Decreased sperm motility is associated with air pollution in Salt Lake City

Long term exposure to road traffic noise and air pollution and risk of infertility in men and women: nationwide Danish cohort study

OBJECTIVE

To investigate associations between long term residential exposure to road traffic noise and particulate matter with a diameter <2.5 µm (PM2.5) and infertility in men and women.

DESIGN

Nationwide prospective cohort study.

SETTING

Denmark.

PARTICIPANTS

526 056 men and 377 850 women aged 30-45 years, with fewer than two children, cohabiting or married, and residing in Denmark between 2000 and 2017.

MAIN OUTCOME MEASURE

Incident infertility in men and women during follow-up in the Danish National Patient Register.

RESULTS

Infertility was diagnosed in 16 172 men and 22 672 women during a mean follow-up of 4.3 years and 4.2 years, respectively. Mean exposure to PM2.5 over five years was strongly associated with risk of infertility in men, with hazard ratios of 1.24 (95% confidence interval 1.18 to 1.30) among men aged 30-36.9 years and 1.24 (1.15 to 1.33) among men aged 37-45 years for each interquartile (2.9 µg/m3) higher PM2.5 after adjustment for sociodemographic variables and road traffic noise. PM2.5 was not associated with infertility in women. Road traffic noise (Lden, most exposed facade of residence) was associated with a higher risk of infertility among women aged 35-45 years, with a hazard ratio of 1.14 (1.10 to 1.18) for each interquartile (10.2 dB) higher five year mean exposure. Noise was not associated with infertility among younger women (30-34.9 years). In men, road traffic noise was associated with higher risk of infertility in the 37-45 age group (1.06, 1.02 to 1.11), but not among those aged 30-36.9 years (0.93, 0.91 to 0.96).

CONCLUSIONS

PM2.5 was associated with a higher risk of an infertility diagnosis in men, whereas road traffic noise was associated with a higher risk of an infertility diagnosis in women older than 35 years, and potentially in men older than 37 years. If these results are confirmed in future studies, higher fertility could be added to the list of health benefits from regulating noise and air pollution.

Association between fine particulate matter and fecundability in Henan, China: A prospective cohort study

OBJECTIVE

To investigate the relationship between ambient fine particulate matter (PM2.5) exposure and fecundability.

METHODS

This study included 751,270 female residents from Henan Province who participated in the National Free Pre-conception Check-up Projects during 2015-2017. Ambient cycle-specific PM2.5 exposure was assessed at the county level for each participant using satellite-based PM2.5 concentration data at 1-km resolution. Cox proportional hazards models with time-varying exposure were used to estimate the association between fecundability and PM2.5 exposure, adjusted for potential individual risk factors.

RESULTS

During the study period, 568,713 participants were pregnant, monthly mean PM2.5 concentrations varied from 25.5 to 114.0 µg/m3 across study areas. For each 10 µg/m3 increase in cycle-specific PM2.5, the hazard ratio for fecundability was 0.951 (95 % confidence interval: 0.950-0.953). The association was more pronounced in women who were older, with urban household registration, history of pregnancy, higher body mass index (BMI), hypertension, without exposure to tobacco, or whose male partners were older, with higher BMI, or hypertension.

CONCLUSION

In this population-based prospective cohort, ambient cycle-specific PM2.5 exposure was associated with reduced fecundability. These findings may support the adverse implications of severe air pollution on reproductive health.

Association between air pollution and male sexual function: A nationwide observational study in China

This study aimed to explore the associations between air pollution and male sexual function. A total of 5047 male subjects in China were included in this study. The average air pollution exposure (PM2.5, PM10, SO2, CO, NO2, and O3) for the preceding 1, 3, 6, and 12 months before the participants' response was assessed. Male sexual function was evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT). Generalized linear models were utilized to explore the associations between air pollution and male sexual function. K-prototype algorithm was conducted to identify the association among specific populations. Significant adverse effects on the IIEF-5 score were observed with NO2 exposure during the preceding 1, 3, and 6 months (1 m: β = -5.26E-05; 3 m: β = -4.83E-05; 6 m: β = -4.23E-05, P < 0.05). PM2.5 exposure during the preceding 12 months was found to significantly negatively affect the PEDT after adjusting for confounding variables. Our research indicated negative correlations between air pollutant exposures and male sexual function for the first time. Furthermore, these associations were more pronounced among specific participants who maintain a normal BMI, exhibit extroverted traits, and currently engage in smoking and alcohol consumption.

Reduction of ovarian reserves and activation of necroptosis to in vivo air pollution exposures

We investigated the association between air pollution and changes in ovarian follicles, anti-mullerian hormone (AMH) levels, the occurrence of necroptosis cell death by activation of receptor-interacting protein kinase 3 (RIPK3) and, the activation of mixed lineage kinase domain-like (MLKL) proteins. Forty-two female Wistar rats were divided into three groups of 14 each, which were exposed to real-ambient air, filtered air and purified air (control) in two periods of 3 and 5 months. The results showed that the number of ovarian follicles decreased in the group exposed to real-ambient air versus the control group (P < 0.0001). The trend of age-related AMH changes with respect to exposure to air pollutants was affected and its levels decreased after 3 months of exposure. The MLKL increased in the group exposed to the real-ambient air compared to the control group (P = 0.033). Apparently long-term exposure to air pollution can reduce ovarian reserves.

