Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, 04637, Korea.
Department of Preventive Medicine, Korea University College of Medicine, Seoul, 02841, South Korea.
Environ Health Prev Med. 2021 Feb 11;26(1):20. doi: 10.1186/s12199-021-00942-4.
Mounting evidence implicates an association between ambient air pollution and impaired reproductive potential of human. Our study aimed to assess the association between air pollution and ovarian reserve in young, infertile women.
Our study included 2276 Korean women who attended a single fertility center in 2016-2018. Women's exposure to air pollution was assessed using concentrations of particulate matter (PM and PM), nitrogen dioxide (NO), carbon monoxide (CO), sulfur dioxide (SO), and ozone (O) that had been collected at 269 air quality monitoring sites. Exposure estimates were computed for 1, 3, 6, and 12 months prior to the ovarian reserve tests. Anti-Müllerian hormone (AMH) ratio (defined as an observed-to-expected AMH based on age) and low AMH (defined as < 0.5 ng/mL) were employed as indicators of ovarian reserve. We included a clustering effect of 177 districts in generalized estimating equations approach. A secondary analysis was conducted restricting the analyses to Seoul residents to examine the association in highly urbanized setting.
The mean age was 36.6 ± 4.2 years and AMH level was 3.3 ± 3.1 ng/mL in the study population. Average AMH ratio was 0.8 ± 0.7 and low AMH was observed in 10.3% of women (n=235). The average concentration of six air pollutants was not different between the normal ovarian reserve and low AMH groups for all averaging periods. In multivariable models, an interquartile range (IQR)-increase in 1 month-average PM was associated with decrease in AMH ratio among total population (β= -0.06, 95% confidence interval: -0.11, 0.00). When we restrict our analysis to those living in Seoul, IQR-increases in 1 and 12 month-average PM were associated with 3% (95% CI: -0.07, 0.00) and 10% (95% CI: -0.18, -0.01) decrease in AMH ratio. The ORs per IQR increase in the six air pollutants were close to null in total population and Seoul residents.
In a cohort of infertile Korean women, there was a suggestive evidence of the negative association between ambient PM concentration and ovarian reserve, highlighting the potential adverse impact of air pollution on women's fertility.
越来越多的证据表明，环境空气污染与人类生殖潜能受损之间存在关联。我们的研究旨在评估空气污染与年轻不孕女性卵巢储备之间的关系。
我们的研究纳入了 2016 年至 2018 年期间在韩国一家单一生育中心就诊的 2276 名女性。使用在 269 个空气质量监测点收集的颗粒物（PM 和 PM）、二氧化氮（NO）、一氧化碳（CO）、二氧化硫（SO）和臭氧（O）浓度来评估女性的空气污染暴露情况。在卵巢储备测试前 1、3、6 和 12 个月计算暴露估计值。抗苗勒管激素（AMH）比（定义为基于年龄的观察到的与预期的 AMH）和低 AMH（定义为 < 0.5ng/ml）被用作卵巢储备的指标。我们在广义估计方程方法中纳入了 177 个区的聚类效应。在二次分析中，我们限制了分析对象为首尔居民，以检验在高度城市化环境下的关联。
研究人群的平均年龄为 36.6±4.2 岁，AMH 水平为 3.3±3.1ng/ml。平均 AMH 比为 0.8±0.7，10.3%的女性（n=235）出现低 AMH。在所有平均时间内，正常卵巢储备和低 AMH 组的六种空气污染物的平均浓度没有差异。在多变量模型中，PM 1 个月平均浓度的四分位距（IQR）每增加一个单位，与总人群的 AMH 比降低有关（β=-0.06，95%置信区间：-0.11，0.00）。当我们将分析仅限于居住在首尔的人群时，PM 1 个月和 12 个月平均浓度的 IQR 增加与 AMH 比降低 3%（95%CI：-0.07，0.00）和 10%（95%CI：-0.18，-0.01）有关。在总人群和首尔居民中，六种空气污染物的 IQR 每增加一个单位的 OR 接近零。
在韩国一组不孕女性中，有证据表明环境空气中 PM 浓度与卵巢储备之间存在负相关，这突出了空气污染对女性生育能力的潜在不利影响。
