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Zhang R, Zhao J, Zhang Y, Hong X, Zhang H, Zheng H, Wu J, Wang Y, Peng Z, Zhang Y, Jiang L, Zhao Y, Wang Q, Shen H, Zhang Y, Yan D, Wang B, Ma X. Association between fine particulate matter and fecundability in Henan, China: A prospective cohort study. ENVIRONMENT INTERNATIONAL 2024; 188:108754. [PMID: 38781703 DOI: 10.1016/j.envint.2024.108754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To investigate the relationship between ambient fine particulate matter (PM2.5) exposure and fecundability. METHODS This study included 751,270 female residents from Henan Province who participated in the National Free Pre-conception Check-up Projects during 2015-2017. Ambient cycle-specific PM2.5 exposure was assessed at the county level for each participant using satellite-based PM2.5 concentration data at 1-km resolution. Cox proportional hazards models with time-varying exposure were used to estimate the association between fecundability and PM2.5 exposure, adjusted for potential individual risk factors. RESULTS During the study period, 568,713 participants were pregnant, monthly mean PM2.5 concentrations varied from 25.5 to 114.0 µg/m3 across study areas. For each 10 µg/m3 increase in cycle-specific PM2.5, the hazard ratio for fecundability was 0.951 (95 % confidence interval: 0.950-0.953). The association was more pronounced in women who were older, with urban household registration, history of pregnancy, higher body mass index (BMI), hypertension, without exposure to tobacco, or whose male partners were older, with higher BMI, or hypertension. CONCLUSION In this population-based prospective cohort, ambient cycle-specific PM2.5 exposure was associated with reduced fecundability. These findings may support the adverse implications of severe air pollution on reproductive health.
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Affiliation(s)
- Rong Zhang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Jun Zhao
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, China
| | - Yue Zhang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, China
| | - Xiang Hong
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, China
| | - Hanyue Zheng
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, China
| | - Lifang Jiang
- Institute of Reproductive Health, Henan Academy of Innovations in Medical Science, NHC Key Laboratory of Birth Defects Prevention, Henan, China
| | - Yueshu Zhao
- The Third Affiliated Hospital of Zhengzhou University, Henan, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Bei Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Center, Beijing, China.
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Lei J, Liu C, Meng X, Sun Y, Huang S, Zhu Y, Gao Y, Shi S, Zhou L, Luo H, Kan H, Chen R. Associations between fine particulate air pollution with small-airway inflammation: A nationwide analysis in 122 Chinese cities. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123330. [PMID: 38199484 DOI: 10.1016/j.envpol.2024.123330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/24/2023] [Accepted: 01/06/2024] [Indexed: 01/12/2024]
Abstract
Alveolar nitric oxide is a non-invasive indicator of small-airway inflammation, a key pathophysiologic mechanism underlying lower respiratory diseases. However, no epidemiological studies have investigated the impact of fine particulate matter (PM2.5) exposure on the concentration of alveolar nitric oxide (CANO). To explore the associations between PM2.5 exposure in multiple periods and CANO, we conducted a nationwide cross-sectional study in 122 Chinese cities between 2019 and 2021. Utilizing a satellite-based model with a spatial resolution of 1 × 1 km, we matched long-term, mid-term, and short-term PM2.5 exposure for 28,399 individuals based on their home addresses. Multivariable linear regression models were applied to estimate the associations between PM2.5 at multiple exposure windows and CANO. Stratified analyses were also performed to identify potentially vulnerable subgroups. We found that per interquartile range (IQR) unit higher in 1-year average, 1-month average, and 7-day average PM2.5 concentration was significantly associated with increments of 17.78% [95% confidence interval (95%CI): 12.54%, 23.26%], 8.76% (95%CI: 7.35%, 10.19%), and 4.00% (95%CI: 2.81%, 5.20%) increment in CANO, respectively. The exposure-response relationship curves consistently increased with the slope becoming statistically significant beyond 20 μg/m3. Males, children, smokers, individuals with respiratory symptoms or using inhaled corticosteroids, and those living in Southern China were more vulnerable to PM2.5 exposure. In conclusion, our study provided novel evidence that PM2.5 exposure in long-term, mid-term, and short-term periods could significantly elevate small-airway inflammation represented by CANO. Our results highlight the significance of CANO measurement as a non-invasive tool for early screening in the management of PM2.5-related inflammatory respiratory diseases.
