Huang Kai, Hu Meihong, Zhang Zeling, Li Zhenhua, Hu Chengyang, Bai Shun, Li Ruojie, Wu Li-Min, Zhang Xiu-Jun, Xu Bo
The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
Center for Reproduction and Genetics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 17 Lujiang Road, Hefei 230001, China.
Sci Total Environ. 2025 Jan 1;958:177919. doi: 10.1016/j.scitotenv.2024.177919. Epub 2024 Dec 9.
Existing evidence has explored the relationship between exposure to air pollutants with ovarian reserve in women receiving assisted reproductive technology (ART). However, few studies have followed up on ART pregnancy outcomes and evaluated how ovarian reserve is involved in the association between air pollutant exposure and specific ART outcomes. We aimed to determine whether air pollutants affect ART outcomes by interfering with ovarian reserve through long-term follow-up. A total of 5354 women who underwent ART treatment and completed antral follicle count (AFC) detection at the First Affiliated Hospital of University of Science and Technology of China between 2018 and 2020 were involved. Exposure concentrations (0.1° × 0.1°) for three aerodynamic diameters of particulate matter (PM, PM, PM) and three oxidized pollutants (NO, SO, O) were assigned to each individual according to the latitude and longitude of the participant's residential address. Multivariate linear mixed effects models (LMMs) were performed to estimate the impacts of exposure to air pollutants during the first 6 months of AFC and longer periods on ovarian reserve capacity and ART pregnancy outcomes. Exposure to PM (OR: 0.914, 95%CI: 0.845-0.988), PM (OR: 0.908, 95%CI: 0.850-0.970), PM (OR: 0.924, 95%CI: 0.865-0.987), and SO (OR: 0.908, 95%CI: 0.843-0.978) was linked with decreased OR for live birth. In addition, with each IQR increase in PM, PM, PM, SO, and NO, AFC levels decreased by 0.370, 0.395, 0.064, 0.311, and 0.465, respectively. The mediation effect was more pronounced for NO and SO, with AFCs explaining 26.83 % and 9.54 % of their associations with live birth, respectively. Additionally, 6.49 %, 9.16 %, and 6.79 % of live birth failures were ascribed to PM, PM, and PM, respectively. Findings of this study suggest that exposure to air pollutants may affect reproductive outcomes in women receiving ART by reducing their ovarian reserve capacity.
现有证据探讨了接受辅助生殖技术（ART）的女性接触空气污染物与卵巢储备之间的关系。然而，很少有研究对ART妊娠结局进行随访，并评估卵巢储备在空气污染物暴露与特定ART结局之间的关联中所起的作用。我们旨在通过长期随访确定空气污染物是否通过干扰卵巢储备来影响ART结局。本研究纳入了2018年至2020年间在中国科学技术大学附属第一医院接受ART治疗并完成窦卵泡计数（AFC）检测的5354名女性。根据参与者居住地址的纬度和经度，为每个人分配三种空气动力学直径的颗粒物（PM、PM、PM）和三种氧化污染物（NO、SO、O）的暴露浓度（0.1°×0.1°）。采用多元线性混合效应模型（LMMs）来估计AFC前6个月及更长时间内接触空气污染物对卵巢储备能力和ART妊娠结局的影响。接触PM（OR：0.914，95%CI：0.845 - 0.988）、PM（OR：0.908，95%CI：0.850 - 0.970）、PM（OR：0.924，95%CI：0.865 - 0.987）和SO（OR：0.908，95%CI：0.843 - 0.978）与活产的OR降低有关。此外，PM、PM、PM、SO和NO每增加一个四分位数间距（IQR），AFC水平分别下降0.370、0.395、0.064、0.311和0.465。NO和SO的中介效应更为明显，AFC分别解释了它们与活产关联的26.83%和9.54%。此外，活产失败分别有6.49%、9.16%和6.79%归因于PM、PM和PM。本研究结果表明，接触空气污染物可能通过降低接受ART的女性的卵巢储备能力来影响其生殖结局。
