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Abstract

Air pollution is a current research priority because of its adverse effects on human health, including on fertility. However, the mechanisms through which air pollution impairs fertility remain unclear. In this article, we perform a systematic review to evaluate currently available evidence on the impact of air pollution on fertility in humans. Several studies have assessed the impact of air pollutants on the general population, and have found reduced fertility rates and increased risk of miscarriage. In subfertile patients, women exposed to higher concentrations of air pollutants while undergoing IVF showed lower live birth rates and higher rates of miscarriage. After exposure to similar levels of air pollutants, comparable results have been found regardless of the mode of conception (IVF versus spontaneous conception), suggesting that infertile women are not more susceptible to the effects of pollutants than the general population. In addition, previous studies have not observed impaired embryo quality after exposure to air pollution, although evidence for this question is sparse.

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... Recent reviews of the literature regarding the associations of ambient air pollution with fertility and pregnancy loss have addressed important issues for epidemiology, including the synthesis of key results in human [1][2][3] and animal studies [4][5][6], the comparison of fertility in the general population, and those attempting to conceive through assisted reproductive technology (ART) [1,2,5,6], considerations of biological mechanisms [4,6], and the assessment of the relevant timing of exposure for these outcomes [3,4]. These reviews highlight the associations that have been found between the criteria air pollutants identified by the U.S. Environmental Protection Agency (EPA), including ground-level ozone (O 3 ), particulate matter (PM), carbon monoxide (CO), sulfur dioxide (SO 2 ), nitrogen oxides (NO x ), and lead (Pb) [7], and fertility and pregnancy loss. ...
... Recent reviews of the literature regarding the associations of ambient air pollution with fertility and pregnancy loss have addressed important issues for epidemiology, including the synthesis of key results in human [1][2][3] and animal studies [4][5][6], the comparison of fertility in the general population, and those attempting to conceive through assisted reproductive technology (ART) [1,2,5,6], considerations of biological mechanisms [4,6], and the assessment of the relevant timing of exposure for these outcomes [3,4]. These reviews highlight the associations that have been found between the criteria air pollutants identified by the U.S. Environmental Protection Agency (EPA), including ground-level ozone (O 3 ), particulate matter (PM), carbon monoxide (CO), sulfur dioxide (SO 2 ), nitrogen oxides (NO x ), and lead (Pb) [7], and fertility and pregnancy loss. ...
... In this systematic review, we aim to summarize and compare the results from studies on criteria air pollutants and spontaneous fertility and pregnancy loss in humans within and across distinct exposure assessment techniques and recommend air pollution exposure assessment methods for future research in this subject area. Here, we consider eight commonly used approaches to air pollution exposure assessment: (1) proximity models, (2) surface monitor data, ...
Article
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Purpose of Review We reviewed the exposure assessments of ambient air pollution used in studies of fertility, fecundability, and pregnancy loss. Recent Findings Comprehensive literature searches were performed in the PUBMED, Web of Science, and Scopus databases. Of 168 total studies, 45 met the eligibility criteria and were included in the review. We find that 69% of fertility and pregnancy loss studies have used one-dimensional proximity models or surface monitor data, while only 35% have used the improved models, such as land-use regression models (4%), dispersion/chemical transport models (11%), or fusion models (20%). No published studies have used personal air monitors. Summary While air pollution exposure models have vastly improved over the past decade from a simple, one-dimensional distance or air monitor data to models that incorporate physiochemical properties leading to better predictive accuracy, precision, and increased spatiotemporal variability and resolution, the fertility literature has yet to fully incorporate these new methods. We provide descriptions of each of these air pollution exposure models and assess the strengths and limitations of each model, while summarizing the findings of the literature on ambient air pollution and fertility that apply each method.
... The maximum level concentration was measured to be about 1 mg/m 3 . Further, NO 2 gas, which is also considered to be one of the most dangerous pollutants in atmosphere, as noted by Checa et al., had its bad effects (Checa Vizcaíno et al., 2016;Er, 2002). Inhaling a high concentration of NO 2 leads to increase in pharyngeal irritation and causes respiratory diseases such as inflammation in lungs and edema. ...
... NO 2 reacts with OH molecules to form nitric acid which causes considerable health and environmental imbalances (Cariolle et al., 2008). Exposure to high concentrations of NO 2 has been stated to increase the probability of miscarriage in pregnant women (Checa Vizcaíno et al., 2016;Pintarić et al., 2012). Inhalation of SO 2 gas also causes respiratory infections and sometimes suffocation, while long time exposure can cause severe asthma and lung damages (Jarraud and Chung, 2008). ...
... Inhalation of SO 2 gas also causes respiratory infections and sometimes suffocation, while long time exposure can cause severe asthma and lung damages (Jarraud and Chung, 2008). Industrial processes such as smelting of sulphur ores release sulphur oxides into atmosphere (Checa Vizcaíno et al., 2016;Güneş, 2005). Incomplete combustion of fossil fuels releases CO and CO 2 . ...
Article
In 2017, during spring and summer, the concentration of sulphur dioxide (SO 2), nitrogen dioxide (NO 2), carbon monoxide (CO) and particulate matter 2.5 (PM 2.5) were monitored over a period of 6 months in Kodungaiyur, Chennai, India and compared with the National Ambient Air Quality standard (NAAQS) of India. The maximum mean daily concentration values of NO 2 , SO 2 , CO and PM 2.5 were found to be 66 μg/m 3 , 96 μg/m 3 , 180 μg/m 3 and 425 μg/m 3 respectively. In this work, a survey of the diseases onset in the locality Kodungaiyur was conducted to bring out the effects mainly due to PM 2.5 on human beings. The diseases surveyed include mostly allergic complications in the lungs, eye and ENT. The results showed associations between pollution exposure and increased percentage of infection in the age group from 21 to 30 years, with a confidence level of 95%.
... The effects of long-term exposure to air pollution on fertility [21][22][23][24][25] and perinatal outcomes [26][27][28][29][30][31][32] are also well documented. However, there is some controversy in the published literature regarding the effect of shortterm exposure to air pollutants, and what phases during the reproductive process are women most vulnerable to this exposure. ...
... * Models adjusted by co-pollutants and subacute exposure. Results expressed in odds ratio (95% condifence interval) There is epidemiological evidence to suggest that longterm exposure to air pollution has a deleterious effect on reproductive life [21][22][23] and perinatal outcomes [26][27][28][29][30][31][32]. There is also some evidence among women undergoing IVF to suggest that short-term exposure could impair reproductive outcomes [23]. ...
... Results expressed in odds ratio (95% condifence interval) There is epidemiological evidence to suggest that longterm exposure to air pollution has a deleterious effect on reproductive life [21][22][23] and perinatal outcomes [26][27][28][29][30][31][32]. There is also some evidence among women undergoing IVF to suggest that short-term exposure could impair reproductive outcomes [23]. Results from this study support the findings described in previous retrospective trials that have addressed this issue [21,22,[33][34][35]53]. ...
Article
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Background There is evidence to suggest that long term exposure to air pollution could be associated with decreased levels of fertility, although there is controversy as to how short term exposure may compromise fertility in IVF patients and what windows of exposure during the IVF process patients could be most vulnerable. Methods This prospective cohort study aimed to evaluate the impact of acute exposure that air pollution have on reproductive outcomes in different moments of the IVF process. Women undergoing IVF living in Barcelona were recruited. Individual air pollution exposures were modelled at their home address 15 and 3 days before embryo transfer (15D and 3D, respectively), the same day of transfer (D0), and 7 days after (D7). The pollutants modelled were: PM2.5 [particulate matter (PM) ≤2.5 μm], PMcoarse (PM between 2.5 and 10μm), PM10 (PM≤10 μm), PM2.5 abs, and NO2 and NOx. Outcomes were analyzed using multi-level regression models, with adjustment for co-pollutants and confouding factors. Two sensitivity analyses were performed. First, the model was adjusted for subacute exposure (received 15 days before ET). The second analysis was based on the first transfer performed on each patient aiming to exclude patients who failed previous transfers. Results One hundred ninety-four women were recruited, contributing with data for 486 embryo transfers. Acute and subacute exposure to PMs showed a tendency in increasing miscarriage rate and reducing clinical pregnancy rate, although results were not statistically significant. The first sensitivity analysis, showed a significant risk of miscarriage for PM2.5 exposure on 3D after adjusting for subacute exposure, and an increased risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 on 3D. The second sensitivity analysis showed a significant risk of miscarriage for PM2.5 exposure on 3D, and a significant risk of achieving no pregnancy for PM2.5, PMcoarse and PM10 particularly on 3D. No association was observed for nitrogen dioxides on reproductive outcomes. Conclusions Exposure to particulate matter has a negative impact on reproductive outcomes in IVF patients. Subacute exposure seems to increase the harmful effect of the acute exposure on miscarriage and pregnancy rates. Nitrogen dioxides do not modify significantly the reproductive success.
... Toxic air pollutants pose different risks to health depending on the specific pollutant [18]. Cancers of the lung, kidney, and stomach, as well as damage to the central nervous system, birth defects, lung disorders, and impaired fertility, are all life-threatening conditions induced by toxic pollutants [18][19][20][21][22][23][24][25]. ...
... Many pollutants that enter the respiratory system through inhalation and causes respiratory and cardiovascular disorders [26], reproductive and central nervous system dysfunctions [22,25], and cancer [18][19][20], is one of them. Air pollutants that are detrimental to humans include nitrogen oxide [27], sulphur dioxide [28], volatile organic compounds [29], and polycyclic aromatic hydrocarbons [30]. ...
... Epidemiological studies have shown a direct correlation between decreased lung function, cardiovascular disease, increased hospital admissions, mortality and concentrations of pollutants in the air (Kelly, 2003). One of the most disquieting outcomes of air pollution is the negative impact on pregnant women, newborns and children, considered more vulnerable (Vizcaíno et al., 2016;Mannucci and Franchini, 2017). Numerous studies show that exposure to polluted air may cause miscarriages, reduce women's fertility, or trigger health problems in newborns due to mother transmission of pollutants (Vizcaíno et al., 2016). ...
... One of the most disquieting outcomes of air pollution is the negative impact on pregnant women, newborns and children, considered more vulnerable (Vizcaíno et al., 2016;Mannucci and Franchini, 2017). Numerous studies show that exposure to polluted air may cause miscarriages, reduce women's fertility, or trigger health problems in newborns due to mother transmission of pollutants (Vizcaíno et al., 2016). The respiratory system is also heavily affected. ...
Article
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Abstract:Air is necessary for human survival and the preservation of the environment. The scientific community is concerned about the ongoing rapid expansion of the population, which uses resources faster, and thus the accumulation of an enormous amount of waste will gradually worsen the air quality. The change in the pollutants released in the atmosphere became more complex throughout human history, and they were released in huge quantities. The sources of air pollution vary greatly – from burning fuel, the household, agricultural or mining activities to natural disasters or significant industrial accidents. New techniques that monitor the air composition are being developed to ensure air quality control. The population exposed to these harmful compounds is predisposed to various health concerns, including skin, cardiovascular, brain, blood, and lung illnesses. The substances also contribute to global warming, acid rains and ozone depletion. During the COVID-19 pandemic, it was noticed that reducing human activities causing pollution leads to improved air quality, which shows that long-term solutions can also be found. This paper aims to offer an overview of the air pollution problems persisting around the globe and present the current state, causes and evolution of air pollution. Some of the solutions we propose in this article include energy-saving, public transportation and material recycling. We also emphasize the need to develop new technologies to control the air quality and implement a sustainable approach.
... Toxic air pollutants pose different risks to health depending on the specific pollutant [18]. Cancers of the lung, kidney, and stomach, as well as damage to the central nervous system, birth defects, lung disorders, and impaired fertility, are all life-threatening conditions induced by toxic pollutants [18][19][20][21][22][23][24][25]. ...
... Many pollutants that enter the respiratory system through inhalation and causes respiratory and cardiovascular disorders [26], reproductive and central nervous system dysfunctions [22,25], and cancer [18][19][20], is one of them. Air pollutants that are detrimental to humans include nitrogen oxide [27], sulphur dioxide [28], volatile organic compounds [29], and polycyclic aromatic hydrocarbons [30]. ...
Article
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Current study delineates the synthesis and environmental applications of ZnO/CuO nanocomposite in photocatalysis and gas sensing. The ZnO/CuO nanocomposites (1:1, 1:2, and 2:1) were synthesized by a cost-effective and simple co-precipitation method. X-ray diffraction and high-resolution transmission electron microscopy investigation confirms the monoclinic crystal phase for the CuO and hexagonal wurtzite for ZnO in ZnO/CuO nanocomposites. The Raman spectroscopic analysis also revealed the monoclinic crystal phase for the CuO with C2h space group. The morphological features were explored by scanning electron microscopy. The successful synthesis of the ZnO/CuO nanocomposites with their very stable + II oxidation state is revealed by the X-ray photoelectron spectroscopy investigation. Optical properties and band gap measurements were explored by ultra-violet diffuse reflectance spectroscopy and the synthesized ZnO/CuO nanocomposite (1:1) was found to exhibit the direct band gap of 2.34 eV. The photocatalytic degradation by ZnO/CuO nanocomposite (1:1) was studied for the degradation of crystal violet (CV) dye. Nearly 90% photocatalytic degradation of CV dye was accomplished using this photocatalyst. The parameters like effect of pH, contact time, catalyst dose, kinetic study and scavenging study were investigated in the present study. The photocatalytic degradation products were analyzed by LC–MS analysis and fragmentation pathway has been depicted. Besides, the synthesized ZnO/CuO nanocomposites (1:1, 1:2, and 2:1) were studied as gas sensor for monitoring gases like LPG, ethanol, ammonia and NO2. ZnO/CuO nanocomposite was proved to be efficient ethanol gas sensor as compared to other tested gases. Graphical Abstract
... 14,15 Fine-particulate air pollutants can considerably affect the reproductive health of women via the sex hormone axis and cause symptoms, such as ovarian failure, endometriosis, dysregulated menstruation and reduced fertility and pregnancy viability. [16][17][18][19] Because PMS may also be associated with sex hormone axis dysregulation, 20 investigating the direct association between air pollutant concentrations and PMS is critical. ...
... 27 Kirk et al. 28 reported that xenoestrogens inhibit sulfotransferases and Ca 2þ -ATPases, resulting in increased concentrations of active estrogen levels and possible cytotoxic effects of elevated intracellular Ca 2þ concentrations. Furthermore, even at extremely low doses, estrogenic compounds can contribute to the pathophysiology of breast cancer, 29 endometriosis, 30 dysregulated menstrual cycle, 31,32 premature ovarian failure 19 and polycystic ovary syndrome. 33 Therefore, xenoestrogen-containing air pollutants may antagonize the production of progesterone 34 and disrupt the balance between estrogen and progesterone, resulting in the manifestations of the PMS symptoms. ...
