Zhang Kaili, Chen Wei, Divigalpitiya Prasanna, Xing Shasha, Luo Erdan
Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, 819-0395, Japan.
School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China.
Sci Rep. 2025 May 28;15(1):18605. doi: 10.1038/s41598-025-03601-8.
Few studies explored air pollution's role in female infertility, especially with temperature factors. Investigating these effects is essential given global climate change and declining fertility rates. This retrospective study, conducted in Chengdu, China, included 1158 patients with primary infertility, 804 patients with secondary infertility, and 1809 fertile women who visited outpatient clinics between 2018 and 2023. Individual exposure levels to six air pollutants and temperatures were determined based on residential addresses. Multinomial logistic regression assessed the associations between air pollutants, temperature, and female infertility across five exposure windows (3-36 months before diagnosis). A stratified analysis by age was performed, and the interactions and combined exposure effects were further evaluated. Exposure to NO during 6 and 24 months before diagnosis was associated with a higher risk of primary infertility [OR (95% CI) = 1.17 (1.06-1.28); 1.08 (1.03-1.14)], exposure to PM during 24 months before diagnosis was associated with a higher likelihood of primary infertility (OR = 1.32 [1.04-1.57]). Exposure to PM during the 3 months before diagnosis had a higher risk of secondary infertility (OR = 1.32 [1.08-1.56]), as well as during the 36 months before diagnosis (OR = 1.08 [1.01-1.13]). PM exposure during the 3 months, 12, and 36 months before diagnosis (OR = 1.09 [1.01-1.17]; 1.21 [1.05-1.38]; 1.14 [1.03-1.23]), was associated with a higher risk of secondary infertility. Higher temperature exposure in the 3 months before diagnosis was associated with a lower risk of both primary and secondary infertility [OR = 0.92 (0.85-0.96); 0.91 (0.83-0.95)]. Women under 32 years of age exhibited increased sensitivity to NO, CO, and temperature exposure. Additionally, co-exposure to low temperatures and high concentrations of SO or NO heightened the risk of primary infertility during the 3 months before diagnosis [OR = 1.86 (1.12-3.04); 1.62 (1.13-2.33)]. Co-exposure to low temperatures and high concentrations of PM increased the risk of secondary infertility during 3, 12, and 36 months before diagnosis [OR = 1.51 (1.13-2.03); 1.48 (1.07-2.21); 1.71 (1.13-2.52)]. This study emphasizes the potential for mitigating female infertility risk through reduced exposure to NO, PM, and PM, and by appropriately adjusting environmental temperatures.
很少有研究探讨空气污染在女性不孕中的作用，尤其是与温度因素相关的作用。鉴于全球气候变化和生育率下降，研究这些影响至关重要。这项在中国成都进行的回顾性研究纳入了1158例原发性不孕患者、804例继发性不孕患者以及1809例在2018年至2023年期间到门诊就诊的有生育能力的女性。根据居住地址确定个体对六种空气污染物和温度的暴露水平。多项逻辑回归分析评估了在五个暴露窗口（诊断前3至36个月）期间空气污染物、温度与女性不孕之间的关联。进行了年龄分层分析，并进一步评估了相互作用和联合暴露效应。诊断前6个月和24个月暴露于一氧化氮与原发性不孕风险较高相关[比值比（95%置信区间）=1.17（1.06 - 1.28）；1.08（1.03 - 1.14）]，诊断前24个月暴露于细颗粒物与原发性不孕可能性较高相关（比值比=1.32[1.04 - 1.57]）。诊断前3个月暴露于细颗粒物有较高的继发性不孕风险（比值比=1.32[1.08 - 1.56]），诊断前36个月也是如此（比值比=1.08[1.01 - 1.13]）。诊断前3个月、12个月和36个月暴露于细颗粒物（比值比=1.09[1.01 - 1.17]；1.21[1.05 - 1.38]；1.14[1.03 - 1.23]）与继发性不孕风险较高相关。诊断前3个月较高的温度暴露与原发性和继发性不孕风险较低相关[比值比=0.92（0.85 - 0.96）；0.91（0.83 - 0.95）]。32岁以下的女性对一氧化氮、一氧化碳和温度暴露表现出更高的敏感性。此外，在诊断前3个月，低温与高浓度二氧化硫或一氧化氮的联合暴露增加了原发性不孕的风险[比值比=1.86（1.12 - 3.04）；1.62（1.13 - 2.33）]。在诊断前3个月、12个月和36个月，低温与高浓度细颗粒物的联合暴露增加了继发性不孕的风险[比值比=1.51（1.13 - 2.03）；1.48（1.07 - 2.21）；1.71（1.13 - 2.52）]。本研究强调了通过减少一氧化氮、细颗粒物和可吸入颗粒物的暴露以及适当调节环境温度来降低女性不孕风险的可能性。