Associations of exposure to ambient fine particulate matter constituents from different pollution sources with semen quality: Evidence from a prospective cohort

The association between ambient fine particulate matter (PM2.5) exposure and semen quality remains inconclusive, possibly due to variations in pollution sources and PM2.5 compositions. Studies investigating the constituents of PM2.5 have been hindered by small sample sizes, and research exploring the relationships between PM2.5 pollution sources and semen quality is lacking. To address this gap, we conducted a comprehensive study based on the Anhui prospective assisted reproduction cohort to evaluate the associations between semen quality and the constituents and pollution sources of PM2.5. This study included 9013 semen samples from 4417 males in the urban districts of Hefei. The median concentrations of PM2.5 constituents, including eight metals and four water-soluble ions (WSIs), were measured for seven days per month at two monitoring stations during the 0-90-day exposure window. A linear mixed-effects model, weighted quantile sum regression, and positive matrix factorisation were used to evaluate the associations of the constituents and pollution sources of PM2.5 with semen quality. The results showed that exposure to PM2.5-bound metals (antimony, arsenic, cadmium, lead, and thallium) and WSIs (sulphate and chloride) were negatively associated with semen quality parameters. Moreover, mixtures of PM2.5-bound metals and WSIs were negatively associated with semen quality. Additionally, PM2.5 derived from traffic emissions was negatively associated with semen quality. In summary, our study revealed that ambient PM2.5 and its constituents, especially metals, were negatively associated with semen quality. Antimony, lead, and thallium emerged as the primary contributors to toxicity, and PM2.5 from traffic emissions was associated with decreased semen quality. These findings have important public health implications for the management of PM2.5 pollution in the context of male reproductive health.

Decrease in Sperm Parameters in the 21st Century: Obesity, Lifestyle, or Environmental Factors? An Updated Narrative Review

Semen quality represents a compelling factor for fertility, and delineating the normal values has proven difficult. In the last four decades, several authors have reported a noticeable decline in sperm parameters. Also, studies investigating 'time to pregnancy' have shown that fecundity begins to be reduced when sperm numbers decrease below 30 million, even though according to the 6th edition of the WHO manual, the normal value is currently 16 million/mL or 39 million per ejaculate. There exists sufficient data to suggest a decline in sperm counts over time, even though the clear reason for this adverse trend is not well established, but some associations have been hypothesised, such as maternal smoking during pregnancy. Additional potential factors have yet to be fully illustrated but involve poor diet, increased obesity, and exposure to environmental toxins. Moreover, the change in environmental conditions and more common exposure to endocrine-disrupting chemicals (EDCs), such as pesticides and herbicides, as well as bisphenol A, phthalates, polychlorinated biphenyls, and heavy metals, starting from prenatal life and continuing into adulthood, may exhibit probable features explaining the reduction in sperm parameters. Therefore, the main goal of this narrative review is to furnish an overview of the possible effects of exposure to EDCs on testicular function and spermatogenesis and, also, to summarise the evidence regarding a decrease in sperm quality and examine its potential consequences.

Exposure to air pollution and ovarian reserve parameters

Exposure to air pollution is associated with many different health effects, especially cardiovascular and respiratory diseases. Additionally, highly significant links between exposure to air pollution and fertility, particularly male fertility was observed, however the studies regarding exposure to selected air pollutants and female fertility assessed by ovarian reserve are rare. Hence, the main aim of the study was to analyze relationship between exposure to ambient air pollution and ovarian reserve parameters among Polish women. The study population consisted of 511 women, who attended to infertility clinic because of diagnostic purposes. Participants filled in the questionnaire about social-demographic, lifestyle and health factors. Infertility specialists assessed ovarian parameters such as: antral follicle count (AFC) and concentration of hormones: Anti-Müllerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol (E2). The air pollutants level (sulfur dioxide, nitrogen dioxide, carbon monoxide, ozone, particulate matters) were obtained via National Environmental Protection Inspectorate database. Significant negative association between PM2,5 and AHM (p = 0.032) as well as AFC (p = 0.044) was observed. Moreover, SO2 concentrations decrease AFC (p = 0.038). The results also suggest that PM10, PM2.5, SO2 exposure on antral follicle count may be more pronounced among women with a female factor infertility diagnosis. Additionally, exposure to PM2.5 and NOx on AFC and AMH was stronger among older women (> 35 years of age). To conclude, the present study found that air pollution could lead to decrease in follicle antral count and Anti-Müllerian hormone level, especially exposure to PM2,5 and SO2 thus the evidence suggest negative impact to ovarian reserve.

