Personal exposure to particulate matter air pollution and outcomes of ovarian stimulation: a pilot study in Massachusetts, US

Abstract

BACKGROUND AND AIM: Higher exposure to ambient air pollution has been associated with lower fertility in women including specific adverse effects on ovarian steroidogenesis and folliculogenesis; however, no previous studies have measured personal exposure to air pollution which quantifies a woman’s real exposure levels. METHODS: We enrolled nine women undergoing a fresh, autologous assisted reproductive technology (ART) cycle at the Massachusetts General Hospital Fertility Center 2018-2019. At the woman’s baseline ultrasound appointment (cycle day 3), they were given an AirBeam2 monitor, which measures three size fractions of particulate matter (PM1, PM₂.₅, and PM10), a smartphone, and a 3-day activity diary. Women collected exposure data for the following 72 hours. Between cycle day 11 and 16, women underwent oocyte retrieval and information was collected on number of total and mature oocytes retrieved. Multivariable generalized linear models were used to evaluate associations between personal PM exposures and ovarian stimulation outcomes. RESULTS:Women collected PM data for an average (minimum, maximum) of 33.7 (8.4, 64.4) hours during ovarian stimulation. Their median (interquartile range [IQR]) exposure to PM1, PM₂.₅, and PM10 was 0.4 (4.1), 2.3 (5.5), 3.7 (8.3) μg/m³, respectively. After adjusting for age, stimulation protocol, infertility diagnosis, and average temperature exposure, an IQR increase in average exposure to PM1, PM₂.₅, and PM10 during cycle days 3 to 5 was associated with -26.8% (95% CI -37.6, -14.2%), -47.9% (95% CI -61.6, -29.1%), and -43.8% (95% CI -57.3, -26.0%) fewer oocytes retrieved, respectively. An IQR increase in PM1, PM₂.₅, and PM10 exposure was also associated with -18.4% (95% CI -33.9, 0.6%), -38.2% (95% CI -58.5 -8.1%), and -34.0% (95% CI -53.8, -5.6%) fewer mature oocytes retrieved, respectively. CONCLUSIONS:In this small pilot study of women undergoing ART in Massachusetts, higher personal exposure to PM during ovarian stimulation was associated with poorer oocyte yield. KEYWORDS: Air pollution, Particulate matter, Reproductive Outcomes, Short-term exposure, Environmental epidemiology