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Affiliation(s)
- Jian Lei
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China; Department of Occupational and Environmental Health, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China.
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yiqing Sun
- Eberly College of Science, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Suijie Huang
- Guangzhou Homesun Medical Technology Co., Ltd, Guangdong, 518040, China
| | - Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Su Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Lu Zhou
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Huihuan Luo
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
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Wang X, Ding N, Harlow SD, Randolph JF, Gold EB, Derby C, Kravitz HM, Greendale G, Wu X, Ebisu K, Schwartz J, Park SK. Associations between exposure to air pollution and sex hormones during the menopausal transition. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168317. [PMID: 37949144 DOI: 10.1016/j.scitotenv.2023.168317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
Menopause is a significant milestone in a woman's life, characterized by decreasing estradiol (E2) and increasing follicle-stimulating hormone (FSH) levels. Growing evidence suggests that air pollution may affect reproductive health and disrupt hormone profiles, yet the associations in women undergoing menopausal transition (MT) remains underexplored. We examined the associations between annual air pollutant exposures and repeated measures of E2 and FSH in 1365 women with known final menstrual period (FMP) date from the Study of Women's Health Across the Nation. Air pollution was calculated as the annual averages of 24-h average PM2.5 levels, daily one-hour maximum NO2 levels, and daily 8-h maximum O3 levels. Linear mixed models with piece-wise linear splines were used to model non-linear trajectories of E2 and FSH in three distinct time periods: up to 2 years before the FMP (early MT), within 2 years before and 2 years after FMP (transmenopause), and >2 years post-FMP (postmenopause). In the transmenopausal period, an interquartile (5 μg/m3) increase in PM2.5 was associated with a significant decrease in E2 levels (-15.7 %, 95 % CI: -23.7, -6.8), and a 10 ppb increase in NO2 was associated with a significant decrease in E2 levels (-9.2 %, 95 % CI: -16.2, -1.7). A higher PM2.5 was also associated with an accelerated rate of decline in E2. Regarding FSH, a 10 ppb increase in NO2 was associated with decline in FSH levels (-11.7 %, 95 % CI: -21.8, -0.1) in the early MT and accelerated rates of decline in the postmenopause (-1.1 % per year, 95 % CI: -2.1, -0.1). Additionally, inverse associations between O3 and FSH were observed in the transmenopause and postmenopause. Our study suggests that increases in PM2.5, NO2, and O3 exposures are linked to significant declines in E2 and FSH levels across menopausal stages, suggesting the detrimental impact of air pollutants on women's reproductive hormones.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Ning Ding
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - John F Randolph
- Department of Obstetrics and Gynecology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Ellen B Gold
- Department of Public Health Sciences, University of California, Davis, School of Medicine, Davis, CA, USA
| | - Carol Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Howard M Kravitz
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Gail Greendale
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Xiangmei Wu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Keita Ebisu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Joel Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Uncu G, Aslan K, Cakir C, Avci B, Kasapoglu I, Alviggi C. Do we overlook predictive factors in Poseidon 1 patients? A retrospective analysis co-evaluating antral follicle counts & diameters. J Ovarian Res 2024; 17:1. [PMID: 38169411 PMCID: PMC10759700 DOI: 10.1186/s13048-023-01323-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND An unexpected impaired ovarian response pertains to an insufficient reaction to controlled ovarian hyperstimulation. This deficient reaction is identified by a reduced count of mature follicles and retrieved oocytes during an IVF cycle, potentially diminishing the likelihood of a successful pregnancy. This research seeks to examine whether the characteristics of antral follicles can serve as predictive indicators for the unexpected impaired ovarian response to controlled ovarian stimulation (COS). METHODS