Implications of Exposure to Air Pollution on Male Reproduction: The Role of Oxidative Stress

Air pollution, either from indoor (household) or outdoor (ambient) sources, occurs when there is presence of respirable particles in the form of chemical, physical, or biological agents that modify the natural features of the atmosphere or environment. Today, almost 2.4 billion people are exposed to hazardous levels of indoor pollution, while 99% of the global population breathes air pollutants that exceed the World Health Organization guideline limits. It is not surprising that air pollution is the world's leading environmental cause of diseases and contributes greatly to the global burden of diseases. Upon entry, air pollutants can cause an increase in reactive oxygen species (ROS) production by undergoing oxidation to generate quinones, which further act as oxidizing agents to yield more ROS. Excessive production of ROS can cause oxidative stress, induce lipid peroxidation, enhance the binding of polycyclic aromatic hydrocarbons (PAHs) to their receptors, or bind to PAH to cause DNA strand breaks. The continuous and prolonged exposure to air pollutants is associated with the development or exacerbation of pathologies such as acute or chronic respiratory and cardiovascular diseases, neurodegenerative and skin diseases, and even reduced fertility potential. Males and females contribute to infertility equally, and exposure to air pollutants can negatively affect reproduction. In this review, emphasis will be placed on the implications of exposure to air pollutants on male fertility potential, bringing to light its effects on semen parameters (basic and advanced) and male sexual health. This study will also touch on the clinical implications of air pollution on male reproduction while highlighting the role of oxidative stress.

The effect of various air pollution and participants' age on semen quality in southern Taiwan

OBJECTIVE

This study aimed to investigate the association between semen quality and air pollution in southern Taiwan.

MATERIALS AND METHODS

In this retrospective study, 4338 males aged 21-70 years were recruited between 2001 and 2018 from a reproductive medical center. Semen quality was assessed according to standardized methods outlined in the World Health Organization (WHO) Laboratory Manual 1999 and 2010, including total sperm count, progressive sperm motility (%), rapid progressive sperm motility (%), and sperm with normal morphology (%). All designated national air quality automatic continuous monitoring stations measured the levels of air pollution [particulate matter (PM10 and PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3)], and was documented by Environmental Protection Administration in Taiwan. We collected data on the levels of air pollution based on the participants' residential addresses.

RESULTS

In our study, we found that progressive and rapid progressive sperm motility significantly decreased annually (p < 0.05). In addition, increasing age influenced total sperm count, progressive sperm motility, rapid progressive sperm motility, and sperm with normal morphology (p < 0.05). Among different air pollution, we observed SO2 was associated with lower rapid progressive sperm motility and lower sperm with normal morphology (β = -0.103, p = 0.043; β = 0.118, p = 0.001, respectively). However, NO2 was associated with higher rapid progressive sperm motility and a high number of sperm with normal morphology (β = 0.129, p = 0.002; β = 0.127, p < 0.001, respectively).

CONCLUSIONS

The semen quality in southern Taiwan appears to have declined in recent years. The participant's age for semen analysis was most strongly associated with semen parameters, Moreover, a significant association between SO2 and NO2 levels and semen motility was observed, even after adjusting for multiple comparisons. Further study is required to analyze the dose-dependent effect of SO2 and NO2 on semen parameters.

The role of total antioxidant capacity and malondialdehyde of seminal plasma in the association between air pollution and sperm quality

Accumulating evidence has suggested that men exposed to air pollution are associated with decreased sperm quality, and seminal plasma plays a pivotal role in maintaining sperm viability. However, the role of seminal plasma in air pollution related sperm quality decline remain unestablished. In current study, we recruited 524 participants from couples who underwent in vitro fertilization treatment due to female factors at a fertility clinic in China from March to August 2020. Conventional sperm parameters, total antioxidant capacity (T-AOC), malondialdehyde (MDA) and testosterone were measured using semen samples. The six main air pollutants (PM2.5, PM10, NO2, SO2, CO, O3) during four key periods of sperm development (meiotic stage, spermiogenesis stage, epididymal stage and total sperm cycle period) were estimated using inverse distance weighting method. Multiple linear regression models were employed to investigate the exposure-outcome relationships. And we found that PM10 exposures were negatively related to sperm total motility and the exposures of PM2.5 and PM10 were inversely associated with sperm progressive motility during epididymal stage. Furthermore, PM2.5 and PM10 exposures were positively associated with seminal plasma MDA and PM10 was negatively related to seminal plasma T-AOC during epididymal stage. PM2.5, PM10 and CO exposures during total sperm cycle period might relate to increased seminal plasma testosterone. Mediation analysis indicated seminal plasma MDA and T-AOC partially mediated PM10 associated reduction of sperm motility during epididymal stage. Our study suggested MDA and T-AOC of seminal plasma played a role in air pollution associated decline of sperm motility.

Exposure to Fine Particulate Matter Constituents and Human Semen Quality Decline: A Multicenter Study

Exposure to fine particulate matter (PM < 2.5 μm in diameter [PM2.5]) may accelerate human sperm quality decline, although research on this association is limited. Our objective was to investigate the relationship between exposure to the chemical constituents of PM2.5 air pollution and decreased sperm quality and to further explore the exposure-response relationship. We conducted a multicenter population-based cohort study including 78,952 semen samples from 33,234 donors at 6 provincial human sperm banks (covering central, northern, southern, eastern, and southwestern parts of China) between 2014 and 2020. Daily exposure to PM2.5 chemical composition was estimated using a deep learning model integrating a density ground-based measure network at a 1 km resolution. Linear mixed models with subject- and center-specific intercepts were used to quantify the harmful impacts of PM2.5 constituents on semen quality and explore their exposure-response relationships. Per interquartile range (IQR) increase in PM2.5 exposure levels during spermatogenesis was significantly associated with decreased sperm concentration, progressive motility, and total motility. For PM2.5 constituents, per IQR increment in Cl- (β: -0.02, 95% CI: [-0.03, -0.00]) and NO3- (β: -0.05, 95% CI: [-0.08, -0.02]) exposure was negatively associated with sperm count, while NH4+ (β: -0.03, 95% CI: [-0.06, -0.00]) was significantly linked to decreased progressive motility. These results suggest that exposure to PM2.5 chemical constituents may adversely affect human sperm quality, highlighting the urgent need to reduce PM2.5 exposure.

