Abstract: P-560

An Analysis of the Effects of Particulate Matter on Ovarian Reserve

Presenter: Rachel Grimes


Abstract


AN ANALYSIS OF THE EFFECTS OF PARTICULATE MATTER ON OVARIAN RESERVE.

Author Block: Rachel Grimes, M.D.1, Bruce Pier, M.D. 1,
Jeff Szychowski, Ph.D.1, Gordon W. Bates, M.D.1, Mamie McLean, M.D.2
1 University of Alabama at Birmingham Center for Women’s Reproductive Health, Birmingham, AL; 2Alabama Fertility Specialists, Birmingham AL

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AN ANALYSIS OF THE EFFECTS OF PARTICULATE MATTER ON OVARIAN RESERVE.

Author Block: Rachel Grimes, M.D.1, Bruce Pier, M.D. 1,
Jeff Szychowski, Ph.D.1, Gordon W. Bates, M.D.1, Mamie McLean, M.D.2
1 University of Alabama at Birmingham Center for Women’s Reproductive Health, Birmingham, AL; 2Alabama Fertility Specialists, Birmingham AL

Abstract:
OBJECTIVE: Ambient air pollution, specifically particulate matter (PM) and ozone (O3), have been associated with serious health problems. PM is a mixture of solid particles and liquid droplets and O3 is a secondary pollutant generated from precursors of NO2 and volatile organic compounds in the presence of sunlight. Declining air quality is associated with decreased fecundability and adverse reproductive outcomes including lower live birth rates, preterm birth, and decreased chance of conception in the IVF population. The mechanisms driving these adverse reproductive outcomes are unknown, but may be due to changes in oocyte quality. The impact of air quality on ovarian reserve has not been studied.
DESIGN: Our study is a retrospective cohort study in women from an academic reproductive endocrinology and infertility clinic with ovarian reserve testing.
MATERIALS AND METHODS: The primary outcome is diminished ovarian reserve, defined as FSH >10 or an FSH ≤ 10 and E2 > 80. Normal ovarian reserve (or non-DOR) is defined as FSH ≤ 10. Inclusion criteria: age 22 - 45 years, and a listed zip code. Exclusion criteria: history of cancer treatment, or prior ovarian surgery. There were 1156 women included in ouranalysis. Particulate matter exposure, specifically O3 and total PM levels, were assessed by zip code according to the EPA database in relation to different time points from the FSH result. Baseline characteristics were compared using t-test or chi-square and Fisher’s exact tests as appropriate. Multivariable logistic regression was utilized to evaluate the relationship between exposure to particulate matter and ovarian reserve while controlling for confounders.
RESULTS: In our cohort, 601 were Non-DOR (52%) and 555 were DOR (48%). Women with DOR were older and have had prior pregnancy. There were no differences in race, BMI, or smoking history by DOR vs non-DOR. Women with DOR had lower O3 exposure within the week prior to FSH assessment compared to non-DOR (37.6 +/- 7.5 vs. 38.8 +/- 8.4, p =0.03). There were no differences by DOR vs non-DOR for PM exposure nor other time intervals of O3 exposure. In multivariable logistic regression models, the odds of non-DOR increase with increasing O3 exposure (OR 0.98, 95% CI 0.97-1.00).

CONCLUSIONS: Our study found no evidence of DOR among women living in areas with higher exposure to O3 and total PM, contrary to our hypothesis. Potentially other types of particulate matter, not assessed in this study, are associated with DOR, or the association of particulate matter with adverse reproductive outcomes is not mediated by ovarian reserve. Further investigation is warranted.

Financial Support & References:
Financial Support: None
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