卵泡发生、子宫内膜发育和精子发生过程中环境空气污染对生育能力的影响：一项针对使用玻璃化供体卵母细胞体外受精患者的研究。
The influence of ambient air pollution during folliculogenesis, endometrial development, and spermatogenesis on fertility: A study among patients using vitrified donor oocyte in vitro fertilization.
作者信息
LaPointe Sarah, Lee Jaqueline C, Nagy Zsolt P, Shapiro Daniel B, Chang Howard H, Wang Yifeng, Russell Armistead G, Hipp Heather S, Gaskins Audrey J
机构信息
Department of Epidemiology, Emory University Rollins School of Public Heath, Atlanta, GA, USA.
Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
出版信息
Environ Res. 2025 Aug 11;285(Pt 4):122576. doi: 10.1016/j.envres.2025.122576.
BACKGROUND
Air pollution is associated with reduced fertility; however, the independent effects of air pollution exposure during folliculogenesis, endometrial development, and spermatogenesis on human reproduction remains unclear.
OBJECTIVE
We investigated the associations between air pollution during critical windows and clinical outcomes of in vitro fertilization (IVF) using patients undergoing vitrified donor oocyte IVF.
METHODS
We included 551 non-identified oocyte donors and 1353 recipients who underwent 2533 embryo transfers at Reproductive Biology Associates in Atlanta, Georgia (2008-2019). Daily ambient exposure to air pollutants was estimated using spatiotemporal models linked to residential addresses and averaged over folliculogenesis (90 days before stimulation) and during stimulation in donors, three months and three weeks prior to transfer in recipients, and spermatogenesis (72 days prior to oocyte thaw) in male partners. Multivariable generalized estimating equations were used to estimate adjusted odds ratios (aOR) and 95 % confidence intervals (CI) per interquartile range increase in pollutants in relation to clinical IVF outcomes.
RESULTS
Higher carbon monoxide (CO) exposure during folliculogenesis (aOR = 0.86 95 % CI 0.77, 0.96) and ovarian stimulation (aOR = 0.88 95 % CI 0.79, 0.98) in donors was associated with lower odds of positive pregnancy test. Higher elemental carbon (EC) exposure during folliculogenesis was associated with lower odds of live birth (aOR = 0.87 95 % CI 0.79, 0.96) and higher odds of pregnancy loss (aOR = 1.16 95 % CI 1.02, 1.32). During ovarian stimulation, higher coarse particulate matter (PM) exposure was associated with lower odds of live birth (aOR = 0.90 95 % CI 0.80, 1.00) and higher odds of pregnancy loss (aOR = 1.18 95 % CI 1.02, 1.36). Among male partners, higher PM exposure during spermatogenesis was associated with higher odds of pregnancy loss (aOR = 1.45 95 % 1.09, 1.92). Air pollution exposures in the recipient were generally not associated with IVF outcomes.
CONCLUSIONS
Preconception air pollution exposure during both folliculogenesis and spermatogenesis may adversely impact IVF outcomes.
背景
空气污染与生育力下降有关；然而，卵泡发生、子宫内膜发育和精子发生过程中暴露于空气污染对人类生殖的独立影响仍不清楚。
目的
我们使用接受玻璃化供体卵母细胞体外受精（IVF）的患者，研究关键窗口期的空气污染与体外受精临床结局之间的关联。
方法
我们纳入了佐治亚州亚特兰大生殖生物学协会的551名身份不明的卵母细胞供体和1353名接受者，他们进行了2533次胚胎移植（2008 - 2019年）。使用与居住地址相关的时空模型估计每日环境空气中污染物的暴露量，并计算卵泡发生期（刺激前90天）、供体刺激期、接受者移植前三个月和三周以及男性伴侣精子发生期（卵母细胞解冻前72天）的平均暴露量。使用多变量广义估计方程来估计污染物每增加一个四分位数间距与体外受精临床结局相关的调整优势比（aOR）和95%置信区间（CI）。
结果
供体卵泡发生期较高的一氧化碳（CO）暴露（aOR = 0.86，95% CI 0.77，0.96）和卵巢刺激期（aOR = 0.88，95% CI 0.79，0.98）与妊娠试验阳性的较低几率相关。卵泡发生期较高的元素碳（EC）暴露与活产几率较低（aOR = 0.87，95% CI 0.79，0.96）和流产几率较高（aOR = 1.16，95% CI 1.02，1.32）相关。在卵巢刺激期，较高的粗颗粒物（PM）暴露与活产几率较低（aOR = 0.90，95% CI 0.80，1.00）和流产几率较高（aOR = 1.18，95% CI 1.02，1.36）相关。在男性伴侣中，精子发生期较高的PM暴露与流产几率较高（aOR = 1.45，95% CI 1.09，1.92）相关。接受者的空气污染暴露一般与体外受精结局无关。
结论
卵泡发生期和精子发生期受孕前暴露于空气污染可能对体外受精结局产生不利影响。
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