Article
Objective: Air pollution had been reported to be associated with the reproductive health of women. However, the association of particulate matter (PM) and acid gases air pollution with premenstrual syndrome (PMS) warrants investigation. This study investigated the effects of air pollution on PMS risk. Population: We combined data from the Taiwan Air Quality-Monitoring Database (TAQMD) and the Longitudinal Health Insurance Database. In total, an observational cohort of 85078 Taiwanese women not diagnosed as having PMS. Methods: Air pollutant concentrations were grouped into four levels based on the concentration quartiles of several types of air pollutants.Main Outcome Measures: We then applied univariable and multivariable Cox proportional hazard regression models to assess PMS risk in association with each pollutant type. Results: Women exposed to Q4-level SO2 exhibited a 7.77 times higher PMS risk compared with those to Q1-level SO2 (95% confidence interval [CI] = 6.22-9.71). Women exposed to Q4-level NOx exhibited a 2.86 times higher PMS risk compared with those exposed to Q1-level NOx (95% CI = 2.39-3.43). Women exposed to Q4-level NO exhibited a 3.17 times higher PMS risk compared with women exposed to Q1-level NO (95% CI = 2.68-3.75). Finally, women exposed to Q4-level PM with a ≤ 2.5-µm diameter (PM2.5) exhibited a 3.41 times higher PMS risk compared with those exposed to Q1-level PM2.5 (95% CI = 2.88-4.04). Conclusions: High incidences of PMS were noted in women who lived in areas with higher concentrations of SO2, NOx, NO, NO2, and PM2.5.
... Biology literature documents several mechanisms through which air pollution can contribute to high rates of high-risk pregnancy, including oxidative stress to the developing fetus, maternal endocrine disruption, and systematic maternal inflammation prompting placentation and growth abnormalities (Leiser et al., 2019). Approximately 50% of early pregnancy spontaneous losses occur because of non-chromosomal abnormalities (Møller & Loft, 2010), and maternal exposure to combustion particles is associated with oxidative damage of deoxyribonucleic acid (DNA) and lipids (Vizcaíno et al., 2016), which can be harmful to a growing fetus. Vrijheid et al. (2010) assert that exposure to air pollution inhibits embryo implantation, which is a risk factor for pregnancy loss. ...
Preprint
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We examine the effect of air pollution clean-up measures on reducing pregnancy risks in China. Using policy-driven variations across provinces and over time, we undertake a natural experiment that examines the effect of mandated Flue Gas Desulfurization (FGD) installation in Chinese power plants. Matching our novel measure of FGD intensity with province-level administrative data spanning the period 2002-2011, our estimates indicate that desulfurizing a power plant with a capacity of 10,000 megawatts decreases high-risk pregnancy for at least 177 mothers in every 10,000 cases. On the potential mechanism, we find that this desulfurization intervention decreases both prenatal and postnatal medical examinations because there is a decrease in the incidence of gynecological diseases. Our results are robust to a wide array of randomization tests, restrictive specifications, omitted variable biases, and to falsification and placebo tests. From a policy perspective, we estimate that the adoption of FGD in China saves approximately 83,405 mothers from high-risk pregnancy in a five-year period. JEL Classification: I12, I18, O13, Q53
... DSÖ'ye göre 2016 yılında dünya nüfusunun % 91'i DSÖ'nün Hava Kalitesi Kılavuzlarının karşılanmadığı yerlerde yaşamaktadır (7). Hava kirliliğinin hastane acil servis başvurularını artırdığı ve kardiyovasküler hastalıklar, solunum yolu enfeksiyonları, astım ve allerjik semptomları ile ilişkili olduğu bir çok çalışmada bildirilmektedir (8)(9)(10). Bazı çalışmalar ise hava kirliliği ile infertilite arasındaki ilişkiyi ortaya koymaktadır (11). ...
Conference Paper
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Amaç: Bu çalışmanın amacı Şanlıurfa’da 2010-2019 yılları arası PM10 ve SO2 değerlerini değerlendirmektir. Yöntem: Şanlıurfa’da 2010-2019 yılları arasında SO2 ve PM10 konsantrasyonlarını Ulusal Hava Kalite İzleme Ağından elde edildi. 24 saatlik ortalama PM10 ve SO2 konsantrasyonlarını yıllık, sezonluk, aylık olarak karşılaştırıldı. Bulgular: SO2 için yönetmelikçe belirlenen 20 μg/m3 sınır değeri 2018 ve 2019 yıllarında sırasıyla 34.82 μg/m3 ve 39.16 μg/m3 olarak aşılmıştır. 2010-2019 yılları arasında SO2 değerleri istatistiksel olarak anlamlı farklılık bulunmuştur. Yıllar içerisinde değişiklik gösteren SO2 değerleri özellikle 2018 ve 2019 yıllarında önemli düzeyde artmıştır. PM10 sınır değeri (40 μg/m3) 2010-2019 yılları arası 2016 yılı dışında aşılmıştır. 2010-2019 yılları arasında PM10 değerleri istatistiksel olarak anlamlı farklılık bulunmuştur. PM10 değerleri 2010-2019’da tüm yıllarda kış sezonlarında yaz sezonlarına göre istatistiksel olarak anlamlı düzeyde yüksekti. SO2 değerleri ise 2012 yılı dışında 2010-2019 yıllarında kış sezonlarında yaz sezonlarına göre istatistiksel olarak anlamlı düzeyde yüksekti. PM10 değerleri en yüksek olarak sırasıyla Ocak ayında 94.72 μg/m3; Aralık ayında 93.25 μg/m3; Şubat ayında 78.70 μg/m3; SO2 değerleri ise en yüksek olarak sırasıyla Aralık ayında 39.17 μg/m3; Ocak ayında 35.33 μg/m3; Şubat ayında 27.15 μg/m3 gözlendi. Sonuç: PM10 değerleri 2016 yılı dışında 2010-2019 yılları arasında 40 μg/m3 sınır değerini aşmıştır. SO2 değerlerinin 2018 öncesinde sınır değeri aşmadığı ancak 2018 ve 2019 yılında aştığı bulundu. PM10 ve SO2 değerleri kış ayları boyunca yaz aylarına göre daha yüksektir. Anahtar kelimeler: Hava Kirliliği, PM10, SO2, Şanlıurfa
... Several studies have shown that air pollution has a variety of negative effects on human health, such as cardiovascular diseases [2,3], respiratory diseases [4,5], type 2 diabetes mellitus [6], mental disease [7,8], and so on. In recent years, more evidences showed that there was a correlation between ambient air pollution and human reproductive outcomes, such as infertility, preeclampsia, miscarriage and preterm delivery [9,10]. ...
Preprint
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Background Globally, air pollution has a significant impact on human health. However, the effects of air pollution on pregnancy outcomes in patients undergoing in vitro fertilization (IVF) have not been fully understood. In this study, we analyzed the effects of air pollution on IVF pregnancy outcomes in Taiyuan, which is a heavy polluted city in northern China. Methods 516 patients who underwent first fresh IVF cycle were enrolled in the retrospective study from January 1, 2015 to May 31, 2020. We collected medical record data from the electronic medical record system and daily average air pollution data from air quality monitoring station. Logistic regression was used to analyze the relationship between six atmospheric pollutants (PM2.5, PM10, O3, NO2, SO2, CO) and air quality index (AQI) and IVF pregnancy outcomes (biochemical pregnancy and clinical pregnancy) in different exposure periods. Results The results indicated that exposure to NO2 was negatively associated with the odds of biochemical pregnancy and clinical pregnancy, whereas exposure to O3 presented positive association. Furthermore, we also found that AQI was negatively associated with IVF pregnancy outcomes. Conclusions Our findings suggested that exposure to ambient air pollution during any period may have an impact on IVF pregnancy outcomes, and poor air quality is more likely to reduce clinical pregnancy rates.
... More generally, our state-level estimates reflect the robust evidence that exposure to air pollution affects all systems in the human body, including prenatal development, neurological function, cardiovascular health, respiratory function, mental health, and geriatric health [1,3,20,116,[152][153][154]. Additionally, the distribution of the health burden across the population in our study (Figure 4), rather than just in "sensitive groups" (e.g., the elderly, young, and those with underlying health conditions), supports a growing consensus that there are no "insensitive groups" [4, 116,155,156]. ...
Article
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Air pollution causes more damage to health and economy than previously understood, contributing to approximately one in six deaths globally. However, pollution reduction policies remain controversial even when proven e�ective and cost negative, partially because of misunderstanding and growing mistrust in science. We used an expert assessment to bridge these research–policy divides in the State of Utah, USA, combining quantitative estimates from 23 local researchers and specialists on the human health and economic costs of air pollution. Experts estimated that air pollution in Utah causes 2480 to 8000 premature deaths annually (90% confidence interval) and decreases the median life expectancy by 1.1 to 3.6 years. Economic costs of air pollution in Utah totaled $0.75 to $3.3 billion annually, up to 1.7% of the state’s gross domestic product. Though these results were generally in line with available estimates from downscaled national studies, they were met with surprise in the state legislature, where there had been an almost complete absence of quantitative health and economic cost estimates. We discuss the legislative and personal responses of Utah policy makers to these results and present a framework for increasing the assimilation of data into decision making via regional expert assessment. In conclusion, combining quantitative assessments from local experts is a responsive and cost-e�ective tool to increase trust and information uptake during time-sensitive policy windows.
... • Air pollution Air pollution has been associated with an adverse effect on various sperm parameters in the ART setting (250)(251)(252) and may even influence sperm sex ratio (253) and sperm aneuploidy (254). For women, various air pollutants adversely affect fertility treatment outcomes, including the probability of intrauterine pregnancy and live birth (255)(256)(257)(258). The results are evident even after short-term exposure (259,260). ...
Article
There is accumulating evidence demonstrating that positive lifestyle modification and the optimization of the preconceptual period can influence the reproductive potential for both men and women. However, a large percentage of couples attending fertility clinics with potential to improve preconception habits may not always receive appropriate preconceptual advice. Additionally, supplements and adjuncts that promise to increase fertility treatment success rates are marketed to infertile patients despite lack of convincing evidence supporting benefit. This review aims to identify possible associations between lifestyle factors for couples seeking fertility treatment and fertility treatment outcomes and to offer possible explanations of the biological basis of these associations. An electronic search was conducted from 1978 until July 2019 linking preconceptual behaviors for women and men with the outcome of fertility treatment. The literature search explored the importance of numerous factors including smoking, caffeine, alcohol, obesity, physical exercise, recreational drugs, stress, diet, supplements, alternative medicine, environmental factors and pollutants. Some associations were found to be more significant than others. The preconceptual period is undeniably a delicate and important window which should not be overlooked during fertility counseling. Simple lifestyle modifications could positively influence fertility treatment outcomes. Fertility teams, consisting of clinicians, fertility nurses, dieticians, psychologists, exercise advisors and others, should dedicate time to offer evidence-based preconceptual advice and targeted interventions to couples seeking fertility treatment.
... İnfertilite üzerinde etkili olan durumların fizyopatolojisi yeterince açıklanamamış olsa da hormonal bozukluklar, oksidatif stres indüksiyonu, hücre DNA'sı ve epigenetik değişikliklerin etkili olduğu düşünülmektedir 59 . Yine bir başka sistematik derlemede dokuz çalışma irdelenmiş, hava kirliliği ile doğurganlığın düşüşü arasında anlamlı bir ilişki olduğu saptanmıştır 60 . Kadın infertilitesi ve hava kirliliğini irdeleyen bir başka sistematik derlemede 11 çalışma inclenmiş ve IVF durumunda maruz kalınan NO ve O3'ün canlı doğum oranlarını olumsuz etkilediği, yüksek oranda PM10'a maruz kalmanın da IVF sonrası abortusa neden olabildiği belirtilmiştir 61 . ...
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Climate change is an important issue that concerns the entire world for nearly half a century. Recently, some changes in the climate system started to appear, such as increases and decreases in temperature, changes in precipitation, and severe weather events. These changes in the natural balance of the world show physiological and psychological effects on human health. Climate change affects human life in many dimensions such as air pollution, infectious diseases, an increase in the inability to provide clean water and food and vector-borne diseases. The health effects of climate change vary depending on both extent of change and the status of the overall health of the individual. However, some groups are more susceptible to the effects of climate change on health due to age (children and elders) and gender (women, especially pregnant women). Women who make up half the world population are considered as a vulnerable group to the effects of climate change. This review is written to draw attention to the effects of climate change on women's reproductive health. ÖZET İklim değişikliği, neredeyse yarım yüzyıldır tüm dünyayı ilgilendiren önemli bir sorundur. Bu süreçte, sıcaklıkta artış ve azalışlar, yağışlarda değişimler, şiddetli hava olaylarının artışı gibi iklim sisteminin özelliklerinde bir takım değişimler görülmeye başlanmıştır. Dünyanın doğal dengesinde yaşanan bu değişimler, insan sağlığı üzerinde fizyolojik ve psikolojik etki gösterir. İklim değişikliği, hava kirliliği, enfeksiyon hastalıklarında artış, temiz su ve besin temin edilememesi ve vektör kaynaklı hastalıklar gibi pek çok boyutta insan hayatına etki eder. İklim değişikliğinin sağlığa etkileri, hem değişikliğin boyutuna hem de bireyin genel sağlık durumuna bağlı olarak değişir. Ancak bazı gruplar, yaşları (çocuk-yaşlı) ve cinsiyeti (kadın, özellikle gebeler) gibi nedenlerle iklim değişikliğinin sağlık üzerindeki etkilerine karşı daha hassastır. Dünya nüfusunun yarısını oluşturan kadınların da iklim değişikliğinin etkilerine karşı hassas bir grup olduğu düşünülmektedir. Bu derleme, iklim değişikliğinin kadın üreme sağlığı üzerindeki etkilerine dikkat çekmek amacı ile yazılmıştır. Anahtar kelimeler: İklim değişikliği, üreme sağlığı, kadın Giriş İklim değişikliği, temel olarak, sera etkisi oluşturan gazların yoğunluğunun atmosferde artması nedeni ile yeryüzüne inen güneş ışınlarının tekrar atmosfere yansıtılamaması sonucu oluşur 1. İklim değişikliği, sıcaklıktaki artış ve azalışlar, yağışlardaki değişimler, şiddetli hava olaylarının artışı gibi iklim sisteminin özelliklerindeki değişiklikleri kapsar 2. Küresel iklim değişikliği, yaklaşık 50 yıldır dünya gündeminde yer alan ciddi bir sorundur 1. Hava olaylarında ve doğal dengede yaşanan değişimler, fizyolojik ve psikolojik olarak insan sağlığını farklı boyutlarda etkiler. Hava ve iklimin insan sağlığı üzerindeki etkileri çeşitli ve önemlidir. Her ne kadar insan sağlığı, iklim ve hava koşullarından etkilense de bu etki, iklim değişikliğinin yarattığı etki kadar büyük değildir. İklim değişikliğinin insan sağlığı ve hayatı üzerine etkileri oldukça geniştir. Örneğin, yaşanan aşırı hava olayları ve sel gibi doğal afetler, temiz su ve gıda ile güvenli barınak bulma imkânını azaltır. Vektör kaynaklı bulaşların artması, Batı Nil virüsü veya Lyme hastalığı gibi hastalıkların hem sıklığının hem de yaygınlığının artmasına yol açar. Ayrıca, küresel iklim değişikliği bireylerin sadece fiziksel sağlığını etkilemekle kalmaz ruh sağlığı üzerinde de değişimlere neden olur 2. İklim değişikliğinin sağlığa etkileri, yaşanan değişikliğin kapsamı, hızı
... This could be explained by the difficulties involved in studies on female gametogenesis, limiting the current evidence about the correlation between pollution and female fertility. In 2016, a systematic review summarised the association between elevated air pollution and diminished fertility outcomes in the exposed population, including also fertility and live birth rates (Checa Vizcaino et al., 2016). These results were recently confirmed in women attending IVF and suggested that nitrogen dioxide (NO 2 ) and ozone were associated with a reduced live birth rate while PM10 is associated with an increasing miscarriage rate (Conforti et al., 2018). ...
