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首页> 外文会议>Joint annual meeting of the International Society of Exposure Science and the International Society for Environmental Epidemiology >Effect Modification of the Association between Ambient Air Pollution Exposure and Fecundity by Infertility Type among Women Undergoing In Vitro Fertilization
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Effect Modification of the Association between Ambient Air Pollution Exposure and Fecundity by Infertility Type among Women Undergoing In Vitro Fertilization

机译：体外受精妇女环境空气暴露量与不孕类型生殖力关联的影响

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Mounting evidence indicates air pollution (AP) is adversely associated with birth outcomes, but few studies characterize the association with fecundity. We evaluated the association between long-term ambient AP and outcomes in women undergoing in vitro fertilization (IVF). This study takes advantage the known date of pregnancy attempt in IVF and investigates if type of infertility acts as a modifier of the AP-live birth association. Clinical data on women initiating their 1st autologous IVF cycle in 2012-13 were obtained from four US clinics. Annual average exposure prior to IVF start were estimated at residential address using a national spatial model that used land use regression and universal kriging to estimate particulate matter <2.5 (PM2.5), PM10, and nitrogen dioxide (NO2). Modified Poisson regression was used to measure the association between AP and fertilization, pregnancy, pregnancy loss, and live birth. Additive effect modification (EM) of AP and live birth by type of infertility (diminished ovarian reserve (DOR), male, ovulation, tubal) was evaluated using relative excess risk due to interaction (RERI). Higher exposure to PM2.5, by IQR-unit, was associated with a lower likelihood of live birth (RR:0.96, 95%CI:0.90-1.02) and higher likelihood of pregnancy loss (RR.1.09, 9S%CI: 0.93-1.26). Results were similar for PM10 and NO2. RERI analysis resulted in negative values, indicating lower likelihood of live birth with EM on an additive scale comparing high AP and DOR (PM2.5,PM10,NO$2all p<0.01) or high AP and male infertility (PM2.5,PM10,NO2, all p<0.001) with low AP and no DOR or male factor, respectively. Despite suggestive but uncertain findings for the association between AP and IVF outcomes, we found an indication of synergistic effects of AP and DOR or male infertility on the likelihood of live birth in women undergoing IVF. This suggests that DOR and male infertility should be further explored in future research evaluating effect of AP on fecundity.
机译：越来越多的证据表明，空气污染（AP）与出生结局成反比，但很少有研究将其与生育力相关联。我们评估了长期体外受精与体外受精（IVF）妇女结局之间的关系。这项研究利用了IVF中已知的怀孕尝试日期，并研究了不孕类型是否是AP活产相关性的修正。从2012年美国的四家诊所获得了有关女性在2012-13年开始其第一个自体试管婴儿周期的临床数据。在IVF开始之前，在居民住址使用国家空间模型估算了IVF的年平均暴露量，该模型使用土地利用回归和通用克里金法来估算<2.5（PM2.5），PM10和二氧化氮（NO2）的颗粒物。修正的Poisson回归用于测量AP与受精，妊娠，流产和活产之间的关联。使用由于交互作用引起的相对过高风险（RERI）评估了不孕症类型的AP和活产的加和效应修饰（EM）（卵巢储备减少（DOR），雄性，排卵，输卵管）。以IQR为单位的PM2.5暴露量越高，活产的可能性就越低（RR：0.96，95％CI：0.90-1.02）和妊娠流产的可能性就越高（RR.1.09，9S％CI：0.93）。 -1.26）。 PM10和NO2的结果相似。 RERI分析得出负值，表明与高AP和DOR（PM2.5，PM10，NO $ 2all p <0.01）或高AP和男性不育症（PM2.5，PM10）相比，EM活产的可能性较低，NO2，所有p <0.001）分别具有低AP和无DOR或雄性因子。尽管提示AP和IVF结果之间存在关联，但提示性但不确定，但我们发现AP和DOR或男性不育对接受IVF的妇女活产的可能性具有协同作用。这表明在未来评估AP对生殖力影响的研究中应进一步探讨DOR和男性不育。

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