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. 2021 Oct 6;19(1):151.
doi: 10.1186/s12958-021-00838-6.

The effect of short term exposure to outdoor air pollution on fertility

Mireia González-Comadran  1   2 , Bénédicte Jacquemin  3   4   5   6 , Marta Cirach  4   5   6 , Rafael Lafuente  7 , Thomas Cole-Hunter  4   5   6   8 , Mark Nieuwenhuijsen  4   5   6 , Mario Brassesco  7 , Buenaventura Coroleu  9 , Miguel Angel Checa  10   11   12   13   14
Affiliations

The effect of short term exposure to outdoor air pollution on fertility

Mireia González-Comadran et al. Reprod Biol Endocrinol. .

Abstract

Background: There is evidence to suggest that long term exposure to air pollution could be associated with decreased levels of fertility, although there is controversy as to how short term exposure may compromise fertility in IVF patients and what windows of exposure during the IVF process patients could be most vulnerable.

Methods: This prospective cohort study aimed to evaluate the impact of acute exposure that air pollution have on reproductive outcomes in different moments of the IVF process. Women undergoing IVF living in Barcelona were recruited. Individual air pollution exposures were modelled at their home address 15 and 3 days before embryo transfer (15D and 3D, respectively), the same day of transfer (D0), and 7 days after (D7). The pollutants modelled were: PM2.5 [particulate matter (PM) ≤2.5 μm], PMcoarse (PM between 2.5 and 10μm), PM10 (PM≤10 μm), PM2.5 abs, and NO2 and NOx. Outcomes were analyzed using multi-level regression models, with adjustment for co-pollutants and confouding factors. Two sensitivity analyses were performed. First, the model was adjusted for subacute exposure (received 15 days before ET). The second analysis was based on the first transfer performed on each patient aiming to exclude patients who failed previous transfers.

Results: One hundred ninety-four women were recruited, contributing with data for 486 embryo transfers. Acute and subacute exposure to PMs showed a tendency in increasing miscarriage rate and reducing clinical pregnancy rate, although results were not statistically significant. The first sensitivity analysis, showed a significant risk of miscarriage for PM2.5 exposure on 3D after adjusting for subacute exposure, and an increased risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 on 3D. The second sensitivity analysis showed a significant risk of miscarriage for PM2.5 exposure on 3D, and a significant risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 particularly on 3D. No association was observed for nitrogen dioxides on reproductive outcomes.

Conclusions: Exposure to particulate matter has a negative impact on reproductive outcomes in IVF patients. Subacute exposure seems to increase the harmful effect of the acute exposure on miscarriage and pregnancy rates. Nitrogen dioxides do not modify significantly the reproductive success.

Keywords: Acute exposure; Fertility; Miscarriage; NO2; Nitrogen dioxide; PM10; PM2.5; Particulate matter; Pregnancy.

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Conflict of interest statement

The authors declare no conflict of interest

Figures

Fig. 1
Fig. 1
Risk of miscarriage compared with the risk of clinical pregnancy for the acute exposure (from 3 days prior to ET to 7 days after the ET). * Model adjusted by co-pollutants and subacute exposure. Results expressed in odds ratio (95% condifence interval)
Fig. 2
Fig. 2
Risk of achieving no pregnancy compared with the risk of clinical pregnancy for the acute exposure (from 3 days prior to ET to 7 days after the ET). * Models adjusted by co-pollutants and subacute exposure. Results expressed in odds ratio (95% condifence interval)
See this image and copyright information in PMC

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