Article
Study question: Are there any associations between environmental pollutants and ovarian reserve, expressed by anti-Mullerian hormone (AMH) serum levels? Summary answer: In this first real-world approach to demonstrate the relationship between air pollutants and serum AMH levels, adverse associations were observed for nitrogen dioxide (NO2) but not with particulate matter. What is known already: In recent years, air pollution has emerged as a potential disrupter to the homeostasis of physiological hormones, possibly affecting human reproduction. Although the influence of age and smoking on AMH levels is largely accepted, the relationship between AMH and the environment has not currently been established. Study design, size, duration: A longitudinal, observational, retrospective, real-world study was carried out, including all AMH measurements performed in a single laboratory from January 2007 to October 2017. Participants/materials, setting, methods: Serum AMH data were connected to patients' age and residential address, to include air pollution data after geo-localisation. The air pollution considered daily particulate matter (PM) and NO2 values. Main results and the role of chance: A total of 1463 AMH measurements were collected (mean 1.94 ng/ml, median 0.90 ng/ml). AMH was inversely related to patients' age in women older than 25 years (adjusted R-squared 0.120, P < 0.001), but not in those younger than 25 years (adjusted R-squared 0.068, P = 0.055). AMH levels were inversely related to environmental pollutants, such as PM10 (Rho = -0.088, P = 0.001), PM2.5 (Rho = -0.062, P = 0.021) and NO2 (Rho = -0.111, P < 0.001). After subdividing the dataset into quartiles for PM10 and PM2.5, the influence of age on AMH serum levels was found to be a stronger influence than that exerted by PM (P = 0.833 and P = 0.370, respectively). On the contrary, considering NO2 quartiles, higher AMH levels were observed in third quartile compared to fourth quartile, even after adjustment for age (P = 0.028), indicating a stronger influence of NO2 exposure on AMH serum levels. Considering an AMH cut-off of 0.3 ng/ml, a significant higher frequency of women with severe ovarian reserve reduction in the fourth quartile was shown only for NO2 (P = 0.010). Limitations, reasons for caution: Several limitations should be underlined, such as the lack of information about work and life habits of each patient and the retrospective nature of the analysis performed on real-world data. Wider implications of the findings: Although the genetic component is highly predictive for defining the ovarian reserve at birth, potentially modifiable environmental factors could influence the rate of decline in AMH and ovarian reserve during adulthood. Study fundingcompeting interest(s): Authors have neither funding nor competing interests to declare. Trial registration number: N/A.
... In recent years, increasing environmental pollution owing to continuous industrialization and psychological stresses [1,2] have resulted in an increase in infertility issues worldwide. Infertility in men now accounts for approximately 50% of the fertility-related problems [3]. ...
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Background: Patients with severe oligospermia and nonobstructive azoospermia have very limited numbers of viable sperm in their epididymal and testicular samples. Thus, cryopreservation of their sperm is performed to avoid repeated sperm retrievals and to preserve their sperm from any side effects of any treatment regimens. Main body: The development of intracytoplasmic sperm injection technology has extended the therapeutic capacity of assisted reproductive technology for men with azoospermia via the surgical or percutaneous isolation of sperm from the testis/epididymis. The conventional cryopreservation techniques are inadequate for preserving individually selected sperm. The technique for freezing single sperm was first developed in 1997 and has been explored from the perspective of frozen carriers, freezing programs, and cryoprotectant formulations. Among these methods, advances in frozen carriers have directly improved single-sperm freezing technology. In this review, we evaluate the different technologies for the cryopreservation of single sperm by discussing the advantages and disadvantages of different freezing methods, their clinical applications, and the outcomes for a range of frozen carriers. Conclusion: Our review article describes the latest and current technologies implemented for the cryopreservation of single sperm that could potentially benefit patients with severe oligospermia and who rarely have any sperm in their ejaculate. This review provides a platform to understand the process and pitfalls of single-sperm cryopreservation to ensure further improvements in the cryopreservation technology in future studies.
... Air pollution represents one of the biggest environmental health risks affecting people around the world (Achilleos et al. 2017;Checa Vizcaíno et al. 2016;Moore et al. 2016;Requia et al. 2018). The WHO (2018) estimated that 58% of outdoor air pollution-related premature deaths were due to strokes and ischaemic heart disease, 18% due to chronic obstructive pulmonary disease and acute lower respiratory infections and 6% of deaths due to lung cancer in 2016. ...
Article
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Cycling is often promoted as a means of reducing vehicular congestion, greenhouse gases, noise and air pollutant emissions in urban areas. It is also endorsed as a healthy means of transportation in terms of reducing the risk of developing a range of physical and psychological conditions. However, people might not be aware of the negative health impacts of cycling near heavy traffic. This study aimed to compare personal exposure with particulate air pollution among cyclists commuting in Perth, Western Australia. The study involved 122 number of cyclists riding bicycles in four different routes: two routes within community areas (Route 1 and Route 2) and two routes near freeways (Route 3 and Route 4). The participants were males and females aged between 20 and 55 years with the selection criteria including non-smokers who cycle at least 150 km/week—ideally along one of the four study routes. Personal exposure of respirable particulate air pollution during cycling at the high and low level of exertions (self-perceived) were assessed. Ambient concentrations of selected air pollutants were also measured at each cycling route. We found that Route 3 appeared to be the most polluted route and concentrations of nitrogen dioxide and sulphur dioxide exceeded the Australian standards. This study concluded that personal exposure to respirable particles was influenced by the speed, time of cycling and seasonal variation.
... According to the World Health Organization, nine out of ten people breathe polluted air every day (WHO 2019). Obesity, physical inactivity, and pollution are important risk factors for the development of many chronic diseases, inducing morbidity and early mortality (Kampa and Castanas 2008;Burnett et al. 2014;Checa Vizcaíno et al. 2016;Pope et al. 2016). Worryingly, 91% of the world's population lives in places where air quality exceeds the WHO guideline limits. ...
Article
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Obesity and physical inactivity threats human health, otherwise exercise is able to solve both of them. However, the ventilation rate increases during exercise, leading to higher pollutants inhalation. Exposure to air pollution increases the incidence and progression of acute and chronic diseases. Therefore, it is important to investigate the relation of the triad: body mass index, exercise and, air pollution. The aim of the study was to investigate the pollution inhalation of lean, overweight and obese individuals in a low and high intensity exercise session. Healthy sedentary men (n=135) classified as lean, overweight and obese, were enrolled in our study. All participants performed a cardiopulmonary exercise testing (CPX) in order to collect ventilation rate (VE) data, which was used to predict total ventilation and pollutants inhalation of a 5km running session. Air pollutants concentration of the summer and winter seasons was evaluated. Also, toxicological risk was estimated based on the potential intake dose of the pollutants and the reference dose. In the first ventilatory threshold, obese individuals demonstrated higher VE (p=0.0114) and VO2 (p=0.0462) and decreased speed (p<0.001). In the second ventilatory threshold, VO2 and speed were decreased in obese group (p<0.001). In the hypothetical exercise session, total VE and time in both first and second threshold were increased in obese group (p<0.001) (p<0.001). The inhalation of PM2.5, PM10, NO2 and O3, during the hypothetical session, was increased in obese individuals (p<0.001). Obese individuals should be considered a susceptible population, once they are more exposed to air pollution during exercise.
... The inhalation of pollutants threatens human health by increasing the risk of cardiovascular, respiratory and metabolic diseases, stroke, cancer, and infertility [14][15][16][17]. The estimated mortality from outdoor pollution is 4.2 million, while indoor pollution leads to 3.8 million deaths attributable to household air pollution [7,18,19]. ...
Article
The urbanization process resulted in incredible achievements for society, unfortunately together with economic, social, and technological development it deteriorates air quality and encourages sedentary behavior. Air pollution inhalation is responsible for a massive negative health effect. The practice of regular physical exercise is strongly encouraged to achieve a healthy lifestyle. However, particularly during a physical exercise session, the respiratory system undergoes some physiological adaptations that lead to an increase in the volume of inhaled air, so exercising in a polluted environment would consequently augment the number of pollutants inhaled. In this scenario, would it be safer to stay physically inactive? Or to choose an indoor facility to exercise? Or to keep performing outdoor activities once the benefits achieved with exercise will overcome the possible damage caused by additional exposure to air pollution? Currently, these questions still do not have a decisive answer, so we designed a hypothesis to be tested in which exercise would be beneficial regardless of the chosen place. Outdoor and indoor pollution are both equally harmful to health, however, we do not know if it would have a difference to exercise in one of them.
... It causes air pollution and envisages severe detrimental impacts on human health and quality of life in developing countries [13][14][15]. Further, indoor air pollution poses a potential threat to the fertility and mortality of women and girls mostly [16][17][18]. It causes various lung diseases, stunted growth, child malnutrition, other infectious and parasitic diseases [19]. ...
Article
The twofold novelty of the paper complements the debate about the health impacts of multidimensional energy poverty. First, an adjusted multidimensional energy poverty index (MEPI) is employed to gauge and monitor multidimensional energy poverty. Second, the study targets South and Southeast Asia, the regions previously neglected, to identify the adverse health impacts of multidimensional energy poverty for women using the structural equation modeling technique. With these objectives, the study analyses household survey data of eleven developing countries in Asia: five countries from South Asia and six from Southeast Asia. The results statistically verified the fitness of the study model checking the estimates of good fitness of the structural equation modeling approach. An empirically significant negative causal relationship was found between the indicators of multidimensional energy poverty and health for women including sources and purification of water, types of toilet facility, termination of pregnancy, fertility, contraception or family planning, age at sterilization, mosquito-borne diseases, coverage of health insurance, marital status, literacy, and occupation, subsequently, implying the significant theoretical as well as practical policy implications to mitigate these detrimental health impacts of multidimensional energy poverty in developing countries.
... More generally, our state-level estimates reflect the robust evidence that exposure to air pollution affects all systems in the human body, including prenatal development, neurological function, cardiovascular health, respiratory function, mental health, and geriatric health [1,3,20,116,[152][153][154]. Additionally, the distribution of the health burden across the population in our study (Figure 4), rather than just in "sensitive groups" (e.g., the elderly, young, and those with underlying health conditions), supports a growing consensus that there are no "insensitive groups" [4, 116,155,156]. ...
Article
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Understanding the costs and causes of air pollution in Utah is crucial to implementing effective solutions. To address disagreement in the public discussion of these costs, we compiled research from the best medical and economic studies and collected Utah-specific estimates and input from 21 researchers with expertise in medicine, public health, atmospheric science, or economics. This process—known as expert assessment—has proven highly reliable at compiling the best available evidence to solve time-sensitive issues in engineering, medicine, and many other research fields. The Utah-based experts combined their own research and professional expertise with the broader scientific literature to provide integrative estimates of the costs, causes, and potential solutions for air pollution in Utah.
... Par exemple la pollution augmente directement la morbidité et la mortalité (Pope III et al. (2002), Evans and Smith (2005), Pope III et al. (2004)). A ces effets directs de l'exposition à la pollution, s'ajoutent des effets néfastes sur la fertilité (Vizcaíno et al. (2016), Carré et al. (2017)) ou la productivité. Par exemple, des études ont révélé des effets négatifs de la pollution sur l'efficacité de l'éducation (Marcotte and Marcotte (2017) périmés. ...
Thesis
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Sustainable development in Caribbean Small Islands Developing States (SIDS) is difficult to obtain because of their economic and social vulnerabilities. This thesis examines the sustainable resource allocation and economic growth of Caribbean SIDS using theoretical and numerical methods, and focusing on interactions between demographic and environmental dimensions. Due to their regional importance, I examine the effects of migration and remittances while taking into account local pollution and climate change.First, I describe the impacts of remittances on savings, fertility and education, with a special focus on intergenerational strategies. I show that potential positive effects from migration or remittances depend strongly on its positive effect on human capital accumulation, i.e. whether it is larger or not than the population growth.Because human capital accumulation also depends on the environment, in the second chapter I study the potential interactions between migration gains and environmental quality. If pollution exposure during childhood harms the human capital process, first there are new conditions for gains from migration which can decrease the demographic pressure on natural assets, second an environmental policy is beneficial.Finally, Caribbean SIDS cannot reduce the extent of climate change, leaving them no choice but to adapt to its effects, however this is costly and difficult to implement. The third chapter of this thesis addresses the use of migration, which leads to remittances that can fund adaptation measures. Therefore, I test whether there is a complementarity or a substitutability between the two strategies and show that it depend on the fundamentals of the economy.
... Prior to this study, the majority of existing data concerning the correlation between air pollution and women's health have been focused on pregnancy outcomes such as miscarriage, infertility, and premature delivery (Arroyo et al., 2019;Checa Vizcaino et al., 2016;Ha et al., 2018;Laurent et al., 2016). Until now, all the available evidence regarding the relationship between air pollutants and menstrual disorders has focused on the potential effects of long-term exposure. ...
Article
Menstrual disorders are common diseases among reproductive-aged women with increasing concerns. Until now, there have been limited studies about the association between menstrual disorders and air pollution. This study aimed to investigate the association between short-term (concurrent day and within 1 week prior) ambient air pollution exposure and menstrual disorder outpatient visits in Xi'an, a metropolis in northwestern China. Daily baseline outpatient data of menstrual disorders from January 1, 2010 to February 18, 2016 (2239 days) were obtained. An over-dispersed Poisson generalized additive model was applied to discover the relationship between short-term air pollution exposure and the number of menstrual disorder outpatient visits by adjusting the day of the week and weather conditions. A total of 51,893 outpatient visits for menstrual disorders were recorded. A 10 μg/m3 increase of PM10 and NO2 concentrations corresponded to 0.236% (95% Cl: 0.075%, 0.397%) and 2.173% (95% Cl: 0.990%, 3.357%) elevations in outpatient-visits for menstrual disorders at lag 7 and lag 01 (concurrent day and previous 1 day), respectively. The association was more significant in young females (18-29 years) and there was no obvious association observed between SO2 and menstrual disorder outpatient visits. This is the first evidence that short-term exposure to ambient air pollution can be associated with an increased risk of menstrual disorder attacks. The results of our study may help to establish more comprehensive understanding of the health effects of ambient air pollution on menstrual disorders and other reproductive diseases.
