Effect of air quality on assisted human reproduction

Legro, Richard S.; Sauer, Mark V.; Mottla, Gilbert L.; Richter, Kevin S.; Li, Xian; Dodson, William C.; Liao, Duanping

doi:10.1093/humrep/deq021

Cited by 104 publications

(53 citation statements)

References 36 publications

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“…The influence of environmental factors on assisted reproductive technology (ART) results, and notably on IVF techniques, has been suspected for many years [33], but the specific effects of air pollution on IVF have been little studied in the literature [26]. In 7403 women undergoing their first IVF cycle, Legro et al assessed the effects of various air pollutants (SO 2 , NO 2 , O 3 , PM2.5 and PM10) along 4 different steps of the procedure: from the first day of ovarian stimulation to oocyte retrieval (T1); from oocyte retrieval to embryo transfer (T2); from embryo transfer to pregnancy test (T3) and from embryo transfer to pregnancy outcome (T4) [34]. They found negative impacts of a one standard deviation increase in NO 2 concentrations on live births in all stages of the IVF cycle except T4 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Altogether, the data from the 3 available human studies about air quality and IVF results provide a weak level of evidence because they consist in retrospective studies, with long observation periods (7 [34] to 10 years [35,36] during which effectiveness of IVF procedures may have improved), with approximated exposures based either on estimated levels from national models of air quality [34] or on average daily exposure of an entire city [35,36], without accounting for the exact home address [35,36] or its distance from the nearest monitoring station [34] or with residual confounding from tobacco exposure [34]. Furthermore, the results of these studies are discordant regarding PM10, the only air pollutant commonly evaluated by these studies.…”

Section: Resultsmentioning

confidence: 99%

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Does air pollution play a role in infertility?: a systematic review

et al. 2017

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Background: Air pollution is involved in many pathologies. These pollutants act through several mechanisms that can affect numerous physiological functions, including reproduction: as endocrine disruptors or reactive oxygen species inducers, and through the formation of DNA adducts and/or epigenetic modifications. We conducted a systematic review of the published literature on the impact of air pollution on reproductive function. Eligible studies were selected from an electronic literature search from the PUBMED database from January 2000 to February 2016 and associated references in published studies. Search terms included (1) ovary or follicle or oocyte or testis or testicular or sperm or spermatozoa or fertility or infertility and (2) air quality or O 3 or NO 2 or PM2.5 or diesel or SO 2 or traffic or PM10 or air pollution or air pollutants. The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We have included the human and animal studies corresponding to the search terms and published in English. We have excluded articles whose results did not concern fertility or gamete function and those focused on cancer or allergy. We have also excluded genetic, auto-immune or iatrogenic causes of reduced reproduction function from our analysis. Finally, we have excluded animal data that does not concern mammals and studies based on results from in vitro culture. Data have been grouped according to the studied pollutants in order to synthetize their impact on fertility and the molecular pathways involved.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Does air pollution play a role in infertility?: a systematic review

et al. 2017

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“…Couple-based fecundability was assessed in Teplice, where pregnancy in the first month of unprotected intercourse was less likely when couples were exposed to higher levels of nitrogen dioxide (NO 2 ) and PM 2.5 (9). NO 2 was associated with lower live birth rates and PM 2.5 with decreased conception rates after in vitro fertilization (IVF),(10) whereas miscarriage rates appeared higher in couples exposed to the highest quartile of PM exposure prior to IVF or embryo transfer(11). In mice, traffic-related pollutant exposures decreased fertility with effects demonstrated for both males and females as well as mating pairs(12;13) and reductions in placental and fetal weight were observed among mice housed near roadways in Brazil(14).…”

Section: 0 Introductionmentioning

confidence: 99%

Proximity to major roadways and prospectively-measured time-to-pregnancy and infertility

Mendola

Sundaram

Louis

et al. 2017

Science of The Total Environment

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We aimed to study the potential impact of proximity to major roadways on time-to-pregnancy and infertility in couples attempting pregnancy in the Longitudinal Investigation of Fertility and Environment (LIFE) study (2005-2009), a population-based, prospective cohort study. Couples attempting pregnancy (n=500) were enrolled and followed prospectively until pregnancy or 12 months of trying and 393 couples (78%) had complete data and full follow-up. Time-to-pregnancy was based on a standard protocol using fertility monitors, tracking estrone-3-glucuonide and luteinizing hormone, and pregnancy test kits to detect human chorionic gonadotropin (hCG). The fecundability odds ratio (FOR) and 95% confidence interval (CI) were estimated using proportional odds models. Infertility was defined as 12 months of trying to conceive without an hCG pregnancy and the relative risk (RR) and 95% CI were estimated with log-binomial regression. Final models were adjusted for age, parity, study site, and salivary alpha-amylase, a stress marker. Infertile couples (53/393; 14%) tended to live closer to major roadways on average than fertile couples (689 m vs. 843 m, respectively) but the difference was not statistically significant. The likelihood of pregnancy was increased 3% for every 200 meters further away the couples residence was from a major roadway (FOR=1.03; CI=1.01-1.06). Infertility also appeared elevated at moderate distances compared to 1000 meters or greater, but estimates lacked precision. Our findings suggest that proximity to major roadways may be related to reductions in fecundity. Prospective data from larger populations is warranted to corroborate these findings.

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“…This is a challenge because of the variable nature of different VOCs in room air. Since indoor air quality is impacted by outdoor air, which varies regionally, the observation that air pollution affects fertility [30][31][32] provides further evidence for the importance of air filtration.…”

Section: Future Directionsmentioning

confidence: 99%

Air quality in the assisted reproduction laboratory: a mini-review

Morbeck

2015

J Assist Reprod Genet

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Quality of air in the clinical embryology laboratory is considered critical for high in vitro fertilization (IVF) success rates, yet evidence for best practices is lacking. Predominantly anecdotal reports on relationships between air quality and IVF success rates have resulted in minimal authentic clinical laboratory guidelines or in recommendations that are based on industrial cleanroom particulate standards with little attention to chemical air filtration. As a result, a nascent industry of costly, specialized air handling equipment for IVF laboratories has emerged to provide air quality solutions that have not been clearly assessed or verified. Clinics are embracing such technology because their embryology laboratories have become epicenters of assisted reproductive technology as the practice of IVF has moved to blastocyst transfers and utilization of trophectoderm biopsy for preimplantation genetic testing (PGT). Thus, a laboratory's ability to culture, biopsy, and freeze blastocysts is a rate-limiting step that depends on technical proficiency and a supportive and stable culture environment based on a foundation of high-quality ambient air. This review aims to describe how evidence for the importance of air quality, in particular the role of volatile organic compounds (VOC), has resulted in an evolution of clinical practice that has arguably contributed to improved outcomes.

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Effect of air quality on assisted human reproduction

Abstract: The effects of declining air quality on reproductive outcomes after IVF are variable, cycle-dependent and complex, though increased NO(2) is consistently associated with lower live birth rates. Our findings are limited by the lack of direct measure of pollutants at homes and lab sites.

Cited by 104 publications

References 36 publications

Does air pollution play a role in infertility?: a systematic review

Does air pollution play a role in infertility?: a systematic review

Proximity to major roadways and prospectively-measured time-to-pregnancy and infertility

Air quality in the assisted reproduction laboratory: a mini-review

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