This retrospective cohort study was conducted at a tertiary university hospital. The electronic database of the ART (assisted reproductive technologies) center was screened between the years 2012-2022. Infertile women under 35 years, with normal ovarian reserve [anti-Müllerian hormone (AMH) > 1.2 ng/ml, antral follicle count (AFC) > 5] who underwent their first controlled ovarian stimulation (COS) cycle were selected. Women with < 9 oocytes retrieved (group 1 of the Poseidon classification) constituted the group A, whereas those with ≥ 9 oocytes severed as control (normo-responders) one (group B). Demographic, anthropometric and hormonal variables together with COS parameters of the two groups were compared. RESULTS The number of patients with < 9 oocytes (group A) was 404, and those with ≥ 9 oocytes were 602 (group B). The mean age of the group A was significantly higher (30.1 + 2.9 vs. 29.4 + 2.9, p = 0.01). Group A displayed lower AMH and AFC [with interquartile ranges (IQR); AMH 1.6 ng/ml (1-2.6) vs. 3.5 ng/ml (2.2-5.4) p < 0.01, AFC 8 (6-12) vs. 12 (9-17), p < 0.01]. The number of small antral follicles (2-5 mm) of the group A was significantly lower [6 (4-8) vs. 8 (6-12) p < 0.01), while the larger follicles (5-10 mm) remained similar [3 (1-5) vs. 3(1-6) p = 0.3] between the groups. CONCLUSION The propensity of low ovarian reserve and higher age are the main risk factors for the impaired ovarian response. The proportion of the small antral follicles may be a predictive factor for ovarian response to prevent unexpected poor results.
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Affiliation(s)
- Gürkan Uncu
- Faculty of Medicine, Dept. of Obstetrics and Gynecology, Bursa Uludag University, Bursa, Turkey.
| | - Kiper Aslan
- Faculty of Medicine, Dept. of Obstetrics and Gynecology, Bursa Uludag University, Bursa, Turkey
| | - Cihan Cakir
- Faculty of Medicine, Dept of Histology and Embryology, Bursa Uludag University, Bursa, Turkey
| | - Berrin Avci
- Faculty of Medicine, Dept of Histology and Embryology, Bursa Uludag University, Bursa, Turkey
| | - Isil Kasapoglu
- Faculty of Medicine, Dept. of Obstetrics and Gynecology, Bursa Uludag University, Bursa, Turkey
| | - Carlo Alviggi
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
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LaPointe S, Lee JC, Nagy ZP, Shapiro DB, Chang HH, Wang Y, Russell AG, Hipp HS, Gaskins AJ. Ambient traffic related air pollution in relation to ovarian reserve and oocyte quality in young, healthy oocyte donors. ENVIRONMENT INTERNATIONAL 2024; 183:108382. [PMID: 38103346 PMCID: PMC10871039 DOI: 10.1016/j.envint.2023.108382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Studies in mice and older, subfertile women have found that air pollution exposure may compromise female reproduction. Our objective was to evaluate the effects of air pollution on ovarian reserve and outcomes of ovarian stimulation among young, healthy females. We included 472 oocyte donors who underwent 781 ovarian stimulation cycles at a fertility clinic in Atlanta, Georgia, USA (2008-2019). Antral follicle count (AFC) was assessed with transvaginal ultrasonography and total and mature oocyte count was assessed following oocyte retrieval. Ovarian sensitivity index (OSI) was calculated as the total number of oocytes divided by total gonadotrophin dose × 1000. Daily ambient exposure to nitric oxide (NOx), carbon monoxide (CO), and particulate matter ≤ 2.5 (PM2.5) was estimated using a fused regional + line-source model for near-surface releases at a 250 m resolution based on residential address. Generalized estimating equations were used to evaluate the associations of an interquartile range (IQR) increase in pollutant exposure with outcomes adjusted for donor characteristics, census-level poverty, and meteorological factors. The median (IQR) age among oocyte donors was 25.0 (5.0) years, and 31% of the donors were racial/ethnic minorities. The median (IQR) exposure to NOx, CO, and PM2.5 in the 3 months prior to stimulation was 37.7 (32.0) ppb, 612 (317) ppb, and 9.8 (2.9) µg/m3, respectively. Ambient air pollution exposure in the 3 months before AFC was not associated with AFC. An IQR increase in PM2.5 in the 3 months before AFC and during stimulation was associated with -7.5% (95% CI -14.1, -0.4) and -6.4% (95% CI -11.0, -1.6) fewer mature oocytes, and a -1.9 (95% CI -3.2, -0.5) and -1.0 (95% CI -1.8, -0.2) lower OSI, respectively. Our results suggest that lowering the current 24-h PM2.5 standard in the US to 25 µg/m3 may still not adequately protect against the reprotoxic effects of short-term PM2.5 exposure.