... Prior evidence indicates that PM of a minute size (diameter < 2.5 µM) can penetrate deep into the alveoli of lungs and can potentially enter the blood circulation, crossing the air-blood barrier; it is even capable of reaching other organs (Duan et al., 2017). High concentrations of NO 2 , SO 2 , and O 3 in PM 10 have been shown to increase infertility rates and incidence of miscarriage (Checa Vizcaino et al., 2016). The various intracellular toxic effects generated by PM 10 are primarily due to an elevation in reactive oxygen species (ROS) levels in addition to the apoptosis resulting from DNA damage and hydroxyl radicals induced by the high iron content in PM 10 (Alfaro- Moreno et al., 2002). ...
Article
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Particulate matter (PM) is a general atmospheric pollutant released into the air by an anthropogenic and naturally derived mixture of substances. Current studies indicate that fine dust can result in different health defects, including endothelial dysfunction, asthma, lung cancer, cardiovascular diseases, uterine leiomyoma, deterioration in sperm quality, and overall birth impairment. However, the most prominent effects of PM 10 (diameter < 10 μM) exposure on the female reproductive system, especially with respect to oocyte maturation, remain unclear. In the present study, maturing mouse oocytes were treated with PM 10 and the phenotypes of the resulting toxic effects were investigated. Exposure to PM 10 led to impairment of maturation capacity by inducing cell cycle arrest and blocking normal polar body extrusion during in vitro maturation and activation of fertilization of mouse oocytes. Additionally, defects in tubulin formation and DNA alignment were observed in PM 10 -treated oocytes during metaphase I to anaphase/telophase I transition. Moreover, PM 10 induced reactive oxygen species generation, mitochondrial dysfunction, DNA damage, and early apoptosis. Taken together, these results indicate that PM 10 exposure leads to a decline in oocyte quality and affects the subsequent embryonic development potential of mammalian oocytes.
... The accumulating evidence has linked exposure to environmental pollution and lifestyles to male reproductive health (Barazani et al., 2014;Jurewicz et al., 2016;Lotti et al., 2015). In recent years, ambient air pollution has received widespread concern regarding its potential association with human infertility and sperm quality (Checa Vizcaino and Gonzalez-Comadran, 2016;Rubes et al., 2005;Selevan et al., 2000). Conventional semen parameters, including semen volume, sperm concentration, total sperm count, sperm motility, and sperm morphology, have been employed to evaluate the male reproductive toxicity of air pollution (Deng et al., 2016;Lafuente et al., 2016), and indeed, these parameters are irreplaceable in terms of ongoing related risk-assessment processes. ...
Article
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Background: Current available evidence regarding the detrimental effects of low-level ambient air pollution on conventional semen parameters is inconclusive. In nonreproductive systems, air pollutant exposure has been demonstrated to induce oxidative stress (OS), which is a crucial mechanism that mediates sperm damage and male infertility. Thus, it may be essential to investigate the effects of air pollution on sperm quality in terms of the perspectives of OS and relative molecular damage. Objectives: We assessed the associations of major air pollutant exposure to oxidative stress-mediated alterations in semen, including seminal plasma malondialdehyde (MDA), sperm mtDNA copy number, and integrity. Methods: The present study used data gathered from 516 young men participating in the Male Reproductive Health in Chongqing College student (MARCHS) cohort study during the follow-up stage in 2014 (n = 427 on the old campus, which is located in an urban area and has worse air quality, and n = 89 on the new campus, which is not urban and has better air quality). Data regarding major air pollutant exposure during 0-90, 0-9, 10-14 and 70-90 days before each semen examination (corresponding to the entire and three key periods of sperm development, respectively) were collected. The Mann-Whitney U nonparametric test was employed to compare distributions of major air pollutants and to explore differences in MDA, mtDNA copy number, and mtDNA integrity between the two campuses. A linear regression model was used as multivariable analysis to investigate associations of major air pollutant exposure with these biomarkers of oxidative damage to sperm and to adjust for potential confounders. Results: During all four key periods of sperm development, compared with college students on the new campus, college students on the old campus were exposed to higher levels of PM10, PM2.5, NO2, and CO, and had higher air quality index (AQI) values, indicating that these participants suffered from worse air quality. The levels of seminal plasma MDA in college students on the old campus were higher than those for the new campus (2.0 nmol/ml; 0.7, 3.6 vs. 1.6 nmol/ml; 0.4, 3.4, p < 0.001) (medians with 5th and 95th percentiles). There were no significant differences in sperm mtDNA copy number and mtDNA integrity between the two campuses. Furthermore, daily average PM10 exposure during 0-90 days before semen ejaculation was found to be significantly and positively associated with seminal plasma MDA level (10.4; 95% CI, 4.4, 16.4) (percentage change per 10-unit increase in air pollutant concentration; same meanings for the results below); daily average SO2 exposure for 70-90 days and NO2 exposure for 0-9 days prior to sampling were also positively associated with MDA level (74.7; 95% CI, 32.1, 119 and 11.9; 95% CI, 4.8, 19.0, respectively). AQI for 0-90 days and 70-90 days prior to sampling positively correlated with seminal plasma MDA concentrations (11.4; 95% CI, 4.7, 18.1 and 12.2; 95% CI, 5.3, 19.1, respectively). Additionally, daily average SO2 exposures for 10-14 and 0-9 days prior to sampling were negatively associated with sperm mtDNA copy number and mtDNA integrity, respectively (-9.0; 95% CI, -16.4, -1.6 and -38.3; 95% CI, -64.1, -11.8, respectively). However, only the correlations between SO2 exposure and AQI value for 70-90 days prior to sampling and MDA levels remained significant after multiplicity adjustment. Conclusions: The results indicate that bad air quality, especially SO2 exposure during certain periods of sperm development, might be correlated with oxidative damage to sperm. These findings can deepen the understanding of the potential impacts of air pollution on sperm quality.
... It is well documented that PM 2.5 exposure is responsible for many adverse health effects such as hypertension, stroke, chronic obstructive pulmonary disease, asthma, and cancer (Kim et al. 2015), which is associated with nearly 3 million premature deaths per year worldwide (Stanaway et al. 2018). Additionally, emerging evidence has indicated that inhaled PM 2.5 could induce inflammation, oxidative stress, or endocrine disruption, which are associated with reproductive health (Carre et al., 2017;Frutos et al., 2015); however, limited studies have estimated its impact on human fecundity (Checa Vizcaino et al. 2016). ...
Article
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Background Whether exposure to airborne particulate matter less than 2.5 μm (PM2.5) could impact human fecundity is unclear. We aimed to evaluate the potential impact of PM2.5 exposure on time to pregnancy (TTP) and the prevalence of infertility in the general Chinese population. Method We collected reproductive information, sociodemographic characteristics, and lifestyle data of 10,211 couples at risk of pregnancy from a large-scale community-based fertility survey in China. Then, we estimated each participant’s 1-year, 3-year, and 5-year average PM2.5 exposure levels based on remote sensing information. After adjusting for demographic, lifestyle, and environmental co-variables, discrete-time Cox regression models were used to estimate the fecundability odds ratio (FOR) per 10 μg/m³ change of PM2.5. We also estimated the odds ratio (OR) of infertility per 10 μg/m³ change of PM2.5, using logistic regression models. Findings Among the 10,211 couples, 6,875 (67%) had conceived spontaneously, with a median TTP of 5 months (interquartile range: 2–10 months). The median PM2.5 exposure was 56.8 μg/m³, with a wide range of 9.2–93.5 μg/m³. In Cox regression models, each increase of 10 μg/m³ in the 1-year average PM2.5 exposure was associated with a significant decrease in fecundity by 11% (FOR: 0.89; 95% confidence interval [CI]: 0.86–0.92). In logistic regression models, it was also associated with an 20% increased likelihood of infertility (OR: 1.20; 95% CI: 1.13–1.27). Conclusion PM2.5 exposure was associated with reduced human fecundity, presented by a longer TTP and higher odds of infertility, which might explain the increased infertility rates in areas with heavy PM2.5 pollution.
... Air and traffic pollution that burden cities and their inhabitants has been studied to reduce fertility (Checa Vizcaíno et al. 2016;Lafuente et al. 2016). It is suspected that these environmental toxins are particularly detrimental to men's ability to reproduce (Bonde et al. 2016). ...
Chapter
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Adopting a lifestyle during the preconception period which involves regular physical activity presents a special challenge to every individual. Due to its proven health benefits, the effect of physical activity on preconception health is generally still recognised as a strong predictor of health in the preconception period. While the increasing global prevalence of overweight and obesity represents a complex and chronic public health challenge, regular physical activity offers an effective approach for the control and reduction of obesity. Improving the health of women before pregnancy is an important strategy for reducing adverse pregnancy outcomes for both the mother and the foetus. During pregnancy, the impacts on foetal health have already been established and it may therefore already be too late to influence certain health behaviours. Physical activity on the other hand is also important factor in men’s reproductive health. Therefore, preconception health promotion strategies are urgently required. The main role of healthcare professionals is to design and implement those strategies, including physical activity programmes, which take due account of specific behavioural characteristics.
... The accumulating evidence has also linked ambient air pollutants exposure to adverse male reproductive outcomes (Checa Vizcaíno et al., 2016;Jurewicz et al., 2018). The most reported pathophysiological pathways for male reproductive health effects of air pollution are inflammation (Chuang et al., 2007), oxidative stress (Colicino et al., 2017) and epigenetic modification (Wang et al., 2020). ...
Article
Air pollution, which is associated with male reproductive health. However, it is unknown the acute effects of ambient air pollutants exposure on male reproductive hormones. The current study, we measured serum levels of reproductive hormone in 2030 blood samples gathered from The Male Reproductive Health in Chongqing College Students (MARHCS) cohort study. We derived a full coverage of ambient air pollutant (PM10, PM2.5, SO2, NO2, CO and O3) concentrations by employing machine learning algorithms, and used a mixed-effect model to estimate single-day and cumulative effects of air pollutants exposure on serum reproductive hormones. Our results showed that (1) PM10 and PM2.5 concentrations were positively associated with estradiol (E2) in both single and cumulative lag days, but were negatively associated with the ratio of Testosterone / E2 (the T/E2 ratio). NO2 was positively associated with estradiol at lag day 2 (95% CI: 0.290, 0.881; corrected P = 0.048) and lag 0–2 days (95% CI: 0.523, 1.337; corrected P = 0.003), with progesterone (P) at lag day 2 and lag day 3 (corrected P < 0.05). There was also a positive association between CO exposure and progesterone at lag day 2. (2) SO2 was inversely associated with E2 at lag day 3, 4 and lag 0–4 days, and progesterone at lag day 0, 1, 2 and lag 0–1, 0–2, 0–4 days, but positively associated with the T/E2 ratio at lag day 3, 4 and lag 0–4 days (corrected P < 0.05). O3 exposure was negatively associated with E2 at lag day 3 (95% CI: -0.216, -0.074, corrected P = 0.03). (3) No significant associations were found between the cumulative daily average air pollutant exposure of CO, O3 and hormone outcomes. This study suggests that short-term exposure to air pollutants may thus alter reproductive hormone levels, especially on serum estradiol, progesterone levels and the T/E2 ratio.
... Epidemiological studies reported that spermatozoa concentration was diminished, worldwide, by over 50% from 1973 to 2011, at the same time sperm motility was also decreased dramatically (Centola et al., 2016;Levine et al., 2017). Various factors are involved in the rapid decline of semen quality, such as environmental toxins (Checa Vizcaíno et al., 2016;Skakkebaek et al., 2016;Virtanen et al., 2017;Han et al., 2019;Zhang et al., 2019), high fat diet (Ding et al., 2020), and cancer treatments (Trost and Brannigan 2012;Vakalopoulos et al., 2015). Many investigations have attempted to improve spermatogenesis and male fertility using a busulfan treated animal model. ...
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β-carotene, precursor of vitamin A, is an excellent antioxidant with many beneficial properties. It is a lipid-soluble antioxidant and a very effective quencher of reactive oxygen species (ROS) to reduce the oxidative stress. In contrast to vitamin A, β-carotene is not toxic even consumed in higher amount when it is delivered from natural plant products. Recently, we found that β-carotene acts as a potential antioxidant in the oocyte to improve its quality. Even though many studies have been reported that β-carotene has the beneficial contribution to the ovarian development and steroidogenesis, it is unknown the effects of β-carotene on the spermatogenesis. This investigation aimed to explore the hypothesis that β-carotene could improve spermatogenesis and the underlying mechanism. And we found that β-carotene rescued busulfan disrupted spermatogenesis in mouse with the increase in the sperm concentration and motility. β-carotene improved the expression of genes/proteins important for spermatogenesis, such as VASA, DAZL, SYCP3, PGK2. Moreover, β-carotene elevated the testicular antioxidant capability by the elevation of the antioxidant glutathione and antioxidant enzymes SOD, GPX1, catalase levels. In conclusion, β-carotene may be applied for the infertile couples by the improvement of spermatogenesis, since, worldly many couples are infertile due to the idiopathic failed gametogenesis (spermatogenesis).
... Environmental pollution has emerged as a major cause for the rising trend of male infertility in today's era all over the world due to the universal presence of environmental contaminants. Recent studies have revealed that air pollution has a significant impact on human fertility and sperm quality [4,5]. ...
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Background Worldwide rising trend in infertility has been observed in the past few years with male infertility arising as a major problem. One main reason for the rise in male infertility cases is declining semen quality. It was found that any factor that affects semen quality can affect male fertility. There are several modifiable factors affecting semen quality including air pollution, use of pesticides and harmful chemicals, exposure to excessive heat, and can lead to decreased male fertility. Main body The present review focuses on some of these environmental factors that affect semen quality and hence, can cause male infertility. The literature from 2000 till June 2021 was searched from various English peer-reviewed journals and WHO fact sheets using the USA National Library of Medicine (PubMed) database, the regional portal of Virtual Health Library, and Scientific Electronic Library Online. The search terms used were: “Air pollution and male fertility”, “Chemicals and male infertility”, “Heat exposure and infertility”, “heavy metals and male fertility”. Conclusion Adverse environmental factors have a significant impact on semen quality, leading to decreased sperm concentration, total sperm count, motility, viability, and increased abnormal sperm morphology, sperm DNA fragmentation, ultimately causing male infertility. However, all these factors are modifiable and reversible, and hence, by mere changing of lifestyle, many of these risk factors can be avoided.