Does Air Pollution Impact on Semen Parameters? Findings from a Real-Life, Cross-Sectional Study in Italian Infertile Men

PURPOSE

In industrialized countries, air pollutants levels have been monitored closely for environmental and research issues. Using Italian data, we aimed to investigate the association between air pollutants levels and semen parameters in a cohort of non-Finnish white-European men presenting for couple's infertility.

MATERIALS AND METHODS

Complete demographic and laboratory data from 1,152 infertile men consecutively assessed between January 2015 and January 2018 were analyzed. Semen analyses were based on the 2010 World Health Organization reference criteria. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). We analyzed the annual average level of the three main markers of air pollution (Pm10, Pm2.5, and NO₂) between 2014 and 2018. Descriptive statistics, linear and logistic regression analyses tested the association between air pollutants levels and semen parameters.

RESULTS

Of 1,152 men, 87 (7.55%) had normal sperm parameters at first semen analysis. Of 1,065 patients with abnormal semen analyses, 237 (22.25%), 324 (30.42%), and 287 (26.95%) patients presented 1, 2 or 3 abnormalities, respectively, and 217 (20.38%) were azoospermic. At linear regression analysis, Pm10, Pm2.5, and NO₂ were negatively associated with sperm morphology (Pm10: β=-0.5288 µg/m³, p=0.001; Pm2.5: β=-0.5240 µg/m³, p=0.019; NO₂: β=-0.4396 µg/m³, p<0.0001). Furthermore, the adjusted odds of normal sperm morphology <4% were 1.06 (95% confidence interval [CI], 1.03-1.09; p=0.007) for Pm10, 1.07 (95% CI, 1.03-1.11; p=0.007) for Pm 2.5, and 1.03 (95% CI, 1.02-1.05; p=0.001) for NO₂, respectively.

CONCLUSIONS

In a large homogenous cohort of infertile men, Pm10, Pm 2.5, and NO₂ levels were negatively associated with sperm morphology. Conversely, no clear association was observed with other macroscopic sperm parameters.

Decrease of air pollution during lockdown in Tuscany (Italy): An effect on sperm DNA fragmentation?

In March 2020, the Italian government imposed a national lockdown which was almost completely removed in June 2020. Due to the abrupt stop of human activities, emissions of air pollutants decreased. Air pollution is an environmental risk factor for noncommunicable disease and mortality. Emerging evidence also suggests a role in male infertility. In this study, we compared sperm DNA fragmentation (sDF) levels and conventional semen parameters between subjects undergoing sDF determination and routine semen analysis in a single Italian centre, during about 6 months before (N = 119) and after lockdown (N = 105). After lockdown, we found an improvement of sperm progressive motility (48.00[38.50-58.00]% vs. 42.00[33.00-53.00]%) and sDF levels (as total: 24.79[18.33-33.97]% vs. 35.02[25.04-45.73]%, p < .001; brighter: 14.02[10.69-17.93]% vs 18.54[13.58-25.82]%, p < .001 and dimmer sDF: 9.24[5.64-15.78]% vs. 12.24[8.08-19.10]%, p < .01), mirrored by a decrease of leukocyte semen concentration (p < .01). The improvement of sperm motility and DNA quality was maintained after adjusting for leukocyte concentration and several conditions known to affect sperm motility and/or sDF levels. With a significant decrease in air pollution observed in Tuscany during and after lockdown, associated improvement in sperm motility and DNA quality in patients referred to the infertility clinic is suggestive of the potential role of air pollution in male infertility.

Exposure to ambient particulate matter affects semen quality: A case study in Wenzhou, China

BACKGROUND

Particulate matter (PM), including PM_2.5 (PM ≤ 2.5 µm in aerodynamic diameter) and PM₁₀ (PM ≤ 10 µm in aerodynamic diameter), is a component of air pollutants, which is linked to semen quality. However, the available evidence of association needs to be strengthened, and some studies have conflicting results.

OBJECTIVES

To evaluate the potential impacts of PM on semen quality during the full (0-90 days before semen examination) and three key sperm development windows (0-9, 10-14, and 70-90 days before semen examination).

METHODS

We included 1494 infertile men in the main urban area in Wenzhou, China, who had undergone semen examinations for fertility between 2014 and 2019. The impacts were assessed by multivariable linear regression models.

RESULTS

Overall, during the full sperm development window, PM_2.5 and PM₁₀ exposures were associated with declined progressive sperm motility (%) (β: -0.6; 95% confidence intervals (CIs): -1.07, -0.13 and -0.46; -0.59, -0.33) and total sperm motility (%) (-1.95; -2.67, -1.23 and -1.32; -1.82, -0.82), and associated with increased sperm concentration (10⁶ /ml) (0.02; 0.006, 0.023 and 0.007; 0.001, 0.013) and total sperm number (10⁶ ) (0.02; 0.01, 0.03 and 0.011; 0.004, 0.017). Furthermore, only PM_2.5 exposure during the 10-14 days window was significantly associated with declined progressive motility (%) (-0.207; -0.395, -0.023).