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Affiliation(s)
- Sarah LaPointe
- Department of Epidemiology, Emory University Rollins School of Public Heath, Atlanta, GA, United States
| | - Jaqueline C Lee
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Zsolt P Nagy
- Reproductive Biology Associates, Sandy Springs, GA, United States
| | - Daniel B Shapiro
- Reproductive Biology Associates, Sandy Springs, GA, United States
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Yifeng Wang
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Armistead G Russell
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Heather S Hipp
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Audrey J Gaskins
- Department of Epidemiology, Emory University Rollins School of Public Heath, Atlanta, GA, United States.
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Liu S, Zhao J, Ye X, Fu M, Zhang K, Wang H, Zou Y, Yu K. Fine particulate matter and its constituent on ovarian reserve: Identifying susceptible windows of exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166744. [PMID: 37659528 DOI: 10.1016/j.scitotenv.2023.166744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Little is known about the associations of exposure to fine particulate matter (PM2.5) and its constituents with ovarian reserve, and the potential susceptible window of exposure remains unclear. METHODS We performed a retrospective cohort study of 5189 women who attended a fertility center in Hubei, China, during 2019-2022, and estimated concentrations of PM2.5 and its major constituents during the development of follicles (4th-6th month [W1], 0-4th month [W2], 0-6th month [W3]) and 1-year before measurement (W4) based on Tracking Air Pollution in China database. We used multivariable linear regression and logistic regression models to examine the associations of PM2.5 and its constituent exposures with anti-Müllerian hormone (AMH), the preferred indicator of ovarian reserve. RESULTS We observed significantly decreased AMH levels associated with increasing PM2.5 concentrations, with the percent changes (95 % confidence intervals [CIs]) of 1.99 % (0.24 %-3.71 %) during W1 and 3.99 % (0.74 %-7.15 %) during W4 for per 10 μg/m3 increases in PM2.5.When PM2.5 exposure levels were equal to 50th percentile (32.6-42.3 μg/m3) or more, monotonically decreased AMH levels and increased risks of low AMH were seen with increasing PM2.5 concentrations during W1 and W4 (P < 0.05). Black carbon (BC), ammonium (NH4+), nitrate (NO3-), and organic matter (OM) during W1, and NH4+, NO3-, as well as sulfate (SO42-) during W4 were significantly associated with decreased AMH. Moreover, PM2.5 and SO42- exposures during W4 were positively associated with low AMH. Additionally, the associations were stronger among women aged <35 years, lived in urban regions, or measured AMH in cold-season (P for interaction <0.05). CONCLUSION PM2.5 and specific chemical components (particularly NH4+, NO3-, and SO42-) exposure during the secondary to antral follicle stage and 1-year before measurement were associated with diminished ovarian reserve (DOR), indicating the adverse impact of PM2.5 and its constituent exposures on female reproductive potential.