... Infertility is a global reproductive health problem and the prevalence rate increased by 0.37% per year for females and the global disease burden of infertility had increased from 1990 to 2017 [1]. With environment and lifestyle changes, the incidence of infertility might be associated with the delay of marriage and giving birth to the first child [2,3], environmental pollution [4], and unhealthy lifestyles [5]. Although not life-threatening, the detrimental influence of infertility to patients, their families, and society should not be underestimated. ...
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Background: Infertility is a reproductive health problem which affects not only individuals, families and social populations. Recently, the infertility rate in China has a trend of increase year by year, and few studies have reported the infertility rate in Henan Province, China. The aim of this study was to investigate the current prevalence and associated factors of infertility among women of childbearing age in Henan Province, China. Methods: This cross-sectional study was conducted from March 2019 to October 2019. We sampled 765 women who were 20-49 years old in eight hospitals of four cities in Henan Province, China. This survey included a questionnaire, physical examination, vaginal ultrasound examinations, and serum anti-Mullerian hormone (AMH) assessment, all of which were conducted under uniform standards by trained personnel. According to the data collected from questionnaire, participants were divided into infertile and fertile groups and analyzed associated factors. Results: Among all the 765 participants in this study, the prevalence of infertility was 24.58%. The prevalence of primary infertility was 6.54%, and the prevalence of secondary infertility was 18.04%. In logistic multivariate regression analyses, infertility was associated with age (p < 0.001), history of gynecological surgery (p < 0.001), sweet food (p = 0.003) and decreased ovarian reserve (DOR) (p < 0.001). After further analyses, factors associated with primary infertility were age of marriage (p = 0.006), age of first sexual intercourse (p = 0.003), long-term air-conditioning environment (p < 0.001), decreased ovarian reserve (p = 0.005) and age (p = 0.002). And factors associated with secondary infertility were history of gynecological surgery (p < 0.001), decreased ovarian reserve (p = 0.002), waist-to-hip ratio (WHR) above 0.85 (p = 0.043), delivery times (p = 0.001) and ages (p < 0.001). Conclusion: The prevalence of infertility among women aged 20-49 was 24.58% and only 61.17% infertile women sought medical help in Henan Province, China. Age, history of gynecological surgeries and DOR may increase the risk of infertility. Local public health departments and medical professionals need to discharge their duty of reducing the high incidence of infertility and protecting women's reproductive health.
... Commuting time: Huinink and Feldhaus (2012). Exposure to other air pollutants: Frutos et al. (2014), Vizcaíno et al. (2016), Casey et al. (2018), Conforti et al. (2018). See app. ...
... Air pollution is a ubiquitous and significant global health threat (Burnett et al., 2018), responsible for many adverse health effects IARC, 2013;Lin et al., 2017). While there is a growing consensus that ambient air pollution is related to worse birth outcomes such as preterm birth and low birth weight (Lamichhane et al., 2015;Shah and Balkhair, 2011), emerging evidence also suggests that air pollution is related to lower human fertility (Carre et al., 2017a;Checa Vizcaíno et al., 2016;Nieuwenhuijsen et al., 2014;Xue and Zhu, 2018a, b), with specific adverse effects on spermatogenesis (Deng et al., 2016;Jurewicz et al., 2018;Lafuente et al., 2016), folliculogenesis (Gai et al., 2017;Gaskins et al., 2019c;Ogliari et al., 2013;Veras et al., 2009), and pregnancy maintenance (Gaskins et al., 2019b;Gaskins et al., 2020;Kioumourtzoglou et al., 2019;Leiser et al., 2019). Although several biological mechanisms including oxidative stress, inflammation, endocrine disruption, and DNA damage have been proposed to underlie these associations, very little mechanistic insight has been gained from studies of human pregnancy. ...
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Background: Air pollution exposure has been linked with diminished fertility. Identifying the metabolic changes induced by periconception air pollution exposure among women could enhance our understanding of the potential biological pathways underlying air pollution's reproductive toxicity. Objective: To identify serum metabolites associated with periconception air pollution exposure and evaluate the extent to which these metabolites mediate the association between air pollution and live birth. Methods: We included 200 women undergoing a fresh assisted reproductive technology (ART) cycle at Massachusetts General Hospital Fertility Center (2005-2015). A serum sample was collected during stimulation, and untargeted metabolic profiling was conducted using liquid chromatography with ultra-high-resolution mass spectrometry. Exposure to nitrogen dioxide (NO2), ozone (O3), fine particulate matter <2.5 µm (PM2.5), and black carbon (BC) was estimated using validated spatiotemporal models. Multivariable linear regression models were used to evaluate the associations between the air pollutants, live birth, and metabolic feature intensities. A meet in the middle approach was used to identify overlapping features and metabolic pathways. Results: From the C18 and HILIC chromatography columns, 10,803 and 12,968 metabolic features were extracted. There were 190 metabolic features and 18 pathways that were significantly associated with both air pollution and live birth (P < 0.05) across chromatography columns. Eight features were confirmed metabolites implicated in amino acid and nutrient metabolism with downstream effects on oxidative stress and inflammation. Six confirmed metabolites fell into two intuitive clusters - "antioxidants" and "oxidants"- which could potentially mediate some of the association between air pollution and lower odds of live birth. Tryptophan and vitamin B3 metabolism were common pathways linking air pollution exposure to decreased probability of live birth. Conclusion: Higher periconception air pollution exposure was associated with metabolites and biologic pathways involved in inflammation and oxidative stress that may mediate the observed associations with lower probability of live birth following ART.
... Air and traffic pollution that burden cities and their inhabitants has been studied to reduce fertility (Checa Vizcaíno et al. 2016;Lafuente et al. 2016). It is suspected that these environmental toxins are particularly detrimental to men's ability to reproduce (Bonde et al. 2016). ...
Article
Epidemiological investigations and animal studies demonstrate a significantly positive relationship between polycyclic aromatic hydrocarbons (PAHs) exposure and reproductive disorders. However, few researches are focused on the reproductive toxicity of low-molecular-weight PAHs (number of benzene ring ≤ 3) which occupy a large part of PAHs. Phenanthrene (Phe), a typical low-molecular-weight PAH, is one of the most abundant PAHs detected in foods. In the present study, oral treatment with Phe at a human exposure related level during gestation (60 μg/kg body weight every three days, six times in total) induced reproductive disorders in F1 adult female mice: the number of antral follicles (an immature stage of follicular development) were significantly increased, while the maturation of oocytes was inhibited and aggravated follicular atresia was observed; the serum levels of luteinizing hormone (LH), testosterone and estradiol were significantly reduced; the receptor of follicle-stimulating hormone (FSHR) and aromatase in the ovary were significantly upregulated; transcriptome analysis demonstrated that the phosphatidylinositol 3-kinase and protein kinase B (PI3K/Akt) signal pathway was upregulated, and the calcium signal pathway was disturbed, which probably accounts for the exacerbated atresia of the growing follicles and the excessive consumption of follicles. The reproductive toxicity of low-molecular-weight PAHs could not be neglected.
Article
Background: Particulate matter (PM) exposure is closely associated with male infertility. Even though an association between poor semen quality and PM exposure has been widely accepted, which and when the semen parameter could be affected are still controversial. The purpose of this study is to estimate the effects of PM exposure on semen quality in Huai'an, China. Objectives and methods: The study included 1955 men with 2073 semen samples between 2015 and 2017 with moderate to high exposure to air pollution in Huai'an, China. Three multivariable linear regression models were used to conduct exposure-response analyses for PM exposure and semen quality and to estimate the influence during different exposure periods by every 15 days period before ejaculation in all participants group and normal semen quality participants group. Results: The average age of the observations was 28.9 ± 5.4 old years and the average abstinence period was 4.2 ± 1.5 days. The results showed high correlations between both PM2.5 and PM10 exposures throughout entire spermatogenesis and the declines of sperm count (β: -0.93, p < 2 × 10-16 and β: -1.00, p < 2 × 10-16), and sperm concentration (β: -1.00, p < 2 × 10-16 and β: -1.06, p < 2 × 10-16), and PM10 exposure decreased sperm total motility (β: -0.60, p = 2.56 × 10-7), but not sperm progressive motility. Furthermore, PM2.5 exposure decreased sperm count and concentration during 15-75 lag days, and PM10 exposure showed significant association with sperm count and concentration during 0-75 lag days. PM2.5 and PM10 exposures during 45-59 lag days were both inversely associated with sperm total motility (all p value < 0.05). Conclusion: The present study revealed that ambient PM exposure throughout spermatogenesis during a long period, especially at early and middle stage were adversely associated with semen quality, sperm count and sperm concentration in particular.
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In the present study, the emission of BTEX compounds has been investigated in a one-year period (2016–2017) in Tehran city. According to, 26 sampling stations were selected in different parts of the city and had been sampled in four seasons of year to determine the concentration of BTEX as well as other meteorological parameters such as temperature, humidity and wind speed. Spatial distribution analysis of BTEX was introduced by using the Inverse Distance Weighting (IDW) method in Arc GIS 10.3. Also, to determine the carcinogenic and non-carcinogenic risk of target compounds, Monte Carlo simulation was used. The results showed that the annual mean of benzene, toluene, ethylbenzene, m-xylene and o-xylene were 30.08 ± 21.97, 54.17 ± 40.29, 25.81 ± 15.21, 27.83 ± 19.1 and 23.16 ± 12.28 μg/m³, respectively. According to the result, the maximum and minimum concentrations of BTEX were in the center and north of the city, respectively. Temporally, the maximum value of BTEX was 232.61 ± 123.93 µg/m³ in the autumn and the minimum value was 57.88 ± 24.93 µg/m³ in the spring. The result obtains from the inhalation lifetime cancer risk (LTCR) indicative the carcinogenic potential of benzene. Noncarcinogenic risk index, namely the hazard quotient (HQ) for all BTEX compound except benzene concentration in the autumn (1.55), were lower than 1 degree so they were not harmful to human health.
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Article
Research question Is polycyclic aromatic hydrocarbon (PAH) exposure associated with the reproductive outcomes of IVF treatment? Design This study was a prospective small-scale monocentric cohort study of couples who underwent IVF treatment between January 2018 and June 2019. Two members of each couple answered a questionnaire on PAH exposure and provided urine samples to measure urinary 1-hydroxypyrene (1-OHP) the day before oocyte pick-up and semen collection for fertilization. To assess the specific PAH exposure of gamete cells, we conducted immunostaining on both spermatozoa and granulosa cells obtained during IVF with an anti-benzo[a]pyrene diol epoxide (BPDE) monoclonal antibody that recognizes BDPE-DNA adducts. To assess DNA damage, we conducted a comet assay on spermatozoa. We compared the PAH exposure between couples who had positive HCG and couples who had negative HCG on Day 14 after embryo transfer. Result(s) Eighteen couples were included. The mean 1-OHP level in women whose HCG tests were positive (n = 6) was significantly lower than that in women with negative HCG tests (0.098 [.042 - .170] vs. 0.177 [.067 - .812] μg/g creatinine, p = 0.048). Similarly, a non-significant trend was observed for a lower amount of BPDE-DNA adducts in granulosa cells in women with positive HCG tests (20.3 [9.3 – 23.3] vs. 29.7 [16.2 – 57.5] arb. Units, p = 0.092). Conversely, the 1-OHP levels of men and BPDE-DNA adducts in spermatozoa showed no differences between groups. Conclusions This exploratory research should encourage further studies to determine the impact of women's exposure to PAHs on reproductive outcomes of IVF treatment.
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One of the critical items in the environmental agenda is managing and controlling regional haze and air pollution. These haze, emissions and air pollution are emitted into the environment, causing dangerous harm and imposing threats to public health, human wellbeing, and fertility issues, which sometimes lead to death. The researcher aims investigates broad effects of environmental pollution, socio-economic factors on total fertility rate in MENA, ECOWAS and ASEAN regions from 1970 to 2019. The Middle East and North Africa (MENA) regions consist of 21 countries, and the Economic Community of West African States (ECOWAS) comprises 15 countries. While 10 viable countries constitute the Association of Southeast Asian Nations (ASEAN). A longitudinal/panel dataset covering the regions is sourced mainly from the 2019 World Development Indicators (WDI) to examine the study objectives. In the methodology, a panel fixed-effect (FE) model are employed in estimating the objective after ascertaining the FE suitability using the Hausman Test. The results show that (i) environmental pollution (as proxied by CO2 emissions) has a negative and statistically significant effect on total fertility rate in MENA and ECOWAS but has a significantly positive effect on TFR in ASEAN. Based on the findings, many robust policies are recommended to manage/control environmental pollution to drive down fertility and other public health threats.
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Perfluorooctane sulfonate (PFOS) is a widespread persistent organic pollutant. Both epidemiological survey and our previous in vivo study have revealed the associations between PFOS exposure and spermatogenesis disorder, while the underlying mechanisms are far from clear. In the present study, GC-2 cells, a mouse spermatocyte-derived cell line, was used to investigate the toxic effects of PFOS and its hypothetical mechanism of action. GC-2 cells were treated with PFOS (0, 50, 100 and 150µM) for 24 h or 48 h. Results demonstrated that PFOS dose-dependently inhibited cell viability, induced G0/G1 cell cycle arrest and triggered apoptosis, which might be partly explained by the decrease in cyclin D1, PCNA and Bcl-2 protein expression; increase in Bax protein expression; and activation of caspase-9, -3. In addition, PFOS did not directly transactivate or repress estrogen receptors (ERs) in gene reporter assays, whereas the protein levels of both ERα and ERβ were significantly altered and the downstream ERK1/2 phosphorylation was inhibited by PFOS. Furthermore, pretreatment with specific ERα agonist PPT (1 μM) significantly attenuated the above PFOS-induced effects while specific ERβ agonist DPN (1 μM) accelerated them. These results suggest that PFOS may induce growth inhibition and apoptosis via non-genomic estrogen receptor/ERK1/2 signaling pathway in GC-2 cells, which provides a novel insight regarding the potential role of ERs in mediating PFOS-triggered spermatocyte toxicity.
