Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.
Reprod Biomed Online. 2022 Jan;44(1):49-62. doi: 10.1016/j.rbmo.2021.09.026. Epub 2021 Oct 7.
Is air pollution related to IVF outcomes in a heavily polluted city in China?
A retrospective cohort study of 8628 fresh, autologous IVF cycles was conducted for the first time at the Reproductive Medicine Center of The Third Affiliated Hospital of Zhengzhou University between May 2014 and December 2018 (oocyte retrieval date). The exposure was divided into four periods (gonadotrophin injection to oocyte retrieval [P1], oocyte retrieval to embryo transfer [P2], 1 day after embryo transfer to embryo transfer +14 days [P3] and gonadotrophin injection to embryo transfer +14 days [P4]) and four levels (Q1-Q4 according to their 25th, 50th and 75th percentiles).
An interquartile range increase (Q2 versus Q1) in particulate matter ≤10 µm (PM10) during P3 and P4 and sulphur dioxide (SO) during P3 significantly decreased the clinical pregnancy rate (adjusted odds ratio [aOR] 0.81, 95% confidence interval [CI] 0.71-0.92 for PM10 of P3; aOR 0.87, 95% CI 0.76-1.00 for PM10 of P4; aOR 0.82, 95% CI 0.73-0.93 for SO of P3). In addition, PM10 was associated with an increased biochemical pregnancy rate (Q3 versus Q1: aOR 1.55, 95% CI 1.09-2.19 for PM10 of P1) and decreased live birth rate (Q2 versus Q1: aOR 0.88, 95% CI 0.77-0.99 for PM10 of P3). The multivariate regression results were consistent with that of multiple treatments propensity score method (PSM) for SO pollutants in P3 and PM10 pollutants in P4.
From the early follicular stage to the pregnancy test period, high concentrations of PM10 and SO may have a negative impact on IVF treatment outcomes in the study area.
在中国污染严重的城市，空气污染是否与试管婴儿结果有关？
这是一项回顾性队列研究，首次在 2014 年 5 月至 2018 年 12 月（取卵日期）在郑州大学第三附属医院生殖医学中心进行，共纳入 8628 个新鲜的自体试管婴儿周期。暴露分为四个时期（促性腺激素注射至取卵期[P1]、取卵至胚胎移植期[P2]、胚胎移植后 1 天至胚胎移植后+14 天[P3]和促性腺激素注射至胚胎移植后+14 天[P4]）和四个水平（根据第 25、50 和 75 百分位数分为 Q1-Q4）。
与 P3 和 P4 期间 PM10 中 10µm 以下颗粒物（PM10）的四分位间距（Q2 与 Q1）增加和 P3 期间二氧化硫（SO）增加相比，临床妊娠率显著降低（调整优势比[aOR]0.81，95%置信区间[CI]0.71-0.92 用于 P3 的 PM10；aOR0.87，95%CI0.76-1.00 用于 P4 的 PM10；aOR0.82，95%CI0.73-0.93 用于 P3 的 SO）。此外，PM10 与生化妊娠率增加相关（Q3 与 Q1：P1 期间 PM10 的 aOR1.55，95%CI1.09-2.19），活产率降低（Q2 与 Q1：P3 期间 PM10 的 aOR0.88，95%CI0.77-0.99）。多变量回归结果与 P3 期间 SO 污染物和 P4 期间 PM10 污染物的多处理倾向评分法（PSM）一致。
从卵泡早期到妊娠试验期，PM10 和 SO 的高浓度可能对研究区域的试管婴儿治疗结果产生负面影响。
