Work

Maternal exposure to fine particulate matter and pregnancy outcomes in women undergoing in vitro fertilization: A multicenter retrospective study

Year: 2025

Type: article

Abstract: Few large-scale studies have systematically examined the effects of maternal exposure to fine particulate matter (PM 2.5 ) on live birth in women undergoing in vitro fertilization (IVF). This study aimed to investigate the associations between ambient PM 2.5 and live birth in women treated with IVF, and determine critical periods, key failure events, and vulnerable populations affected by such exposure. We included 58,637 patients from six reproductive centers in China between 2016 and 2021. We defined six exposure windows and adopted logistic regression with random-effect models to investigate the associations between PM 2.5 exposure and live birth. We further categorized live birth failure as implantation failure, biochemical pregnancy loss, and miscarriage, to determine at which stage PM 2.5 exposure caused the live birth failure. Subgroup analyses were conducted by female age, ovarian response, embryo quality, and transplantation protocol. For each 10 μg/m 3 increase in PM 2.5 concentration during follicle growth phase, preantral-antral follicle phase, and antral-mature follicle phase, the odds ratios for live birth were 0.966 [95% confidence interval (CI): 0.938, 0.995], 0.967 (0.939, 0.996), and 0.978 (0.958, 0.998), respectively. PM 2.5 during these stages was significantly associated only with an increased likelihood of implantation failure, highlighting adverse impact of ambient PM 2.5 on early pregnancy outcome. In addition, we observed relatively stronger associations in women with poor ovarian response, compromised embryo quality, and those undergoing fresh or double embryo transfers. This large-scale population-based study demonstrated the detrimental effects of high PM 2.5 exposure for IVF women, shedding light on clinical and public health practices. • Maternal high PM 2.5 exposure in follicular growth stages were significantly associated with decreased live birth. • The PM 2.5 -associated live birth failures primarily arise in the early pregnancy stages. • Women with poor ovarian response, diminished embryo quality, undergoing fresh or double embryo transfers may be more sensitive to PM 2.5 exposure.

Source: Eco-Environment & Health

DOI: 10.1016/j.eehl.2025.100192