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BACKGROUND Air pollution is both a sensory blight and a threat to human health. Inhaled environmental pollutants can be naturally occurring or human-made, and include traffic-related air pollution (TRAP), ozone, particulate matter (PM) and volatile organic compounds, among other substances, including those from secondhand smoking. Studies of air pollution on reproductive and endocrine systems have reported associations of TRAP, secondhand smoke (SHS), organic solvents and biomass fueled-cooking with adverse birth outcomes. While some evidence suggests that air pollution contributes to infertility, the extant literature is mixed, and varying effects of pollutants have been reported. OBJECTIVE AND RATIONALE Although some reviews have studied the association between common outdoor air pollutants and time to pregnancy (TTP), there are no comprehensive reviews that also include exposure to indoor inhaled pollutants, such as airborne occupational toxicants and SHS. The current systematic review summarizes the strength of evidence for associations of outdoor air pollution, SHS and indoor inhaled air pollution with couple fecundability and identifies gaps and limitations in the literature to inform policy decisions and future research. SEARCH METHODS We performed an electronic search of six databases for original research articles in English published since 1990 on TTP or fecundability and a number of chemicals in the context of air pollution, inhalation and aerosolization. Standardized forms for screening, data extraction and study quality were developed using DistillerSR software and completed in duplicate. We used the Newcastle-Ottawa Scale to assess risk of bias and devised additional quality metrics based on specific methodological features of both air pollution and fecundability studies. OUTCOMES The search returned 5200 articles, 4994 of which were excluded at the level of title and abstract screening. After full-text screening, 35 papers remained for data extraction and synthesis. An additional 3 papers were identified independently that fit criteria, and 5 papers involving multiple routes of exposure were removed, yielding 33 articles from 28 studies for analysis. There were 8 papers that examined outdoor air quality, while 6 papers examined SHS exposure and 19 papers examined indoor air quality. The results indicated an association between outdoor air pollution and reduced fecundability, including TRAP and specifically nitrogen oxides and PM with a diameter of ≤2.5 µm, as well as exposure to SHS and formaldehyde. However, exposure windows differed greatly between studies as did the method of exposure assessment. There was little evidence that exposure to volatile solvents is associated with reduced fecundability. WIDER IMPLICATIONS The evidence suggests that exposure to outdoor air pollutants, SHS and some occupational inhaled pollutants may reduce fecundability. Future studies of SHS should use indoor air monitors and biomarkers to improve exposure assessment. Air monitors that capture real-time exposure can provide valuable insight about the role of indoor air pollution and are helpful in assessing the short-term acute effects of pollutants on TTP.
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Fine particulate matter (PM2.5) pollution arouses public health concerns over the world. Increasing epidemiologic evidence suggests that exposure to ambient airborne PM2.5 increases the risk of female infertility. However, relatively few studies have systematically explored the harmful effect of chronic PM2.5 exposure on ovarian function and the underlying mechanisms. In this study, female C57BL/6J mice are exposed to filtered air or urban airborne PM2.5 for 4 months through a whole‐body exposure system. It is found that PM2.5 exposure significantly caused the alteration of estrus cycles, reproductivity, hormone levels, and ovarian reserve. The granulosa cell apoptosis via the mitochondria dependent pathway contributes to the follicle atresia. With RNA‐sequencing technique, the differentially expressed genes induced by PM2.5 exposure are mainly enriched in ovarian steroidogenesis, reactive oxygen species and oxidative phosphorylation pathways. Furthermore, it is found that increased PM2.5 profoundly exacerbated ovarian oxidative stress and inflammation in mice through the NF‐κB/IL‐6 signaling pathway. Notably, dietary polydatin (PD) supplement has protective effect in mice against PM2.5‐induced ovarian dysfunction.These striking findings demonstrate that PM2.5 and/or air pollution is a critical factor for ovarian dysfunction through mitochondria‐dependent and NF‐κB/IL‐6‐mediated pathway, and PD may serve as a pharmaceutic candidate for air pollution‐associated ovarian dysfunction. Chronic airborne PM2.5 exposure is sufficient to cause ovarian dysfunction, including impaired reproductivity, endocrine disorders, and declined ovarian reserve. PM2.5 induces ovary damage and follicle loss via mitochondria‐dependent apoptosis pathway and NF‐κB/IL‐6 signaling pathway. Polydatin administration as a potential strategy can protect against PM2.5‐induced ovarian dysfunction by decreasing oxidative stress and inflammation.
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Exposure to anthropogenic environmental chemical mixtures could be contributing to the decline in male reproductive health. This study used the biosolid treated pasture (BTP) sheep model to assess the effects of exposure to low-dose chemical mixtures. Maternal BTP exposure was associated with lower plasma testosterone concentrations, a greater proportion of Sertoli cell-only seminiferous tubules, and fewer gonocytes in the testes of neonatal offspring. Transcriptome analysis highlighted changes in testicular mTOR signalling, including lower expression of two mTOR complex components. Transcriptomic hierarchical analysis relative to the phenotypic severity demonstrated distinct differential responses to maternal BTP exposure during pregnancy. Transcriptome analysis between phenotypically normal and abnormal BTP lambs demonstrated separate responses within the cAMP and PI3K signalling pathways towards CREB. Together, the results provide a potential mechanistic explanation for adverse effects. Exposure could lower gonocyte numbers through mTOR mediated autophagy, but CREB mediated survival factors may act to increase germ cell survival.
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This prospective study examined the associations between the levels of eight urinary phthalate metabolites in 599 couples and in vitro fertilization (IVF) outcomes. We used log-binomial multivariate regression to estimate relative risks (RR) for the association between phthalate concentration and IVF binary outcomes (fertilization rate >50%, biochemical pregnancy, clinical pregnancy and live birth) for each woman after adjusting the model for the concentration in a male partner and each relevant confounders. RR was expressed per unit increase in log-transformed urinary metabolite concentration. The percentage of bis-2-ethylhexyl phthalate (DEHP) metabolites excreted as mono-2-ethylhexyl phthalate (MEHP) was calculated as %MEHP. Urinary MEHP in women was associated with an increased risk of biochemical pregnancy (RR = 1.35; p = 0.04), failed clinical pregnancy (RR = 1.56; p = 0.006) and live birth (RR = 1.54; p = 0.011). An increase in monoethyl phthalate was associated with a high risk of failed clinical pregnancy (RR = 1.25; p = 0.03) and live birth (RR = 1.35; p = 0.006). An increase in %MEHP was associated with an increase in the risk of biochemical pregnancy (RR = 1.55; p = 0.05), failed clinical pregnancy (RR = 1.73; p = 0.02) and live birth (RR = 1.65; p = 0.046). Our results demonstrated that exposure to some phthalates may adversely affect IVF outcomes, particularly when couples' exposure was jointly modeled, emphasizing the importance of a couple-based approach in assessing fertility outcomes. The associations between IVF outcomes and DEHP metabolites were stronger in women whose %MEHP was >75th percentile which may be due to their less efficient metabolism and excretion of DEHP and/or MEHP.
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Air pollution has been an important risk factor for female reproductive health. However, epidemiological evidence of ambient air pollution on the predictor for ovarian reserve (antral follicle count, AFC) is deficient. We aim to comprehensively evaluate the association of long-term exposure to ambient air pollution with AFC among women of reproductive age in Shanxi of north China. 600 women with spontaneous menstrual cycle, not using controlled ovarian stimulation, were enrolled in the retrospective study. Two distinct periods of antral follicle development were designed as exposure windows. Generalized linear model was employed to estimate the change of AFC associated with exposure of atmospheric pollutants (SO2, NO2, PM10, PM2.5, CO and O3). Stratification analysis based on age (<30, ≥30 years), university degree (yes, no), years of exposure (2013–2016, 2017–2019) and duration of infertility (<2, 2–5, >5 years) along with two pollutants model were employed to further illustrate the association. We found every 10 μg/m³ increase in SO2 concentration level during the entire development stage of antral follicle was associated with a −0.01 change in AFC (95% confidence interval: −0.016, −0.002) adjusting for the confounders including age, BMI, parity and infertility diagnosis factors. The significant association of increased SO2 level with decreased AFC was particularly observed during the early transition from primary follicle to preantral follicle stage by 10 μg/m³ increase in SO2 exposure level with a −0.01 change (95% CI: -0.015, −0.002) in AFC. The negative association was pronounced among women aged ≥30 years old, and also significant in two pollutants model after adjusting the confounders. No significant associations between other air pollutants and AFC were observed. Our finding suggests that long-term exposure to air pollutant SO2 is associated with lower AFC, raising our concern that atmospheric SO2 exposure may have potential adverse impact on women ovarian reserve.
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Stillbirth has a great impact on contemporary and future generations. Increasing evidence show that ambient air pollution exposure is associated with stillbirth. However, previous studies showed inconsistent findings. To clarify the effect of maternal air pollution exposure on stillbirth, we searched for studies examining the associations between air pollutants, including particulate matter (diameter ≤ 2.5 μm [PM2.5] and ≤ 10 μm [PM10]) and gaseous pollutants (sulfur dioxide [SO2], nitrogen dioxide [NO2], carbon monoxide [CO] and ozone [O3]), and stillbirth published in PubMed, Web of Science, Embase and Cochrane Library until December 11, 2020. The pooled effect estimates and 95% confidence intervals (CI) were calculated, and the heterogeneity was evaluated using Cochran's Q test and I² statistic. Publication bias was assessed using funnel plots and Egger’s tests. Of 7,546 records, 15 eligible studies were included in this review. Results of long-term exposure showed that maternal third trimester PM2.5 and CO exposure (per 10 μg/m³ increment) increased the odds of stillbirth, with estimated odds ratios (ORs) of 1.094 (95% CI: 1.008–1.180) and 1.0009 (95% CI: 1.0001– 1.0017), respectively. Entire pregnancy exposure to PM2.5 was also associated with stillbirth (OR: 1.103, 95% CI: 1.074-1.131). A 10 μg/m³ increment in O3 in the first trimester was associated with stillbirth, and the estimated OR was 1.028 (95% CI: 1.001–1.055). Short-term exposure (on lag day 4) to O3 was also associated with stillbirth (OR: 1.002, 95% CI: 1.001–1.004). PM10, SO2 and NO2 exposure had no significant effects on the incidence of stillbirth. Additional well-designed cohort studies and investigations regarding potential biological mechanisms are warranted to elaborate the suggestive association that may help improve intergenerational inequality.
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Evidences on the association of air pollutants and semen quality were limited and mechanism-based biomarkers were sparse. We enrolled 423 men at a fertility clinic in Shijiazhuang, China to evaluate associations between air pollutants and semen quality parameters including the conventional ones, sperm mitochondrial DNA copy number (mtDNAcn), sperm telomere length (STL) and seminal spermatogenic cells. PM2.5, PM10, CO, SO2, NO2 and O3 exposure during lag0-90, lag0-9, lag10-14 and lag70-90 days were evaluated with ordinary Kringing model. The exposure-response correlations were analyzed with multiple linear regression models. CO, PM2.5 and PM10 were adversely associated with conventional semen parameters including sperm count, motility and morphology. Besides, CO was positively associated with seminal primary spermatocyte (lag70-90, 0.49; 0.14, 0.85) and mtDNAcn (lag0-90, 0.37; 0.12, 0.62, lag10-14, 0.31; 0.12, 0.49), negatively associated with STL (lag0-9, -0.30; -0.57, -0.03). PM2.5 was positively associated with mtDNAcn (0.50; 0.24, 0.75 and 0.38; 0.02, 0.75 for lag0-90 and lag70-90) while negatively associated with STL (lag70-90, -0.49; -0.96, -0.01). PM10 and NO2 were positively associated with mtDNAcn. Our findings indicate CO and PM might impair semen quality testicularly and post-testicularly while seminal spermatogenic cell, STL and mtDNAcn change indicate necessity for more attention on these mechanisms.
Chapter
With the development of human society, factors that contribute to the impairment of female fertility is accumulating. Lifestyle-related risk factors, occupational risk factors, and iatrogenic factors, including cancer and anti-cancer treatments, have been recognized with their negative effects on the function of female reproductive system. However, the exact influences and their possible mechanism have not been elucidated yet. It is impossible to accurately estimate the indexes of female fertility, but many researchers have put forward that the general fertility has inclined through the past decades. Thus the demand for fertility preservation has increased more and more dramatically. Here we described some of the factors which may influence female reproductive system and methods for fertility preservation in response to female infertility.
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Microcystin-leucine arginine (MC-LR), an intracellular toxin to cause reproduction toxicity, is produced by blooming cyanobacteria and widely distributed in eutrophic waters. It is revealed that MC-LR-induced female reproductive toxicity is more severe than male reproductive toxicity. Previous studies mainly focused on male reproductive toxicity, and the molecular mechanisms of MC-LR-induced apoptosis, follicular atresia and infertility in female remain largely unclear. Here, it was found that MC-LR treatment could induce apoptosis, inflammation, follicular atresia, and decrease of gonadal index in mice ovaries. RNA-Seq data showed that the up-regulation of DNA-damage inducible transcript 3 (Ddit3) under endoplasmic reticulum (ER) stress had predominantly regulatory role in MC-LR-induced apoptotic pathway. Furthermore, MC-LR exposure promoted cleavage of activating transcription factor 6 (ATF6, 50kd), inositol-requiring enzyme 1 (Ire1) expression, phosphorylation of IRE1, mitogen-activated protein kinase 5 (Map3k5) and Ddit3 expression, which was accompanied by the upregulation of death receptor 5 (Dr5) and active-caspase-3, and a decrease in Bcl-2 expression. ER stress inhibitor 4-Phenyl butyric acid (4-PBA) ameliorated these MC-LR-induced changes in protein or mRNA level. More importantly, knockdown of Ddit3 suppressed MC-LR-induced cell apoptosis and follicular atresia by directly regulating Dr5 and Bcl-2. Additionally, it was also found that MC-LR increased Map3k5 phosphorylation by inhibiting protein phosphatase 2A (PP2A) activity, and then promoted Ddit3 expression. In short, our data suggests that Ddit3 promotes MC-LR-induced mice ovarian cells apoptosis and follicular atresia via ER stress activation, which provides a new insight into the relation between infertility in females and the emerging water pollutant MC-LR.
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Objective: To determine the effect of maternal age on the average number of euploid embryos retrieved during oocyte harvest as part of an in vitro fertilization (IVF) cycle, including the probability of retrieving at least one euploid embryo in a cohort (PrE). Design: Retrospective study. Setting: Preimplantation genetic screening (PGS) laboratory. Patient(s): Women aged 18 to 48 years undergoing IVF treatment. Intervention(s): Use of 24-chromosome single-nucleotide polymorphism (SNP)-based PGS of day-3 and day-5 embryo biopsies. Main outcome measure(s): Relationships between maternal age and the rate of embryos that tested as euploid (hereafter referred to as "euploid embryos"), the average number and proportion of euploid embryos per IVF cycle, and PrE. Result(s): We analyzed 22,599 day-3 embryos and 15,112 day-5 embryos. In women aged 27 to 35 years, the median proportion of euploid embryos in each cycle remained constant at ∼35% in day-3 biopsies and ∼55% in day-5 biopsies, but it decreased rapidly after age 35. On average, women in their late 20s had four euploid embryos (day 3 or day 5) per cycle, but this number decreased linearly (R(2) ≥ 0.983) after 35 years of age. The effect of maternal age on PrE was similar, with a rapid exponential decline (R(2) = 0.986). Across all maternal ages, the euploid proportion and number of embryos per cycle were counterbalanced, so the number of euploid embryos per cycle was the same for day-3 and day-5 biopsies. This suggests that the loss of embryos from day 3 to day 5 was primarily due to aneuploidy. Conclusion(s): Our results confirm the known inverse relationship between advanced maternal age (>35 years) and embryo euploidy, demonstrating that equal numbers of euploid embryos are available at day 3 and day 5.