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Affiliation(s)
- Shuangyan Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jing Zhao
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Xin Ye
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Mingjian Fu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Kexin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Han Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yujie Zou
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Kuai Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Leathersich SJ, Roche CS, Walls M, Nathan E, Hart RJ. Season at the time of oocyte collection and frozen embryo transfer outcomes. Hum Reprod 2023; 38:1714-1722. [PMID: 37407029 DOI: 10.1093/humrep/dead137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/28/2023] [Indexed: 07/07/2023] Open
Abstract
STUDY QUESTION Does the meteorological season at the time of oocyte retrieval affect live birth rates in subsequent frozen embryo transfers? SUMMARY ANSWER Frozen embryo transfers resulting from oocytes retrieved in summer have 30% increased odds of live birth compared to frozen embryo transfers resulting from oocytes retrieved in autumn, regardless of the season at the time of embryo transfer. WHAT IS KNOWN ALREADY Season at the time of frozen embryo transfer does not appear to be associated with live birth rate. One study in the northern hemisphere found increased odds of live birth with frozen embryo transfer resulting from oocytes collected in summer when compared to those collected in winter. STUDY DESIGN, SIZE, DURATION Retrospective cohort study including all frozen embryo transfers performed by a single clinic over eight years, from January 2013 to December 2021. There were 3659 frozen embryo transfers with embryos generated from 2155 IVF cycles in 1835 patients. Outcome data were missing for two embryo transfers, which were excluded from analysis. Outcomes were analysed by the season, temperatures, and measured duration of sunshine at the time of oocyte collection and at the time of frozen embryo transfer. PARTICIPANTS/MATERIALS, SETTING, METHODS There were no significant differences between patients with oocyte collection or embryo transfers in different seasons. Meteorological conditions on the day of oocyte collection and the day of frozen embryo transfer, and in the preceding 14- and 28-day periods, were collected including mean, minimum, and maximum temperatures, and recorded duration of sunshine hours. Clinical and embryological outcomes were analysed for their association with seasons, temperatures, and duration of sunshine with correction for repeated cycles per participant, age at the time of oocyte retrieval, and quadratic age. MAIN RESULTS AND THE ROLE OF CHANCE Compared to frozen embryo transfers with oocyte retrieval dates in autumn, transfers with oocyte retrieval dates in summer had 30% increased odds of live birth (odds ratio (OR): 1.30, 95% CI: 1.04-1.62) which remained consistent after adjustment for season at the time of embryo transfer. A high duration of sunshine hours (in the top tertile) on the day of oocyte retrieval was associated with a 28% increase in odds of live birth compared to duration of sunshine hours in the lowest tertile (OR 1.28, 95% CI: 1.06-1.53). Temperature on the day of oocyte retrieval did not independently affect the odds of live birth. The odds of live birth were decreased by 18% when the minimum temperature on the day of embryo transfer was high, compared with low (OR: 0.82, 95% CI: 0.69-0.99), which was consistent after correction for the conditions at the time of oocyte retrieval. LIMITATIONS, REASONS FOR CAUTION This was a retrospective cohort study, however, all patients during the study period were included and data was missing for only two patients. Given the retrospective nature, causation is not proven and there are other factors that may affect live birth rates and for which we did not have data and were unable to adjust, including pollutants and behavioural factors. We were also not able to stratify results based on specific patient populations (such as poor- or hyper-responders) nor report the cumulative live birth rate per commenced cycle. WIDER IMPLICATIONS OF THE FINDINGS These findings may be particularly relevant for patients planning oocyte or embryo cryopreservation. Given the increasing utilization of cryopreservation, identification of factors that influence outcomes in subsequent frozen embryo transfers has implications for future therapeutic and management options. Further studies to clarify the physiology underlying the influence of sunshine hours or season on subsequent frozen embryo transfer outcomes are required, including identification of specific populations that may benefit from these factors. STUDY FUNDING/COMPETING INTERESTS No funding was provided for this study. S.L. has received educational travel assistance from Besins, Merck and Organon outside the submitted work. R.H. is National Medical Director of City Fertility and Medical Director of Fertility Specialists of Western Australia, has received honoraria from MSD, Merck Serono, Origio and Ferring outside the submitted work, and has equity interests in CHA SMG. C.R., M.W., and E.N. declare that they have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S J Leathersich