CONCLUSIONS

During the full sperm development window, PM exposure has an adverse impact on sperm motility and positive impacts on sperm concentration and total sperm number. The adverse impact was more severe in the 10-14 days window.

The Association Between Self-Reported Household Renovation and Semen Parameters Among Infertile Men: A Cross-Sectional Study

Previous studies have indicated that outdoor air pollution has a negative impact on semen quality; however, few studies have examined whether living in a recently renovated residence is one of the factors influencing semen parameters. We aimed to examine the association between household renovation and semen parameters among infertile men. Our study was conducted at the Reproductive Medicine Center, The First Hospital of Jilin University (Changchun, China) from July 2018 to April 2020. A total of 2267 participants were enrolled in the study. The participants completed the questionnaire and provided a semen sample. Univariate and multiple logistic regression models were used to estimate the association between household renovations and semen parameters. Of the participants, about one-fifth (n = 523, 23.1%) had undergone renovations in the last 24 months. The median progressive motility was 34.50%. There was a significant difference between participants whose residences had been renovated in the last 24 months and those whose residences had not been recently renovated (z = -2.114, p = .035). Compared with participants whose residences were not recently renovated, participants who moved into the residence within 3 months after renovation had a higher risk of abnormal progressive motility after adjusting for age and abstinence time (odds ratio [OR] = 1.537, 95% confidence interval [CI]: 1.088-2.172). Our findings indicated that progressive motility was significantly associated with household renovations.

Impacts of traffic-related particulate matter pollution on semen quality: A retrospective cohort study relying on the random forest model in a megacity of South China

BACKGROUND

Emerging evidence shows the detrimental impacts of particulate matter (PM) on poor semen quality. High-resolution estimates of PM concentrations are conducive to evaluating accurate associations between traffic-related PM exposure and semen quality.

METHODS

In this study, we firstly developed a random forest model incorporating meteorological factors, land-use information, traffic-related variables, and other spatiotemporal predictors to estimate daily traffic-related PM concentrations, including PM_2.5, PM₁₀, and PM₁. Then we enrolled 1310 semen donors corresponding to 4912 semen samples during the study period from January 1, 2019, and December 31, 2019 in Guangzhou city, China. Linear mixed models were employed to associate individual exposures to traffic-related PM during the entire (0-90 lag days) and key periods (0-37 and 34-77 lag days) with semen quality parameters, including sperm concentration, sperm count, progressive motility and total motility.

RESULTS

The results showed that decreased sperm concentration was associated with PM₁₀ exposures (β: -0.21, 95 % CI: -0.35, -0.07), sperm count was inversely related to both PM_2.5 (β: -0.19, 95 % CI: -0.35, -0.02) and PM₁₀ (β: -0.19, 95 % CI: -0.33, -0.05) during the 0-90 days lag exposure window. Besides, PM_2.5 and PM₁₀ might diminish sperm concentration by mainly affecting the late phase of sperm development (0-37 lag days). Stratified analyses suggested that PBF and drinking seemed to modify the associations between PM exposure and sperm motility. We did not observe any significant associations of PM₁ exposures with semen parameters.

CONCLUSION

Our results indicate that exposure to traffic-related PM_2.5 and PM₁₀ pollution throughout spermatogenesis may adversely affect semen quality, especially sperm concentration and count. The findings provided more evidence for the negative associations between traffic-related PM exposure and semen quality, highlighting the necessity to reduce ambient air pollution through environmental policy.

PM2.5 exposure at different concentrations and modes induces reproductive toxicity in male rats mediated by oxidative and endoplasmic reticulum stress

The molecular mechanisms of PM_2.5 exposure in the male reproductive system, have scarcely been studied. Here, we demonstrate the possible relationship and molecular mechanisms between endoplasmic reticulum stress (ERS), oxidative stress, and reproductive toxicity caused by PM_2.5. A "PM_2.5 real-time online concentrated animal whole-body exposure system" was employed to expose male Wistar rats to PM_2.5 for 12 weeks, which could induce sperm quality decline, apoptosis, inflammation, oxidative stress, ERS, and histopathological damage in the testis. In vitro study on cultured primary testicular spermatogonia and Leydig cells confirmed that treatment with PM_2.5 (0-320 μg/mL) for 24 h decreased cell survival rate, increased reactive oxygen species, lactate dehydrogenase and 8-hydroxydeoxyguanosine levels, induced DNA damage, ERS and apoptosis, and inhibit the secretion and synthesis of testosterone in Leydig cells. These results clarified that ERS pathways triggered by oxidative stress could significantly induce CHOP and caspase-12 activation, which are significantly associated with cell apoptosis. However, oxidative stress and ERS inhibitors significantly inhibited the occurrence of these injuries. In conclusion, PM_2.5 triggers the ERS pathway and induces DNA damage in rat testicular cells through oxidative stress, ultimately leading to cellular apoptosis. Furthermore, high-concentration intermittent inhalation was more harmful than low-concentration continuous inhalation when the total mass of PM_2.5 exposure was the same.