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Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
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Systematic reviews and meta-analyses have become increasingly important in health care. Clinicians read them to keep up to date with their field [1],[2], and they are often used as a starting point for developing clinical practice guidelines. Granting agencies may require a systematic review to ensure there is justification for further research [3], and some health care journals are moving in this direction [4]. As with all research, the value of a systematic review depends on what was done, what was found, and the clarity of reporting. As with other publications, the reporting quality of systematic reviews varies, limiting readers' ability to assess the strengths and weaknesses of those reviews. Several early studies evaluated the quality of review reports. In 1987, Mulrow examined 50 review articles published in four leading medical journals in 1985 and 1986 and found that none met all eight explicit scientific criteria, such as a quality assessment of included studies [5]. In 1987, Sacks and colleagues [6] evaluated the adequacy of reporting of 83 meta-analyses on 23 characteristics in six domains. Reporting was generally poor; between one and 14 characteristics were adequately reported (mean = 7.7; standard deviation = 2.7). A 1996 update of this study found little improvement [7]. In 1996, to address the suboptimal reporting of meta-analyses, an international group developed a guidance called the QUOROM Statement (QUality Of Reporting Of Meta-analyses), which focused on the reporting of meta-analyses of randomized controlled trials [8]. In this article, we summarize a revision of these guidelines, renamed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), which have been updated to address several conceptual and practical advances in the science of systematic reviews (Box 1). Box 1: Conceptual Issues in the Evolution from QUOROM to PRISMA Completing a Systematic Review Is an Iterative Process The conduct of a systematic review depends heavily on the scope and quality of included studies: thus systematic reviewers may need to modify their original review protocol during its conduct. Any systematic review reporting guideline should recommend that such changes can be reported and explained without suggesting that they are inappropriate. The PRISMA Statement (Items 5, 11, 16, and 23) acknowledges this iterative process. Aside from Cochrane reviews, all of which should have a protocol, only about 10% of systematic reviewers report working from a protocol [22]. Without a protocol that is publicly accessible, it is difficult to judge between appropriate and inappropriate modifications.
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Abstract Air pollution has gained considerable interest because of the multiple adverse effects reported on human health, although its impact on fertility remains unclear. A systematic search was performed to evaluate the impact of air pollutants on fertility. Controlled trials and observational studies assessing animal model and epidemiological model were included. Occupational exposure and semen quality studies were not considered. Outcomes of interest included live birth, miscarriage, clinical pregnancy, implantation, and embryo quality. Ten studies were included and divided into two groups: animal studies and human epidemiological studies including the general population as well as women undergoing in vitro fertilization and embryo transfer (IVF/ET). Results from this systematic review suggest a significant impact of air pollution on miscarriage and clinical pregnancy rates in the general population, whereas among subfertile patients certain air pollutants seem to exert a greater impact on fertility outcomes, including miscarriage and live birth rates. Besides, studies in mammals observed a clear detrimental effect on fertility outcomes associated to air pollutants at high concentration. The lack of prospective studies evaluating the effect of air pollution exposure in terms of live birth constitutes an important limitation in this review. Thus, further studies are needed to confirm these findings.
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Ambient air pollution has been associated with restricted fetal growth, which is linked with adverse respiratory health in childhood. We assessed the effect of maternal exposure to low concentrations of ambient air pollution on birthweight. We pooled data from 14 population-based mother-child cohort studies in 12 European countries. Overall, the study population included 74 178 women who had singleton deliveries between Feb 11, 1994, and June 2, 2011, and for whom information about infant birthweight, gestational age, and sex was available. The primary outcome of interest was low birthweight at term (weight <2500 g at birth after 37 weeks of gestation). Mean concentrations of particulate matter with an aerodynamic diameter of less than 2·5 μm (PM2·5), less than 10 μm (PM10), and between 2·5 μm and 10 μm during pregnancy were estimated at maternal home addresses with temporally adjusted land-use regression models, as was PM2·5 absorbance and concentrations of nitrogen dioxide (NO2) and nitrogen oxides. We also investigated traffic density on the nearest road and total traffic load. We calculated pooled effect estimates with random-effects models. A 5 μg/m(3) increase in concentration of PM2·5 during pregnancy was associated with an increased risk of low birthweight at term (adjusted odds ratio [OR] 1·18, 95% CI 1·06-1·33). An increased risk was also recorded for pregnancy concentrations lower than the present European Union annual PM2·5 limit of 25 μg/m(3) (OR for 5 μg/m(3) increase in participants exposed to concentrations of less than 20 μg/m(3) 1·41, 95% CI 1·20-1·65). PM10 (OR for 10 μg/m(3) increase 1·16, 95% CI 1·00-1·35), NO2 (OR for 10 μg/m(3) increase 1·09, 1·00-1·19), and traffic density on nearest street (OR for increase of 5000 vehicles per day 1·06, 1·01-1·11) were also associated with increased risk of low birthweight at term. The population attributable risk estimated for a reduction in PM2·5 concentration to 10 μg/m(3) during pregnancy corresponded to a decrease of 22% (95% CI 8-33%) in cases of low birthweight at term. Exposure to ambient air pollutants and traffic during pregnancy is associated with restricted fetal growth. A substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution was reduced. The European Union.
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Outdoor and indoor air pollution poses a significant cardiovascular risk, and has been associated with atherosclerosis, the main underlying pathology in many cardiovascular diseases. Although, it is well known that exposure to air pollution causes pulmonary disease, recent studies have shown that cardiovascular health consequences of air pollution generally equal or exceed those due to pulmonary diseases. The objective of this article is to evaluate the current evidence on the emerging role of environmental air pollutions in cardiovascular disease, with specific focus on the types of air pollutants and mechanisms of air pollution-induced cardiotoxicity. Published literature on pollution was systematically reviewed and cited in this article. It is hoped that this review will provide a better understanding of the harmful cardiovascular effects induced by air pollution exposure. This will help to bring a better understanding on the possible preventive health measures and will also serve regulatory agencies and researchers. In addition, elucidating the biological mechanisms underlying the link between air pollution and cardiovascular disease is an essential target in developing novel pharmacological strategies aimed at decreasing adverse effects of air pollution on cardiovascular system.
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Purpose: To determine the predictive value of serum anti-müllerian hormone (AMH) concentrations and antral follicle counts (AFC), on ovarian response and live birth rates after IVF and compare with age and basal FSH. Methods: Basal levels of AMH, FSH and antral follicle count were measured in 192 patients prior to IVF treatment. The predictive value of these parameters were evaluated in terms of retrieved oocyte number and live birth rates. Results: Poor responders in IVF were older, had lower AFC and AMH but higher basal FSH levels. In multivariate analysis AFC was the best and only independent parameter among other parameters and AMH was better than age and basal FSH to predict poor response to ovarian stimulation. Addition of AMH, basal FSH, age and total gonadotropin dose to AFC did not improve its prognostic reliability. Area under curve (AUC) for each parameter according to ROC analysis also revealed that AFC performed better in poor response prediction compared with AMH, basal FSH and age. The cut-off point for mean AMH and AFC in discriminating the best between poor and normal ovarian response cycles was 0.94 ng/mL (with a sensitivity of 70% and a specificity of 86%) and 5.5 (with a sensitivity of 91% and a specificity of 91%), respectively. However, age was the only independent predictor of live birth in IVF as compared to hormonal and ultrasound indices of ovarian reserve. Conclusion: AFC is better than AMH to predict poor ovarian response. Although AMH and AFC could be used to predict ovarian response they had limited value in live birth prediction. The only significant predictor of the probability of achieving a live birth was age.
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Background Exposure to air pollution is frequently associated with reductions in birth weight but results of available studies vary widely, possibly in part because of differences in air pollution metrics. Further insight is needed to identify the air pollution metrics most strongly and consistently associated with birth weight. Methods We used a hospital-based obstetric database of more than 70,000 births to study the relationships between air pollution and the risk of low birth weight (LBW, <2,500 g), as well as birth weight as a continuous variable, in term-born infants. Complementary metrics capturing different aspects of air pollution were used (measurements from ambient monitoring stations, predictions from land use regression models and from a Gaussian dispersion model, traffic density, and proximity to roads). Associations between air pollution metrics and birth outcomes were investigated using generalized additive models, adjusting for maternal age, parity, race/ethnicity, insurance status, poverty, gestational age and sex of the infants. Results Increased risks of LBW were associated with ambient O3 concentrations as measured by monitoring stations, as well as traffic density and proximity to major roadways. LBW was not significantly associated with other air pollution metrics, except that a decreased risk was associated with ambient NO2 concentrations as measured by monitoring stations. When birth weight was analyzed as a continuous variable, small increases in mean birth weight were associated with most air pollution metrics (<40 g per inter-quartile range in air pollution metrics). No such increase was observed for traffic density or proximity to major roadways, and a significant decrease in mean birth weight was associated with ambient O3 concentrations. Conclusions We found contrasting results according to the different air pollution metrics examined. Unmeasured confounders and/or measurement errors might have produced spurious positive associations between birth weight and some air pollution metrics. Despite this, ambient O3 was associated with a decrement in mean birth weight and significant increases in the risk of LBW were associated with traffic density, proximity to roads and ambient O3. This suggests that in our study population, these air pollution metrics are more likely related to increased risks of LBW than the other metrics we studied. Further studies are necessary to assess the consistency of such patterns across populations.
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Background: A growing body of evidence has associated maternal exposure to air pollution with adverse effects on fetal growth; however, the existing literature is inconsistent. Objectives: We aimed to quantify the association between maternal exposure to particulate air pollution and term birth weight and low birth weight (LBW) across 14 centers from 9 countries, and to explore the influence of site characteristics and exposure assessment methods on between-center heterogeneity in this association. Methods: Using a common analytical protocol, International Collaboration on Air Pollution and Pregnancy Outcomes (ICAPPO) centers generated effect estimates for term LBW and continuous birth weight associated with PM10 and PM2.5 (particulate matter ≤ 10 and 2.5 µm). We used meta-analysis to combine the estimates of effect across centers (~ 3 million births) and used meta-regression to evaluate the influence of center characteristics and exposure assessment methods on between-center heterogeneity in reported effect estimates. Results: In random-effects meta-analyses, term LBW was positively associated with a 10-μg/m3 increase in PM10 [odds ratio (OR) = 1.03; 95% CI: 1.01, 1.05] and PM2.5 (OR = 1.10; 95% CI: 1.03, 1.18) exposure during the entire pregnancy, adjusted for maternal socioeconomic status. A 10-μg/m3 increase in PM10 exposure was also negatively associated with term birth weight as a continuous outcome in the fully adjusted random-effects meta-analyses (–8.9 g; 95% CI: –13.2, –4.6 g). Meta-regressions revealed that centers with higher median PM2.5 levels and PM2.5:PM10 ratios, and centers that used a temporal exposure assessment (compared with spatiotemporal), tended to report stronger associations. Conclusion: Maternal exposure to particulate pollution was associated with LBW at term across study populations. We detected three site characteristics and aspects of exposure assessment methodology that appeared to contribute to the variation in associations reported by centers.
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Background: It has been proved that air quality is crucial for the success of IVF because of the presence of volatile organic compounds (VOCs), microbes, and perfumes, all of which can be harmful to embryo development in vitro. Therefore IVF laboratories are equipped with high efficiency particulate air (HEPA), and activated carbon filters plus positive pressure for air particulate control, with or without CODA system. Here we introduce a new technology using specially treated Honeycomb matrix media aligned in the Landson ™ series system for our laboratory air purification and its impact on IVF outcome. Methods: Air samples were collected outside and inside the laboratory, and intra-incubator at three different time points, before and after changing carbon filters and after Landson system installation, and we correlated air compounds measure variation with IVF outcome from 1403 cycles. Results: An improvement of air quality was confirmed with passages of total VOCs from 0.42 mg/m(3), 30.48 mg/m(3), 9.62 mg/m3, to 0.1 mg/m(3), 2.5 mg/m(3), 2.19 mg/m(3) through 0.07 mg/m(3), 0.16 mg/m(3), 0.29 mg/m(3), outside the laboratory, inside laboratory and intra-incubator respectively at three separated air sampling times. A clear decrease was observed in some VOCs such as formaldehyde, ethylene, acethylene, propylene, SO2, pentane, NOx, benzene, Hallon-1211, CFC and alcohol. At the same time a significant difference (P<0.05) was found between the third testing time TT3 after carbon filter change and Landson system installation and the first testing time TT1 before carbon filter change in fertilization rate 83.7 % vs 70.1 %, embryo cleavage rate 97.35 % vs 90.8 %, day 5 blastocyst formation rate 51.1 % vs 41.7 %, and pregnancy/implantation rates 54.6 %, 34.4 % vs 40.6 %, 26.4 %. Conclusion: Air purification by the new technology of Landson ™ series significantly improved IVF laboratory air quality, and embryo quality, thus increased pregnancy and implantation rates.
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This article describes how Androfert complied with the Brazilian Cells and Germinative Tissue Directive with regard to air quality standards and presents retrospective data of intracytoplasmic sperm injection (ICSI) outcomes performed in controlled environments. An IVF facility, composed of reproductive laboratories, operating room and embryo-transfer room, was constructed according to cleanroom standards for air particles and volatile organic compounds. A total of 2060 couples requesting IVF were treated in the cleanroom facilities, and outcome measures compared with a cohort of 255 couples treated at a conventional facility from the same practice before implementation of cleanrooms. No major fluctuations were observed in the cleanroom validation measurements over the study period. Live birth rates increased (35.6% versus 25.8%; P = 0.02) and miscarriage rates decreased (28.7% versus 20.0%; P = 0.04) in the first triennium after cleanroom implementation. Thereafter, the proportion of high-quality embryos steadily increased whereas pregnancy outcomes after ICSI were sustained despite the increased female age and decreased number of embryos transferred. This study demonstrates the feasibility of handling human gametes and culturing embryos in full compliance with the Brazilian directive on air quality standards and suggests that performing IVF in controlled environments may optimize its outcomes. RBMOnline
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The purpose of the present study was to examine the risk of stillbirth associated with ambient air pollution during pregnancy. Using live birth and fetal death data from New Jersey from 1998 to 2004, the authors assigned daily concentrations of air pollution to each birth or fetal death. Generalized estimating equation models were used to estimate the relative odds of stillbirth associated with interquartile range increases in mean air pollutant concentrations in the first, second, and third trimesters and throughout the entire pregnancy. The relative odds of stillbirth were significantly increased with each 10-ppb increase in mean nitrogen dioxide concentration in the first trimester (odds ratio (OR) = 1.16, 95% confidence interval (CI): 1.03, 1.31), each 3-ppb increase in mean sulfur dioxide concentration in the first (OR = 1.13, 95% CI: 1.01, 1.28) and third (OR = 1.26, 95% CI: 1.03, 1.37) trimesters, and each 0.4-ppm increase in mean carbon monoxide concentration in the second (OR = 1.14, 95% CI: 1.01, 1.28) and third (OR = 1.14, 95% CI: 1.06, 1.24) trimesters. Although ambient air pollution during pregnancy appeared to increase the relative odds of stillbirth, further studies are needed to confirm these findings and examine mechanistic explanations.
