The Nexus Between Poor Oral Health and Infertility: A Systematic Review and Meta-Analysis

Abstract

Background: Infertility affects 8–12% of reproductive-aged couples worldwide. Emerging evidence suggests that poor oral hygiene and periodontal disease may negatively influence fertility outcomes through systemic inflammation, oxidative stress, microbial translocation, and hormonal dysregulation. However, findings remain inconsistent.

Objective: To systematically review and meta-analyze studies published between 2019 and 2024 examining the association between poor oral hygiene/periodontal disease and fertility outcomes in men and women.

Methods: A PRISMA 2020–guided systematic review and meta-analysis was conducted. Databases searched included PubMed, Scopus, Web of Science, Embase, Cochrane Library, and Google Scholar. Observational and interventional human studies assessing clinically diagnosed periodontal disease and fertility outcomes were included. Quality was assessed using the Newcastle-Ottawa Scale and Cochrane risk-of-bias tools. Random-effects meta-analyses were performed.

Results: Thirty studies (21 observational, 9 interventional) were included. Women with periodontal disease had significantly higher odds of infertility (OR = 1.85; 95% CI: 1.42–2.40) and reduced fecundability (HR = 0.78; 95% CI: 0.66–0.91). Men with periodontal disease showed impaired semen motility (SMD = -0.42) and morphology (SMD = -0.35). ART outcomes showed weaker and inconsistent associations. Periodontal treatment demonstrated modest improvements in semen quality and implantation rates.

Conclusion: Periodontal disease is associated with adverse fertility outcomes in both sexes. Integrating oral health assessment into reproductive healthcare may improve fertility outcomes. Further longitudinal and randomized studies are required to establish causality.