Inverse association between ambient particulate matter and semen quality in Central China: Evidence from a prospective cohort study of 15,112 participants

Emerging evidence indicates that ambient particulate matter (PM) is harmful to male fertility, but the associations between ambient PM exposure and semen quality were inconsistent. This study aimed to quantitatively evaluate the association between ambient PM exposure and semen quality based on a large prospective cohort. Using data from the prospective assisted reproduction cohort in Anhui province, China, we included 15,112 males with 28,267 semen tests, whose partner has undergone assisted reproductive technology from September 1, 2015 to September, 22 2020. Individual ambient PM, gaseous air pollutants, and temperature exposures of the participants during 0-90, 0-9, 10-14, and 70-90 days before semen quality tests were evaluated using inverse distance weighting interpolation. Linear mixed-effects models were conducted to evaluate the relationship between PM_2.5 and PM₁₀ exposures and standardized semen quality parameters. Models were adjusted for age, body mass index, smoking, drinking, education attainment, occupation type, sampling month, temperature and the principal component of gaseous air pollutants. PM_2.5 and PM₁₀ were inversely associated with sperm concentration, total sperm count, total motility, progressive motility, total motile sperm count, and progressively motile sperm count during 0-90, 0-9, and 70-90 days period (all p < 0.05), but not 10-14 days period. The regression coefficients of PM_2.5 exposure on semen quality parameters during 0-90 days period were larger than 0-9 and 70-90 days periods, and the effects of PM_2.5 on semen quality parameters were stronger than PM₁₀. Our results showed that ambient PM_2.5 and PM₁₀ exposures were associated with semen quality, during 70-90 days and 0-9 days before sampling, and the entire spermatogenesis process. The effects of PM_2.5 on semen quality parameters were stronger than PM₁₀, and the long-term effects of PM_2.5 and PM₁₀, throughout spermatogenesis, were stronger than the short-term effects.

Systematic review of climate change effects on reproductive health

Climate change is a major risk factor for overall health, including reproductive health, and well-being. Increasing temperatures, due mostly to increased greenhouse gases trapping excess heat in the atmosphere, result in erratic weather patterns, wildfires, displacement of large communities, and stagnant water resulting in vector-borne diseases that, together, have set the stage for new and devastating health threats across the globe. These conditions disproportionately affect disadvantaged and vulnerable populations, including women, pregnant persons, young children, the elderly, and the disabled. This review reports on the evidence for the adverse impacts of air pollution, wildfires, heat stress, floods, toxic chemicals, and vector-borne diseases on male and female fertility, the developing fetus, and obstetric outcomes. Reproductive health care providers are uniquely positioned and have an unprecedented opportunity to educate patients and policy makers about mitigating the impact of climate change to assure reproductive health in this and future generations.

Seasonal variation in semen quality is not associated with fecundity in the Utah Population Database

We determine whether a suspected seasonal variability in semen quality affect subsequent live birth rates. This is a retrospective, cohort analysis of men who provided semen analyses as part of fertility workup through a large andrology lab between 1996 and 2013 and corresponding birth rates using the Utah Population Database (UPDB). Semen parameters were analysed including total motile count (TMC), total sperm count, sperm concentration and progressive motility. Corresponding live births reflect those born in the state of Utah and were derived from birth certificate data available in the UPDB. Descriptive statistics were reported along with linear regression analysis with mixed effected models to test for an interaction between seasonal variation in semen quality and birth rates, accounting for age at the time of the semen analysis and abstinence time. A total of 11,929 patients and 14,765 semen samples were included. Only 3597 men (39% of men) had one or more values outside the World Health Organization reference range for their semen parameters. Linear regression demonstrated a consistent U-shaped relationship between TMC, total sperm count, and sperm concentration and season, with spring and winter yielding the highest values with a decline in the summer and fall. 7319 of these males had recorded live births for a total of 13,502 live births during the study period after a median follow-up of 7.2 years (IQR: 3.9-11.0). We did not find a significant interaction between specific semen parameters for a specific season and subsequent live births. Semen quality was the highest in the spring and winter, however there was no interaction between seasonal variability in semen quality and subsequent births. This is one of the largest studies describing seasonal variation in semen quality in humans.

Association between sperm mitochondrial DNA copy number and deletion rate and industrial air pollution dynamics

The effects of air pollution on men's reproductive health can be monitored by evaluating semen quality and sperm DNA damage. We used real-time PCR to analyse the effects of air pollution on sperm mitochondrial DNA copy number (mtDNAcn) and deletion (mtDNAdel) rates in semen samples collected from 54 men in two seasons with different levels of industrial and traffic air pollution. MtDNAdel rates were significantly higher following the high exposure period and were positively correlated with mtDNAcn. However, we did not find any difference in mtDNAcn between the two seasons. MtDNAcn was positively correlated with the DNA fragmentation index and the rates of sperm with chromatin condensation defects, previously assessed by sperm chromatin structure assay, and negatively correlated with sperm concentration, progressive motility, viability, and normal morphology. This indicates that mtDNAcn is more closely associated with male fertility than mtDNAdel rates. In contrast, mtDNAdel might be a more sensitive biomarker of air pollution exposure in urban industrial environments.

Concentrated ambient fine particles exposure affects ovarian follicle development in mice

BACKGROUND

Ambient fine particles (PM_2.5) are known to cause various reproductive and developmental diseases. However, the potential mechanisms of PM_2.5 exposure induced female reproductive damage remain unclear.

