Objective

To study the association between ambient air pollutant exposure during the follicular phase and in vitro fertilization (IVF) outcomes.

Design

A single-center retrospective analysis.

Setting

Henan Province, China.

Patients

Patients (n = 6659) living in Zhengzhou, Henan Province in central China who underwent their first IVF cycle at the First Affiliated Hospital of Zhengzhou University between 2013 and 2019 were included for analysis.

Intervention

None.

Main outcome measure

The relationships between PM_2.5, PM₁₀, and AQI (Air Quality Index) with IVF outcomes during the follicular phase (period I, 85 days before oocyte retrieval; period II, gonadotrophin start to oocyte retrieval).

Results

Compared with the bottom tertile, exposure to the top PM_2.5 and PM₁₀ tertiles during period I was associated with decreased clinical pregnancy (PM_2.5: adjusted odds ratio [OR], 0.838%, and 95% confidence interval [CI], 0.723 and 0.971; PM₁₀: adjusted OR, 0.818%, and 95% CI, 0.705 and 0.950), and decreased live birth rate (PM_2.5: adjusted odds ratio [OR], 0.852%, and 95% confidence interval [CI], 0.736 and 0.987; PM₁₀: adjusted OR, 0.850%, and 95% CI, 0.733 and 0.986), and exposure to the top PM_2.5 tertile during period II adversely affected clinical pregnancy and the live birth rate (adjusted OR, 0.824%, and 95% CI, 0.711 and 0.955; adjusted OR, 0.817%, and 95% CI, 0.706 and 0.945). Compared with the bottom PM₁₀ tertile, exposure to the middle PM₁₀ tertile in period II showed decreased clinical pregnancies and live births (adjusted OR, 0.844; 95% CI, 0.729 and 0.978, adjusted OR, 0.846; 95% CI, 0.731 and 0.979). The PM₁₀ level during period II of the follicular phase tend to adversely affect live birth rate, but the tendency did not reach significance (P = 0.051).

Conclusion

Exposure to PM_2.5 and PM₁₀ before oocyte retrieval has an adverse effect on IVF outcomes.

Capsule

Exposure to PM_2.5 and PM₁₀ before oocyte retrieval has an adverse effect on IVF outcomes.