Proximity to inland water and major roadway of residential address and ovarian reserve: a retrospective cohort study

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Background: There are growing interests regarding the potential impact of physical environment on reproductive health. This study was to explore the association between neighborhood environment and women’s fertility.Method: This study is a retrospective cohort study using the data of 7,630 women who have undertaken anti-Mullerian hormone (AMH) test which is a universal indicator for ovarian reserve at a single fertility center in 2016-2018. For indicators of age-adjusted ovarian reserve, we used AMH ratio (defined as AMHmeasured divided by AMHage-appropriate reference). We calculated a distance to nearest inland water (including lake, creek, stream and river) and nearest major roadway for each geocoded address. We used continuous scales for correlation tests and categorized (quartile) scales for multivariable regression analyses. We further analyzed the odds of decreased ovarian reserve (DOR, defined as AMH ratio <0.1) with adjustment for covariates. Body mass index, occupation, smoking and regional deprivation index were used as covariates. Results: Median age was 39.1 years and mean AMH was 3.5 ng/mL. Mean distance to inland water and major road was 443.7 and 3672.8 m, respectively. Spearman correlation coefficient for the association between AMH ratio and distance to inland water was -0.001 (P = 0.934). For the association with distance to major road, the coefficient was -0.023 (P = 0.058). In multivariable analyses using quartiles of distance, the associations between proximity to inland water or major road and AMH ratio were toward null. Odds ratios (OR) of DOR was 1.05 (95% confidence intervals (CI):0.72, 1.53) for the highest quartile of distance to inland water and 1.33 (95% CI: 0.89, 1.98) for the highest quartile of distance to major roadway compared to ORs for the lowest quartile. Conclusion: There was no evidence of association of proximity to inland water or major roadway with women’s ovarian reserve in our study.