- Department of Reproductive Medicine, King Edward Memorial Hospital, Subiaco, Australia
- City Fertility Australia, Claremont, Australia
- Fertility Specialists of Western Australia, Claremont, Australia
| | - C S Roche
- Department of Reproductive Medicine, King Edward Memorial Hospital, Subiaco, Australia
| | - M Walls
- City Fertility Australia, Claremont, Australia
- Fertility Specialists of Western Australia, Claremont, Australia
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, Australia
| | - E Nathan
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, Australia
| | - R J Hart
- Department of Reproductive Medicine, King Edward Memorial Hospital, Subiaco, Australia
- City Fertility Australia, Claremont, Australia
- Fertility Specialists of Western Australia, Claremont, Australia
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, Australia
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Seli DA, Taylor HS. The impact of air pollution and endocrine disruptors on reproduction and assisted reproduction. Curr Opin Obstet Gynecol 2023; 35:210-215. [PMID: 36924404 DOI: 10.1097/gco.0000000000000868] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
PURPOSE OF REVIEW Rapid increase in world population accompanied by global industrialization has led to an increase in deployment of natural resources, resulting in growing levels of pollution. Here, we review recent literature on the impact of environmental pollution on human reproductive health and assisted reproduction outcomes, focusing on two of the most common: air pollution and endocrine disruptors. RECENT FINDINGS Air pollution has been associated with diminished ovarian reserve, uterine leiomyoma, decreased sperm concentration and motility. Air pollution also correlates with decreased pregnancy rates in patients undergoing infertility treatment using in-vitro fertilization (IVF). Similarly, Bisphenol A (BPA), a well studied endocrine disrupting chemical, with oestrogen-like activity, is associated with diminished ovarian reserve, and abnormal semen parameters, while clinical implications for patients undergoing infertility treatment remain to be established. SUMMARY There is convincing evidence that environmental pollutants may have a negative impact on human health and reproductive potential. Air pollutions and endocrine disrupting chemicals found in water and food seem to affect male and female reproductive function. Large-scale studies are needed to determine the threshold values for health impact that may drive targeted policies.
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Affiliation(s)
| | - Hugh S Taylor
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
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Wu S, Zhang Y, Hao G, Chen X, Wu X, Ren H, Zhang Y, Fan Y, Du C, Bi X, Bai L, Tan J. Interaction of air pollution and meteorological factors on IVF outcomes: A multicenter study in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 259:115015. [PMID: 37201423 DOI: 10.1016/j.ecoenv.2023.115015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Previous studies revealed associations between air-pollutant exposure and in vitro fertilization (IVF) outcomes. However, modification effects of air pollution on IVF outcomes by meteorological conditions remain elusive. METHODS This multicenter retrospective cohort study included 15,217 women from five northern Chinese cities during 2015-2020. Daily average concentrations of air pollutants (PM2.5, PM10, O3, NO2, SO2, and CO) and meteorological factors (temperature, relative humidity, wind speed, and sunshine duration) during different exposure windows were calculated as individual approximate exposure. Generalized estimating equations models and stratified analyses were conducted to assess the associations of air pollution and meteorological conditions with IVF outcomes and estimate potential interactions. RESULTS Positive associations of wind speed and sunshine duration with pregnancy outcomes were detected. In addition, we observed that embryo transfer in spring and summer had a higher likelihood to achieve a live birth compared with winter. Exposure to PM2.5, SO2, and O3 was adversely correlated with pregnancy outcomes in fresh IVF cycles, and the associations were modified by air temperature, relative humidity, and wind speed. The inverse associations of PM2.5 and SO2 exposure with biochemical pregnancy were stronger at lower temperatures and humidity. Negative associations of PM2.5 with clinical pregnancy were only significant at lower temperatures and wind speeds. Moreover, the effects of O3 on live birth were enhanced by higher wind speed. CONCLUSIONS Our results suggested that the associations between air-pollutant exposure and IVF outcomes were modified by meteorological conditions, especially temperature and wind speed. Women undergoing IVF treatment should be advised to reduce outdoor time when the air quality was poor, particularly at lower temperatures.
