Table 1_Male reproductive health under environmental, pharmacological, and disease influences: a scoping review.docx

Four additional references were used exclusively to guide scoping-review methodology and reporting, giving 109 references in the complete bibliography. Evidence was charted by exposure or condition, study design, reproductive outcome, quantitative finding where available, mechanistic interpretation, and clinical implication. The mapped literature identifies endocrine-disrupting chemicals, pesticides, metals, air pollution, occupational heat, selected medicines and gonadotoxic treatments, metabolic and infectious diseases, varicocele, genetic disorders, and systemic illness as relevant reproductive-health contexts, but the strength and causal interpretability of evidence vary substantially.

Recurrent mechanisms include oxidative stress, inflammation, endocrine disturbance, mitochondrial dysfunction, vascular impairment, sperm DNA damage, and epigenetic alteration. The review supports couple-centred evaluation, source control of avoidable exposures, treatment of reversible disease, fertility preservation before gonadotoxic therapy, and specialist-led medication decisions.</p>