, as well as of the presumed risks deriving from its exposure, is becoming crucial to preserve male fertility. In particular, this study found that BPA and steroids concentration differed between seminal fluid and blood plasma. In addition, differences in concentrations of individual steroids and BPA across human body fluids were shown by several studies explained above. Inconsistency of results regarding BPA effects on semen quality could be due to intrinsic differences in population sampling across the various studies.} In addition, they created a comprehensive database from thousands of scientific studies on how different substances interact with hormones. In addition, they conduct laboratory studies that help them prioritize endocrine disrupting chemicals for further toxicity testing. In 1972, prenatal exposure to DES was linked to the development of a rare form of vaginal cancer in daughters whose mothers took DES, and with numerous noncancerous changes in both sons and daughters. Hormone replacement therapy (HRT) is often the first-line treatment for low testosterone levels in women. Aside from medical treatment, there are lifestyle changes women can make to help lower their testosterone levels. Medical, natural, or a combination of both types of treatment may help regulate testosterone levels. However, research reveals that some pre-menopausal women with high testosterone levels may be asymptomatic, meaning they never experience symptoms. Many women with high testosterone levels will have irregular menses or no period at all. "There are no established optimal testosterone levels for women, so most clinicians use a lab reference range to diagnose a woman with high testosterone," Dr. Dorr says. Rats were generally exposed to higher concentrations of BPA, ranging from 25 mg/kg/day during 60 days to 200 mg/kg/day for 10–30 days. In fact, methodological differences and distinct study populations can explain some of the contradictory results. As the European Food Safety Authority (EFSA) started a re-evaluation of the safety of BPA for food contact applications in 2017 that will include the CLARITY-BPA study, it is possible that some policies may be updated. However, the recent results of the CLARITY (Consortium Linking Academic and Regulatory Insights on BPA Toxicity)-BPA study intensified the controversy around this topic. The binding to these receptors may lead to other alterations in cells and tissues rather than endocrine disturbance. Additionally, it may also bind to other receptors such as G protein-coupled oestrogen receptor 30 (GPR30/GPER1) 52,53, orphan nuclear oestrogen-related receptor gamma (ERR-γ) 54,55, androgen receptor (AR), peroxisome proliferator-activated receptor gamma (PPAR-γ), and thyroid hormone receptor (TR) .