PFAS (Forever Chemicals) and Fertility Before Pregnancy

What does the evidence say about PFAS during pregnancy?

1. NIEHS funds and tracks research connecting higher PFAS exposure with reduced fertility in women as part of its ongoing PFAS research program, reflecting an active and still-developing area of environmental health science rather than a settled conclusion. 1
2. A systematic review of epidemiological studies on PFAS and reproductive outcomes found that among four high-quality studies of female fertility, PFAS exposure was not clearly linked to clinical pregnancy, live birth, or infertility defined as more than 12 months to conceive, though the authors note four studies are not enough to draw final conclusions. 2
3. In a preconception cohort of women trying to conceive in Singapore, higher blood levels of PFOS and PFDA were associated with lower fecundability ratios of about 0.88 and 0.90 per quartile increase, meaning somewhat lower odds of conceiving in a given cycle, though the authors describe this as an associational finding. 3
4. A 2021 review of male reproductive health research found that higher PFOA and PFOS levels are associated with lower sperm quality measures, including reduced progressive sperm movement, and with lower testosterone levels, while noting the evidence is associational and varies by the specific PFAS chemical studied. 4
5. National Academies guidance on reducing PFAS exposure identifies drinking water filtration, especially reverse osmosis or dual-stage filters, as the most effective everyday step, removing most measured PFAS compounds at roughly 90 percent efficiency or better, alongside cutting back on food packaged in PFAS-containing materials. 5

Is PFAS safe in each trimester?

• First trimester. If you are in the early planning stage before actively trying to conceive, this is a low-pressure time to look at everyday PFAS sources like nonstick cookware, stain-resistant textiles, and food packaging. Swapping a worn nonstick pan or starting to filter drinking water now builds a habit without added pressure, since research on PFAS and fertility is still developing and no single product change is proven to change your odds.
• Second trimester. Once you are actively trying to conceive, a water filter rated to reduce PFAS and fewer takeout containers or fast-food wrappers are the exposure-reduction steps with the most support behind them, since unfiltered water and food packaging are common contributors to blood PFAS levels. These changes are reasonable precautions, not a guaranteed fix, since the research connecting PFAS to fecundability is associational rather than proven cause and effect.
• Third trimester. If you have been trying for six months to a year or longer without success, PFAS exposure is one of many factors worth mentioning to your provider alongside a general fertility evaluation, not a stand-alone explanation. Continuing to reduce exposure through water filtration and consumer product choices remains reasonable, but forever chemicals are unlikely to be the sole reason for a longer trying-to-conceive journey.