Conceptualization of "environmental hidden toxin" and its pathogenesis, differentiation diagnosis and treatment leading to male infertility

Environmental pollutants generated by industrialization, characterized by microplastics, are increasingly impairing male fertility in the form of "environmental hidden toxins". Although the concept of environmental toxicity has been proposed for a long time, its practical application remains limited. Therefore, this study innovatively introduces and elaborates on the concept of "environmental hidden toxins", highlighting its pathogenic characteristics, including latency, turbidity, consumptive nature, concurrent nature, and transmutation. Environmental hidden toxin can be classified into five categories based on the properties: stagnation toxins, scorching toxins, turbid toxins, desiccating toxins, and latent toxins. The core pathogenesis of environmental hidden toxins-induced male infertility involves three stages: firstly, invading the lungs and spleen, leading to the gradual depletion of healthy qi; secondly, forming toxin-stasis complexes that obstruct the spermatic pathway; and lastly, penetrating deeply into the seminal chamber, directly damaging the genuine essence. The treatment principle emphasizes "strengthening the foundation and clearing the source," advocating dual strategies of detoxification and strengthening vital qi. This includes enhancing clarity and lowering turbidity, fortifying the earth to generate metal to replenish healthy qi; resolving stasis, unblocking collaterals, and dispelling toxins to eliminate pathogenic factors; and nourishing the kidneys, replenishing essence, and expelling toxins to preserve the genuine essence. All the above approaches form a holistic traditional Chinese medicine (TCM) strategy that treating both manifestation and root cause of disease. The study provides theoretical foundations and offers novel clinical insights into TCM interventions for male infertility caused by environmental pollutants.