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A growing body of research suggests that prenatal exposure to air pollution may be harmful to fetal development. We assessed the association between exposure to air pollution during pregnancy and anthropometric measures at birth in four areas within the Spanish Children's Health and Environment (INMA) mother and child cohort study. Exposure to ambient nitrogen dioxide (NO2) and benzene was estimated for the residence of each woman (n = 2,337) for each trimester and for the entire pregnancy. Outcomes included birth weight, length, and head circumference. The association between residential outdoor air pollution exposure and birth outcomes was assessed with linear regression models controlled for potential confounders. We also performed sensitivity analyses for the subset of women who spent more time at home during pregnancy. Finally, we performed a combined analysis with meta-analysis techniques. In the combined analysis, an increase of 10 µg/m3 in NO2 exposure during pregnancy was associated with a decrease in birth length of -0.9 mm [95% confidence interval (CI), -1.8 to -0.1 mm]. For the subset of women who spent ≥ 15 hr/day at home, the association was stronger (-0.16 mm; 95% CI, -0.27 to -0.04). For this same subset of women, a reduction of 22 g in birth weight was associated with each 10-µg/m3 increase in NO2 exposure in the second trimester (95% CI, -45.3 to 1.9). We observed no significant relationship between benzene levels and birth outcomes. NO2 exposure was associated with reductions in both length and weight at birth. This association was clearer for the subset of women who spent more time at home.
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The aim of this epidemiologic study was to point out a relationship between the exposure to products of coal combustion, and complications in pregnancy where one third of causes of stillbirth are still unknown. In the town of Labin (Croatia) a coal-powered thermoelectric power plant is the single major air polluter. We compared the records of miscarriages, premature births and stillbirths in two periods: the control and the exposure period. Data on reproductive loss was based on the records of pregnant women visiting for regular monthly pregnancy checkups. At the time of the epidemiological prospective study, 260 women (n = 138 in the clean period and n = 122 in the dirty period) were considered representative. The data were processed using Chi square and correlation tests. The frequencies of miscarriages and stillbirths were significantly lower in the control than in the exposure period (p < 0.05). Methemoglobinemia and stillbirths recorded over the "exposure" period are significantly higher than in the "control" period (p = 0.0205). The level of methemoglobin in the bloodstream is an worthy biomarker, predictor and precursor of environmental toxics' adverse effects on the mother and fetus, and can indirectly explain the unrecognized level of fetal methemoglobin. Methemoglobin and heme, having prooxidant properties, also cause the early and late endothelial dysfunction of vital organs. Despite our retrospective epidemiological study findings, we emphasize that the rate of reproductive loss represents a hypothetical risk, which needs to be confirmed with further fetal clinical and anatomopatholgical researches about the effects of methemoglobin catabolism products on the fetal CNS.
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An increased risk of early pregnancy loss in women briefly exposed to high levels of ambient particulate matter during the preconceptional period was recently observed. The effects of this exposure on early embryo development are unknown. This study was designed to assess the dose-response and biological effects of diesel exhaust particles (DEP) on in vitro embryo development using the in vitro fertilization (IVF) mouse model. Zygotes obtained from superovulated mice after IVF were randomly cultured in different DEP concentrations (0, 0.2, 2, and 20 microg/cm(2)) for 5 days and observed for their capacity to attach and develop on a fibronectin matrix until day 8. Main outcome measures included blastocyst rates 96 and 120 h after insemination, hatching discriminatory score, total cell count, proportion of cell allocation to inner cell mass (ICM) and trophectoderm (TE), ICM morphology, attachment rate and outgrowth area, apoptosis and necrosis rates, and Oct-4 and Cdx-2 expression. Multivariate analysis showed a negative dose-dependent effect on early embryo development and hatching process, blastocyst cell allocation, and ICM morphology. Although blastocyst attachment and outgrowth were not affected by DEP, a significant impairment of ICM integrity was observed in day 8 blastocysts. Cell death through apoptosis was significantly higher after DEP exposure. Oct-4 expression and the Oct-4/Cdx-2 ratio were significantly decreased in day 5 blastocysts irrespective of DEP concentration. Results suggest that DEP appear to play an important role in disrupting cell lineage segregation and ICM morphological integrity even at lower concentrations, compromising future growth and viability of the blastocyst.
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To assess the potential effects of short-term exposure to particulate air pollution during follicular phase on clinical, laboratory, and pregnancy outcomes of women undergoing IVF/ET. Retrospective cohort study of 400 first IVF/ET cycles of women exposed to ambient particulate matter during follicular phase. Particulate matter (PM) was categorized into quartiles (Q(1): < or =30.48 microg/m(3), Q(2): 30.49-42.00 microg/m(3), Q(3): 42.01-56.72 microg/m(3), and Q(4): >56.72 microg/m(3)). Clinical, laboratory, or treatment variables were not affected by follicular phase PM exposure periods. Women exposed to Q(4) period during the follicular phase of conception cycles had a higher risk of miscarriage (odds ratio, 5.05; 95% confidence interval: 1.04-25.51) when compared to women exposed to Q(1-3) periods. Our results show an association between brief exposure to high levels of ambient PM during the preconceptional period and early pregnancy loss, although no effect of this exposure on clinical, laboratory, and treatment outcomes was observed.
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Air pollution has been associated with reproductive complications. We hypothesized that declining air quality during in vitro fertilization (IVF) would adversely affect live birth rates. Data from US Environmental Protection Agency air quality monitors and an established national-scale, log-normal kriging method were used to spatially estimate daily mean concentrations of criteria pollutants at addresses of 7403 females undergoing their first IVF cycle and at the their IVF labs from 2000 to 2007 in the Northeastern USA. These data were related to pregnancy outcomes. Increases in nitrogen dioxide (NO(2)) concentration both at the patient's address and at the IVF lab were significantly associated with a lower chance of pregnancy and live birth during all phases of an IVF cycle from medication start to pregnancy test [most significantly after embryo transfer, odds ratio (OR) 0.76, 95% confidence interval (CI) 0.66-0.86, per 0.01 ppm increase]. Increasing ozone (O(3)) concentration at the patient's address was significantly associated with an increased chance of live birth during ovulation induction (OR 1.26, 95% CI 1.10-1.44, per 0.02 ppm increase), but with decreased odds of live birth when exposed from embryo transfer to live birth (OR 0.62, 95% CI 0.48-0.81, per 0.02 ppm increase). After modeling for interactions of NO(2) and O(3) at the IVF lab, NO(2) remained negatively and significantly associated with live birth (OR 0.86, 95% CI 0.78-0.96), whereas O(3) was non-significant. Fine particulate matter (PM(2.5)) at the IVF lab during embryo culture was associated with decreased conception rates (OR 0.90, 95% CI 0.82-0.99, per 8 microg/m(3) increase), but not with live birth rates. No associations were noted with sulfur dioxide or larger particulate matter (PM(10)). 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.
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Studies have shown associations between air pollution or traffic exposure and adverse birth outcomes, such as low birth weight. However, very few studies have examined the effect of traffic emissions on spontaneous abortion (SAB). The goal of this study was to determine whether residential exposure to vehicular traffic was associated with SAB. Pregnant women from a prepaid health plan in California were recruited into a prospective cohort study in 1990-1991. Three measures of traffic exposure were constructed for the 4,979 participants using annual average daily traffic (AADT) counts near each residence and distance from residence to major roads. SAB was examined in relation to the traffic exposure measures using logistic regression adjusting for a number of demographic and lifestyle variables. Of the traffic measures, maximum annual average traffic within 50 m showed the strongest association with SAB, although it was not statistically significant. The adjusted odds ratio (AOR) for the top 90th percentile (AADT greater than 15,199) versus the bottom 75th percentile (AADT = 0-1,089) was 1.18 [95% confidence interval (CI), 0.87-1.60]. However, subgroup analyses showed statistically significant associations for traffic with SAB among African Americans (AOR = 3.11; 95% CI, 1.26-7.66) and nonsmokers (AOR = 1.47; 95% CI, 1.07-2.04). In this cohort, living within 50 m of a road with AADT of 15,200 or more was significantly associated with SAB among African Americans and nonsmokers. Further research is needed to confirm these results and possibly elucidate the mechanisms responsible for the findings.
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The time-series correlation between ambient levels, indoor levels, and personal exposure to PM2.5 was assessed in panels of elderly subjects with cardiovascular disease in Amsterdam, the Netherlands, and Helsinki, Finland. Subjects were followed for 6 months with biweekly clinical visits. Each subject's indoor and personal exposure to PM2.5 was measured biweekly, during the 24-hr period preceding the clinical visits. Outdoor PM2.5 concentrations were measured at fixed sites. The absorption coefficients of all PM2.5 filters were measured as a marker for elemental carbon (EC). Regression analyses were conducted for each subject separately, and the distribution of the individual regression and correlation coefficients was investigated. Personal, indoor, and ambient concentrations were highly correlated within subjects over time. Median Pearson's R between personal and outdoor PM2.5 was 0.79 in Amsterdam and 0.76 in Helsinki. For absorption, these values were 0.93 and 0.81 for Amsterdam and Helsinki, respectively. The findings of this study provide further support for using fixed-site measurements as a measure of exposure to PM2.5 in epidemiological time-series studies.
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Air pollution epidemiologic studies use ambient pollutant concentrations as surrogates of personal exposure. Strong correlations among numerous ambient pollutant concentrations, however, have made it difficult to determine the relative contribution of each pollutant to a given health outcome and have led to criticism that health effect estimates for particulate matter may be biased due to confounding. In the current study we used data collected from a multipollutant exposure study conducted in Baltimore, Maryland, during both the summer and winter to address the potential for confounding further. Twenty-four-hour personal exposures and corresponding ambient concentrations to fine particulate matter (PM(2.5)), ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide were measured for 56 subjects. Results from correlation and regression analyses showed that personal PM(2.5) and gaseous air pollutant exposures were generally not correlated, as only 9 of the 178 individual-specific pairwise correlations were significant. Similarly, ambient concentrations were not associated with their corresponding personal exposures for any of the pollutants, except for PM(2.5), which had significant associations during both seasons (p < 0.0001). Ambient gaseous concentrations were, however, strongly associated with personal PM(2.5) exposures. The strongest associations were shown between ambient O(3) and personal PM(2.5) (p < 0.0001 during both seasons). These results indicate that ambient PM(2.5) concentrations are suitable surrogates for personal PM(2.5) exposures and that ambient gaseous concentrations are surrogates, as opposed to confounders, of PM(2.5). These findings suggest that the use of multiple pollutant models in epidemiologic studies of PM(2.5) may not be suitable and that health effects attributed to the ambient gases may actually be a result of exposures to PM(2.5).
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Study question: Is there an association between air pollution exposures and incident infertility? Summary answer: Increased exposure to air pollution is associated with an increased incidence of infertility. What is known already: Exposures to air pollution have been associated with lower conception and fertility rates. However, the impact of pollution on infertility incidence is unknown. Study design, size, duration: Prospective cohort study using data collected from 116 430 female nurses from September 1989 to December 2003 as part of the Nurses' Health Study II cohort. Participants/materials, setting, methods: Infertility was defined by report of attempted conception for ≥12 months without success. Participants were able to report if evaluation was sought and if so, offer multiple clinical indications for infertility. After exclusion, 36 294 members were included in the analysis. Proximity to major roadways and ambient exposures to particulate matter less than 10 microns (PM10), between 2.5 and 10 microns (PM2.5-10), and less than 2.5 microns (PM2.5) were determined for residential addresses for the 36 294 members between the years of 1993 and 2003. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using multivariable adjusted Cox proportional hazard models with time-varying covariates. Main results and the role of chance: Over 213 416 person-years, there were 2508 incident reports of infertility. Results for overall infertility were inconsistent across exposure types. We observed a small increased risk for those living closer to compared to farther from a major road, multivariable adjusted HR = 1.11 (CI: 1.02-1.20). This was consistent for those reporting primary or secondary infertility. For women living closer to compared to farther from a major road, for primary infertility HR = 1.05 (CI: 0.94-1.17), while for secondary infertility HR = 1.21 (CI: 1.07-1.36). In addition, the HR for every 10 µg/m(3) increase in cumulative PM2.5-10 among women with primary infertility was 1.10 (CI: 0.96-1.27), and similarly was 1.10 (CI: 0.94-1.28) for those with secondary infertility. Limitations, reasons for caution: Within the 2 year window of infertility diagnosis, we do not have the exact date of diagnosis or the exact timing of the start of attempting conception. As infertility status and subtypes of infertility were prospectively collected biennially, we were unable to tightly examine the timing of exposures on incidence of infertility. In terms of exposure quantification, we used ambient air pollution exposures as a proxy for personal exposures, potentially leading to exposure misclassification. However, several studies suggest that ambient measurements are an acceptable surrogate for individual level exposures in most populations. Wider implications of the findings: We observed an association between all size fractions of PM exposure, as well as traffic-related air pollution, and incidence of infertility. Of note, the strongest association was observed between cumulative average exposures over the course of follow-up and the risk of infertility, suggesting that chronic exposures may be of greater importance than short-term exposures. Study funding/competing interests: The work for this paper was supported by the following: S.M.: Reproductive Scientist Development Program HD000849, and the Building Interdisciplinary Research Careers in Women's Health HD043444, the Boston University CTSI 1UL1TR001430, and a research grant from the Boston University Department of Obstetrics and Gynecology, S.A.M.: R01HD57210 from the National Institute of Child Health and Human Development and the Massachusetts Institute of Technology Center for Environmental Health Sciences Translational Pilot Project Program, R01CA50385 from the National Cancer Institute, J.E.H. and F.L.: 5R01ES017017 from the National Institute for Environmental Health Sciences, 5 P42 ES007381 from the National Institute of Environmental Health at the National Institute of Health. L.V.F.: T32HD060454 in reproductive, perinatal, and pediatric epidemiology from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The Nurses' Health Study II is additionally supported by infrastructure grant UM1CA176726 from the National Cancer Institute, NIH, U.S. Department of Health and Human Services. The authors have no actual or potential competing financial interests to disclose.