Exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to adverse effects on women's fertility. However, information on the transfer of PFAS from blood to follicular fluid (FF) and individual characteristics influencing this process remains limited. We estimated the blood-to-FF transfer efficiencies (BFTEs) of 32 PFAS in samples from 576 women undergoing in vitro fertilization, and identified structural and physico-chemical predictors of BFTEs. The median BFTEs of PFAS ranged from 0.364 to 0.914. Carbon chain length, isomeric structure, functional group and physico-chemical properties including octanol-water partition coefficient (logKow), membrane-water partition coefficient (logKmw), dissociation constant (Kd) and protein-water partition coefficient (logKpw) were determinants of BFTEs. For example, the BFTEs of perfluorooctane sulfonate (PFOS) isomers ranked as follows: n-PFOS (0.753) >
iso-PFOS (0.710) >
3 + 4 +5m-PFOS (0.612) >
1m-PFOS (0.587). One unit increase in carbon chain length, logKow, logKmw, Kd and logKpw was associated with BFTE differences of -0.05 (95 % CI: -0.06, -0.04), -0.16 (95 %CI: -0.19, -0.13), -0.07 (95 % CI: -0.10, -0.04), -0.13 (95 % CI: -0.19, -0.08), and 0.22 (95 % CI: 0.14, 0.29), respectively. However, individual characteristics were not associated with BFTEs. This study suggests that molecular structure and physico-chemical properties are critical factors in assessing reproductive health risk related to PFAS.