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Affiliation(s)
- Shanshan Wu
- Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning 110022, PR China; Key Laboratory of Reproductive Dysfunction Disease and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning 110022, PR China
| | - Yunshan Zhang
- Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300100, PR China
| | - Guimin Hao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, PR China
| | - Xiujuan Chen
- Reproductive Medicine Centre, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, PR China
| | - Xueqing Wu
- Reproductive Medicine Center, Children's Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, Shanxi 030013, PR China
| | - Haiqin Ren
- Jinghua Hospital, Shenyang, Liaoning 110022, PR China
| | - Yinfeng Zhang
- Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300100, PR China
| | - Yanli Fan
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, PR China
| | - Chen Du
- Reproductive Medicine Centre, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, PR China
| | - Xingyu Bi
- Reproductive Medicine Center, Children's Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, Shanxi 030013, PR China
| | - Lina Bai
- Jinghua Hospital, Shenyang, Liaoning 110022, PR China
| | - Jichun Tan
- Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang, Liaoning 110022, PR China; Key Laboratory of Reproductive Dysfunction Disease and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning 110022, PR China.
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Pang L, Yu W, Lv J, Dou Y, Zhao H, Li S, Guo Y, Chen G, Cui L, Hu J, Zhao Y, Zhao Q, Chen ZJ. Air pollution exposure and ovarian reserve impairment in Shandong province, China: The effects of particulate matter size and exposure window. ENVIRONMENTAL RESEARCH 2023; 218:115056. [PMID: 36521537 DOI: 10.1016/j.envres.2022.115056] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/03/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Lack of evidence exists on whether air pollution exposure may affect ovarian reserve, especially for Chinese women. OBJECTIVES To explore the association between exposure to various air pollutants and anti-Müllerian hormone (AMH), a predictor of ovarian reserve, over different exposure windows in Shandong Province, China. METHODS We enrolled 18,878 women who had AMH measurements in the Center for Reproductive Medicine, Shandong University during 2010-2019. Daily average concentrations of ambient particulate matter with diameters ≤1 μm/2.5 μm/10 μm (PM1, PM2.5, and PM10), nitrogen dioxide (NO2) and ozone (O3) were developed at a spatial resolution of 0.01° × 0.01°, and assigned to the residential addresses. Three exposure windows were considered, i.e., the process from primary to small antral follicle stage (W1), from primary to secondary follicle stage (W2), and from secondary to small antral follicle stage (W3). The air pollution-AMH association was fitted using the multivariable linear mixed effect model with adjustment for potential confounders. Stratified analyses were performed by age group, overweight status, residential region, and educational level. RESULTS The level of AMH changed by -8.8% (95% confidence interval (CI): -12.1%, -5.3%), -2.1% (95% CI: -3.5%, -0.6%), -1.9% (95% CI: -3.3%, -0.5%), and -4.5% (95% CI: -7.1%, -1.9%) per 10 μg/m3 increase in PM1, PM2.5, PM10, and NO2, respectively, during W1. The effect estimates were significant during W2 for PM1, PM2.5 and NO2 while minimal association was observed in W3. Greater vulnerability for certain air pollutants were observed for women who lived in inland areas and were less educated. CONCLUSIONS We found that ovarian reserve was negatively associated with air pollution exposure for women, particularly from the primary to secondary follicle stage. The effect estimate increased by the reduction in the diameter of PMs, which also varied across population sub-groups.
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Affiliation(s)
- Lihong Pang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
| | - Wenhao Yu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Jiale Lv
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
| | - Yunde Dou
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
| | - Han Zhao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China
| | - Linlin Cui
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
| | - Jingmei Hu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
| | - Yueran Zhao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, 40225, Germany.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200135, China.
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