METHODS

Four weeks old female C57BL/6 J mice were exposed to filtered air (FA, n = 10) or concentrated ambient PM_2.5 (CAP, n = 10) using a versatile aerosol concentration enrichment system. After 9 weeks of the exposure, mice were sacrificed under sevoflurane anesthesia and tissue samples were collected. Immunohistochemical analysis, enzyme-linked immunosorbent assay, quantitative polymerase chain reaction, and RNA-sequencing were performed to analyze the effects of PM_2.5 exposure on follicle development and elucidate its potential mechanisms.

RESULTS

Chronic PM_2.5 exposure resulted in follicular dysplasia. Compared to the FA-exposed group, follicular atresia in the CAP-exposed mice were significantly increased. Further studies confirmed that CAP induced apoptosis in granulosa cells, accompanied by a distortion of hormone homeostasis. In addition, RNA-sequencing data demonstrated that CAP exposure induced the alteration of ovarian gene expressions and was associated with inflammatory response.

CONCLUSIONS

Chronic exposure to CAP can induce follicular atresia, which was associated with hormone modulation and inflammation.

Association of Exposure to Particulate Matter Air Pollution With Semen Quality Among Men in China

IMPORTANCE

The health effects of exposure to particulate matter (PM) on male fertility remain unclear. Although PM exposure has been linked with semen quality, the results were inconsistent.

OBJECTIVE

To examine the association of different size fractions of PM (<2.5 μm [PM2.5], 2.5-10 μm [PM2.5-10], and ≤10 μm [PM10]) exposure with semen quality in China.

DESIGN, SETTING, AND PARTICIPANTS

This retrospective cohort study was conducted using data on men whose wives underwent assisted reproductive technology procedures in a tertiary hospital in Shanghai, China, from January 1, 2013, to December 31, 2019. Participants were from 340 prefecture-level cities of China and were followed up from the date of their first visit until December 31, 2019. Data were analyzed from December 1, 2020, to May 15, 2021.

EXPOSURES

Exposure to PM2.5, PM2.5-10, and PM10 during the entire period (0-90 days before semen ejaculation) and key periods of sperm development (0-9, 10-14, and 70-90 days before semen ejaculation).

MAIN OUTCOMES AND MEASURES

Semen quality, including sperm count, concentration, and motility.

RESULTS

A total of 33 876 men were included in the final analysis, with a mean (SD) age of 34.1 (5.7) years and large variation of PM exposure. For example, the median exposure to PM2.5 during the entire period of sperm development was 46.05 (IQR, 34.38-61.65) μg/m3. During the entire period of sperm development, exposures to higher levels of PM were significantly associated with lower total and progressive sperm motility. For total sperm motility, an IQR increase in PM2.5 exposure was associated with an estimated effect decrease of -3.60% (95% CI, -3.93% to -3.26%); an increase in PM2.5-10 exposure, with an estimated effect decrease of -0.45% (95% CI, -0.76% to -0.14%); and an increase in PM10 exposure, with an estimated effect decrease of -2.44% (95% CI, -2.91% to -1.96%). Similar results were observed for progressive motility. An IQR increase in PM2.5 or PM10 exposures was associated with an estimated effect decrease on sperm progressive motility of -1.87% (95% CI, -2.37% to -1.36%) and -1.05% (95% CI, -1.45% to -0.64%), respectively. However, no significant associations were observed between PM exposure during the entire period of sperm development and sperm count or concentration.

CONCLUSIONS AND RELEVANCE

These findings suggest that PM exposure may adversely affect sperm motility and highlight the need to reduce ambient particulate air pollution exposure for reproductive-aged men.

Effects of the air pollution dynamics on semen quality and sperm DNA methylation in men living in urban industrial agglomeration

Human populations living in urban industrial regions of developed countries are exposed to high levels of environmental pollutants. The reproductive consequences of the exposure to air pollution can be monitored through semen analysis and molecular methods. In this study, we tested the possible impact of seasonal changes in the level of air pollution on the semen quality and sperm DNA methylation of 24 men living and working in the industrial agglomeration of Ostrava (Czech Republic). The study participants were healthy non-smokers. The study group was homogeneous regarding their profession, moderate alcohol consumption, no drug abuse and no additional exposure to chemical toxicants. We performed targeted methylation next generation sequencing (NGS) using Agilent SureSelect Human Methyl-Seq and Illumina NextSeq 500 platform to analyze semen samples collected repeatedly from the same men following the season of high (winter) and low (summer) air pollution exposure. We did not detect any adverse effects of the increased exposure on the semen quality; neither we found any difference in average sperm DNA methylation between the two sampling periods. Our search for differentially methylated CpG sites did not reveal any specific CpG methylation change. Our data indicate that the seasonal changes in the level of the air pollution probably do not have any substantial effect on sperm DNA methylation of men living in the highly polluted industrial agglomeration for a long period of time.

