Insights into the role of melatonin on the reproductive system toxicity induced by bisphenol A: a systematic review of preclinical studies

Bisphenol A (BPA), an endocrine disruptor, changes many physiological functions of the body, especially the reproductive system. The malfunction of the reproductive system after BPA exposure is one of the causes of infertility reasons. BPA disrupts reproductive functions by elevating oxidative mediators and declining antioxidant enzymes, altering sex hormones, and inducing mitochondrial dysfunction and apoptosis. The present study focuses on the protective effects of melatonin against BPA-induced male and female reproductive alterations. A systematic literature review was conducted up to October 2023 using PRISMA principles in electronic databases, including PubMed, Web of Science, and Scopus. Considering the study purpose, the search keywords were selected and used to search the titles and abstracts. After screening, 19 pertinent papers were selected from 91 publications based on our inclusion and exclusion criteria. The literature showed that melatonin plus BPA protects reproductive cells via multiple mechanisms, including reducing oxidative stress, inflammation, apoptosis, and modulation of mitochondrial function. Furthermore, most indicated melatonin's beneficial effects on the histopathology of reproductive tissues. Also, melatonin induced its protective effects through direct interaction with hormone receptors against BPA-induced hormonal changes. This study indicates evidence of the protective role of melatonin on reproductive injuries and infertility caused by BPA.