摘要：Background Exposure to ambient air pollution has been reported to be inversely correlated with human reproductive health. However, the results of previous studies exploring the association between air pollution and in vitro fertilization (IVF) outcomes are conflicting, and further research is needed to clarify this association. Objectives This study aimed to investigate the associations between exposure to air pollutants and IVF outcomes. Methods We conducted a multicenter retrospective cohort study involving 20,835 patients from four cities in Northern China, contributing to 11,787 fresh embryo transfer cycles, 9050 freeze-all cycles, and 17,676 frozen-thawed embryo transfer (FET) cycles during 2014–2018. We calculated the daily average concentrations of six criteria air pollutants (PM 2.5 , PM 10 , O 3 , NO 2 , CO, and SO 2 ) during different exposure windows in IVF treatment timeline using data from the air monitoring station nearest to the residential site as approximate individual exposure. Generalized estimation equation models were used to assess the association between air pollution exposure and IVF outcomes. Results Exposure to O 3 , NO 2 , and CO during most exposure windows in fresh embryo transfer cycles were correlated with lower possibilities of biochemical pregnancy, clinical pregnancy, and live birth. An inverse association of exposure to O 3 and SO 2 with pregnancy outcomes was observed in FET cycles. In addition, we found a significant association of exposure to air pollutants with a higher risk of ectopic pregnancy and lower oocyte yield. Conclusions Our study provided large-scale human evidence of the association between air pollution and adverse human reproductive outcomes in the population opting for IVF. Thus, exposure to air pollutants in the population opting for IVF should be limited to improve treatment outcomes.
关键词：Air pollution ; In vitro fertilization ; Pregnancy rate ; Live birth ; Ectopic pregnancy ; BMI body mass index ; COH controlled ovarian hyperstimulation ; FET frozen-thawed embryo transfer ; GnRH gonadotropin-releasing hormone ; hCG human chorionic gonadotropin ; IVF in vitro fertilization ; ICSI intracytoplasmic sperm injection ; OHSS ovarian hyperstimulation syndrome ; VIF variance inflation factor ; OR odds ratio ; CI confidence interval
