Investigating climate change impacts on reproductive health reveals a minefield of urgent questions:
- How do heat and pollution affect fetal development?
- What role do endocrine-disrupting chemicals, such as microplastics and PFAS, play in infertility?
- Why have fecundity and fertility declined over the last 40 years, and could climate-related exposures be contributing factors?
In “Climate Change and Reproductive Health”, our team at UC San Francisco sought to synthesize the latest evidence addressing these questions. While many uncertainties remain, emerging research increasingly suggests that climate-related environmental exposures are associated with adverse reproductive health outcomes.
How heat and pollution affect reproductive health
For starters, exposure to extreme heat has been associated with congenital cardiac and neural tube defects, as well as increased risks of preterm birth and stillbirth. The impacts of heat are not limited to female reproduction; rising ambient temperatures have also been linked to poor sperm quality and impaired male reproductive function.
Global emissions are not only driving higher temperatures but also worsening air pollution and chemical exposures that affect reproductive health. In 2019, an estimated 99% of the globe lived in locations where air quality failed to meet recommended WHO guidelines. The fuel exhaust we inhale during our commutes and the microplastics we ingest through food and water may both directly and indirectly impact fertility, pregnancy, newborn health, and cancer risk.
Endocrine disrupting chemicals (EDCs), including compounds found in microplastics and fossil fuel emissions, have been linked to hormonal disruption, infertility, and pregnancy complications. We also now know that fine particles from air pollution, AKA PM2.5 , can cross the placenta and potentially affect fetal development through inflammatory and vascular mechanisms.
It should therefore be no surprise then that while humans have become ever more dependent on polluting products and every year’s carbon emissions surpass that of years prior, our rates of fertility and fecundity have declined substantially in the last 40 years while the rates of miscarriage and preterm birth have increased. Although these trends are influenced by many social, economic, behavioral, and environmental factors, climate-related exposures may be an important and underrecognized contributor.
A new factor in the climate equation
Although our paper was published just last year, the trajectory of climate change has already shifted dramatically.
The objective of that paper was to identify the ways in which climate change drivers, including fossil fuel combustion and industry emissions, lead to higher rates of pollution that disrupt hormonal systems and adversely affect reproductive health outcomes. Yet any current discussion of climate change and reproductive health must also confront an emerging and rapidly evolving issue: the explosive growth of AI development.
AI’s growing energy demands
When we published “Climate Change and Reproductive Health” in June 2025, there were approximately 5,000 AI data center projects in the United States. That number is expected to grow by 40% per year. AI holds enormous promise for applications including cancer research, scientific discovery, and educational access. At the same time, the energy demands of this rapidly expanding infrastructure are staggering.
A recent report by the U.S Department of Energy estimates that electricity consumption from data centers in the US could at least double, and potentially triple, by 2028. This dramatic increase in electricity demand should be a catalyst for accelerating the transition to renewable energy and modernizing the electrical grid. Instead, the rapid expansion of AI data centers risks reinforcing dependence on coal and other fossil fuels, particularly when energy infrastructure is expanded without sufficient investment in clean alternatives.
Who bears the environmental costs?
As the global AI race presses on, we must pay close attention not only to how these technologies are developed and used, but also to the energy systems that sustain them. The critical question is who bears the environmental costs. These burdens may fall disproportionately on communities with fewer resources to absorb them, both in the United States and globally.
In the US, 67% of planned data centers are slated for rural areas, a striking shift from existing facilities, only 13% of which are located in rural areas. Large data centers can place new demands on local water supplies, electrical grids, and infrastructure. Globally, these pressures raise additional equity concerns: one recent United Nations University analysis estimated that by 2030, the water footprint associated with AI data centers could equal the basic annual domestic water needs of 1.3 billion people in Sub-Saharan Africa.
Policies that prolong reliance on fossil fuels, weaken the transition to renewable energy, or place the burdens of increased energy production on already vulnerable communities could deepen the environmental conditions that contribute to poor reproductive health outcomes.
Title: Climate Change and Reproductive Health
Authors: Anna Claire G Fernandez; Sanika Pelnekar; Joshua F Robinson; Gary M Shaw; Amy M Padula; Tracey J Woodruff; Linda C Giudice
About the author
Anna Claire G. Fernández, MD is a resident Emergency Medicine physician at UCSF, with a special interest in reproductive healthcare, immigrant health and healthcare policy. Her research background focuses on wildfire smoke exposure in Northern California and pregnancy outcomes, with special attention to disparities across marginalized groups. She is an alum of the Environmental Scholars Program at the EaRTH Center.
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