Fine Particulate Matter and Its Constituent on Ovarian Reserve: Identifying Susceptible Windows of Exposure

Background: Little is known about the associations of exposure to fine particulate matter (PM) and its constituents with ovarian reserve, and the potential susceptible window of exposure remains unclear.

Methods: We performed a retrospective cohort study of 5189 women who attended a fertility center in Hubei, China, during 2019-2022, and estimated concentrations of PM and its major constituents during the development of follicles (4th-6th month [W1], 0-4th month [W2], 0-6th month [W3]) and 1-year before measurement (W4) based on Tracking Air Pollution in China database. We used multivariable linear regression and logistic regression models to examine the associations of PM and its constituent exposures with anti-Müllerian hormone (AMH), the preferred indicator of ovarian reserve.

Results: We observed significantly decreased AMH levels associated with increasing PM concentrations, with the percent changes (95 % confidence intervals [CIs]) of 1.99 % (0.24 %-3.71 %) during W1 and 3.99 % (0.74 %-7.15 %) during W4 for per 10 μg/m increases in PM.When PM exposure levels were equal to 50th percentile (32.6-42.3 μg/m) or more, monotonically decreased AMH levels and increased risks of low AMH were seen with increasing PM concentrations during W1 and W4 (P < 0.05). Black carbon (BC), ammonium (NH), nitrate (NO), and organic matter (OM) during W1, and NH, NO, as well as sulfate (SO) during W4 were significantly associated with decreased AMH. Moreover, PM and SO exposures during W4 were positively associated with low AMH. Additionally, the associations were stronger among women aged <35 years, lived in urban regions, or measured AMH in cold-season (P for interaction <0.05).

Conclusion: PM and specific chemical components (particularly NH, NO3, and SO4) exposure during the secondary to antral follicle stage and 1-year before measurement were associated with diminished ovarian reserve (DOR), indicating the adverse impact of PM and its constituent exposures on female reproductive potential.