Current Environmental Health Reports

, Volume 5, Issue 1, pp 20–33 | Cite as

Impact of Di-2-Ethylhexyl Phthalate Metabolites on Male Reproductive Function: a Systematic Review of Human Evidence

  • Birgit Bjerre Høyer
  • Virissa Lenters
  • Aleksander Giwercman
  • Bo A.G. Jönsson
  • Gunnar Toft
  • Karin S. Hougaard
  • Jens Peter E. Bonde
  • Ina Olmer Specht
Susceptibility Factors in Environmental Health (B Ritz and Z Liew, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Susceptibility Factors in Environmental Health


Purpose of Review

The purpose of this review is to systematically review the literature linking di-2-ethylhexyl phthalate (DEHP) exposure with effects on reproductive health in adult males.

Recent Findings

Thirty-three papers were included of which 28 were cross-sectional. Twenty-one papers investigated semen samples, 18 investigated reproductive hormones, and three studies investigated time to pregnancy. Studies revealed some but inconsistent indications that higher urinary DEHP metabolite levels are associated with an increase in the proportion of spermatozoa with damaged DNA and to a decrease in sperm concentration and motility. A negative association between DEHP metabolites and testosterone levels was more consistent. DEHP metabolites do not seem to be associated with a delay in time to pregnancy, but data are sparse.


The studies on DEHP exposure and reproductive biomarkers in men converge to support the hypothesis that DEHP exposure is related to impaired male reproductive function. Longitudinal studies are needed to establish if the observed associations are causal.


Review Phthalic acids Fecundity Reproduction Semen quality Gonadal steroid hormones 



It is with our deepest sorrow that we inform you of the passing of our co-author, Bo A.G. Jönsson during the writing of this article.

Funding Information

This systematic review was part of the CLEAR collaboration funded by the European Commission 7th Framework Program FP7-ENV-2008-1 Grant no.: 226217; the Danish Research Council (10-082745); ReproHigh, the Öresund-Kattegat-Skagerrak-Program; and funded by the European Regional Development Fund. This article was furthermore a part of the ReproUnion collaborative study, co-financed by the European Union, Intereg V ÖKS.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All reported studies with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

Supplementary material

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Birgit Bjerre Høyer
    • 1
    • 2
    • 3
  • Virissa Lenters
    • 4
  • Aleksander Giwercman
    • 5
  • Bo A.G. Jönsson
    • 6
  • Gunnar Toft
    • 2
  • Karin S. Hougaard
    • 7
    • 8
  • Jens Peter E. Bonde
    • 1
  • Ina Olmer Specht
    • 1
    • 9
  1. 1.Department of Occupational and Environmental MedicineBispebjerg and Frederiksberg HospitalCopenhagenDenmark
  2. 2.Department of Clinical EpidemiologyAarhus UniversityAarhus NDenmark
  3. 3.Department of Occupational MedicineAarhus University HospitalAarhus CDenmark
  4. 4.Department of Environmental Exposure and EpidemiologyNorwegian Institute of Public HealthOsloNorway
  5. 5.Molecular Reproductive Medicine, Department of Translational MedicineLund UniversityMalmoSweden
  6. 6.Division of Occupational and Environmental MedicineLund UniversityLundSweden
  7. 7.National Research Centre for the Working EnvironmentCopenhagenDenmark
  8. 8.Section of Occupational and Environmental Health, Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
  9. 9.The Parker Institute, Research Unit for Dietary StudiesBispebjerg-Frederiksberg HospitalCopenhagenDenmark

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