短期空气污染对辅助生殖周期结局的影响

Effects of short-term exposure to ambient air pollution on outcomes of in vitro fertilization and embryo transfer(IVF-ET)cycles

目的探讨女性患者短期暴露于不同浓度PM_(2.5)对辅助生殖周期结局的影响。方法回顾性分析443例年龄不大于36岁、接受常规体外受精-胚胎移植(IVF-ET)手术的患者,按照他们暴露于不同浓度的PM_(2.5),将其分成3组(第1组:≤35μg/m^3;第2组:35.01-75μg/m^3;第3组:≥75.01μg/m^3)。比较其实验室结局(包括受精率、卵裂率和优胚率)和临床结局(包括着床率、临床妊娠率、流产率以及活产率)。结果各组间的临床结局差异不显著;在实验室结局方面:受精率和卵裂率在各组患者间差异不显著。第1组和第2组的优胚率分别为66.3%和61.4%,要显著高于第3组的54.0%,但是第1组与第2组之间差异不显著。将PM_(2.5)的浓度与优胚率进行相关性分析,表明他们之间存在明显的负相关,且PM_(2.5)浓度每上升1μg/m3,优胚率就有下降0.7%的风险(OR:0.99,95%CI:0.99-1.00,P=0.001)。结论在辅助生殖周期中,女性患者短期暴露于高浓度的PM_(2.5),可能会造成优胚率的下降,但是对临床结局无较大影响。

Objective：This study aimed to investigate the effects of short-term exposure to particulates smaller than 2.5 μm in aerodynamic diameter（PM2.5）on outcomes of women undergoing in vitro fertilization-embryo transfer（IVF-ET）process.Methods：A retrospective study was carried out on 443 IVF-ET cycles of the couples exposed to ambient particulate matter.The ages of females in all cycles are no more than 36 years old.PM2.5 average values for the short-term exposure were divided into three groups（Group 1：≤ 35 μg/m^3,Group 2：35.01-75 μg/m～3 and Group 3：≥ 75.01 μg/m^3）.Then laboratory（including fertilization rate,cleavage rate and good quality embryo rate）and clinical（including implantation rate,clinical pregnancy rate,abortion rate and live birth rate）outcomes of women among of the three groups were analyzed.Results：Clinical outcomes were not affected by exposure to different levels of PM2.5.For laboratory outcomes,we found that females in Group 1（66.3%）and Group 2（61.4%）have higher good quality embryo rates compared to females in Group 3（54.0%）.The risk of good quality embryo rate decreased 0.7% per unit increase in PM2.5 average（OR：0.99,95% CI：0.99-1.00）.However no differences were observed in any other laboratory outcomes.Conclusion：Our results indicated that increased levels of PM2.5 exposure could be have an adverse effect on good quality embryo rate in IVF-ET cycles.