Exposure to Fine Particulate Matter and Ovarian Reserve Among Women from a Fertility Clinic

Background: An increasing number of studies have linked air pollution to decreased fertility. Whether this is due to an effect on ovarian reserve is unknown. Method: Our study included 632 women attending the Massachusetts General Hospital Fertility Center (2004-2015) who had a measured antral follicle count. Validated spatiotemporal models estimated daily particulate matter <2.5 mu g/m(3) (PM2.5) (based on residential address) for the 3 months before the antral follicle count. We analyzed associations with Poisson regression. Results: Every 2 mu g/m(3) increase in estimated PM 2.5 exposure was associated with a -7.2% (95% confidence interval = -10.4%, -3.8%) lower antral follicle count adjusting for age, body mass index, smoking status, and year and season of the count. The association of PM2.5 with antral follicle count was stronger among women with female factor infertility (-16.3% per 2 mu g/m(3)). Conclusions: Among women from an infertility clinic, higher PM2.5 exposure was associated with lower ovarian reserve, raising concern that air pollution may accelerate reproductive aging.