Association between exposure to ambient air pollution and semen quality in adults: a meta-analysis

Air pollution has become a global concern and may be hazardous to human reproductive capacity, but the impact of exposure to air pollutants on semen quality remains controversial. We performed the meta-analysis to examine the association between air pollution exposure and semen quality. We searched PubMed, Web of Science Core Collection, and Cochrane Library databases (before December 2019). We selected original epidemiological studies on humans, written and published in English, that provided quantitative information to determine the associations between air pollution and sperm parameters. A random-effects model was used when the pooled effect estimates were found to be heterogeneous (I² > 50% or P < 0.05), otherwise, a fixed-effects model was applied. Publication bias was not evaluated for less than 10 included articles. Our meta-analysis showed that the standardised mean differences (SMDs) (95% confidence interval, 95% CI) of sperm concentration, sperm count, and sperm total motility were -0.17 (-0.20, -0.13), -0.05 (-0.08, -0.02), and -0.33 (-0.54, -0.11), respectively. However, exposure to air pollution was not related to sperm progressive motility (SMD = 0.00, 95% CI: -0.13, 0.12). The results indicated that exposure to air pollutants at a higher level was associated with impaired semen quality, including declined sperm concentration, reduced sperm count, and declined total motility. The results suggested that high level of air pollution exposure had a negative effect on semen quality. Improvement of air quality is important for enhancing semen quality.

Association between ambient particulate matter exposure and semen quality in fertile men

BACKGROUND

Several studies have suggested adverse effects of particulate matter (PM) exposure on male reproductive health; few have investigated the association between PM exposure and semen quality in a large population of fertile men.

METHODS

We evaluated 14 parameters of semen quality in 1554 fertile men in Nanjing from 2014 to 2016. Individual exposure to particular matter ≤10 μm in diameter (PM₁₀) and ≤ 2.5 μm in diameter (PM_2.5) during key periods of sperm development (0-90, 0-9, 10-14, 15-69, and 70-90 days before semen collection) were estimated by inverse distance weighting interpolation. Associations between PM exposure and semen quality were estimated using multivariable linear regression.

RESULTS

Higher 90-days average PM_2.5 was in association with decreased sperm motility (2.21% for total motility, 1.93% for progressive motility per 10 μg/m³ increase, P <  0.001) and four quantitative aspects of sperm motion (curvilinear velocity (VCL), straight line velocity (VSL), average path velocity (VAP), and amplitude of lateral head displacement (ALH), P <  0.01). The association between PM_2.5 exposure and semen quality were generally stronger for the earlier exposure window (70-90 days prior to ejaculation) than for recent exposure (0-9, 10-14, or 15-69 days). In the subgroup of men who had normal sperm parameters (n = 1019), similar results were obtained. Ninety-days PM₁₀ exposure was associated only with decreased VCL and VAP and was not related to sperm concentration.

CONCLUSIONS

Exposure to PM_2.5 adversely affects semen quality, specifically lower sperm motility, in fertile men.

Air pollutants and impairments of male reproductive health-an overview

Excessive air pollution, both ambient and indoor are might be detrimental to human wellbeing and are related to morbidity and mortality, it may also affect the reproductive function and its outcome. It is a recognized fact that air pollution contains several toxicants, gases, particulate matter, toxic metals etc. Some of them might affect reproductive and developmental process and a few are persistent. The information accessible on air pollution to human male reproduction is stated to affect semen quality by diminishing one or more sperm quality parameters i.e., sperm morphology, concentration, motility etc. and may causes sperm DNA damage, these might alter the fertility potential which in turn affect pregnancy or its outcome. The impact might be related to the pollutant's concentration and duration of exposure. The data on impact of air contamination on endocrine function are inadequate, inconsistence and the diversity of existence of air contaminants in area to area and multiplicity in semen quality parameters assessed in various studies as well as study design variables complicated the problem of evaluation of impact of air pollution on male reproduction. The data available suggests the air pollution is might be injurious to human male reproductive health, which depends upon amounts of air pollutants in the air, duration of exposure etc. but more comprehensive data are needed to substantiate the findings. The data are also needed on indoor air pollution on reproduction as people are might be subjected to greater quantities of some of the indoor air pollutants as compared to ambient air pollution.

Beyond the mean: Quantile regression to differentiate the distributional effects of ambient PM2.5 constituents on sperm quality among men

Ambient PM_2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter) constituents have been related to mean changes in semen quality, but focusing on the mean response may not well capture distributional and heterogeneous effects of PM_2.5 constituents on semen quality. In this study, 2314 semen samples of 622 men between Jan 1, 2019 and Dec 31, 2019 from Guangdong Human Sperm Bank were subjected to semen quality analysis. Daily average concentrations of PM_2.5 constituents including 4 water-soluble ions and 15 metals/metalloid were measured for 7 days per month at 3 fixed atmospheric pollutant monitoring stations. We used quantile regression for longitudinal data to examine whether the associations between PM_2.5 constituents and quality indicators of semen varied across quantiles of outcome distribution. Heterogeneous associations were found between PM_2.5 constituents and sperm quality across different quantiles. An interquartile range (14.0 μg/m³) increase in PM_2.5 mass was negatively associated with lower tails of sperm concentration and upper tails of sperm count distribution. PM_2.5 vanadium exposure was significantly related to the 90th percentile of sperm count distribution, but not to the lower quantiles. In addition, those subjects with relatively high sperm motility were more susceptible to sulfate, chromium, and manganese constituents in PM_2.5. Our results indicate that PM_2.5 and certain constituents were associated with sperm quality, especially sperm motility, and the associations are more pronounced in men with relatively high or low sperm motility.

Male fertility as a marker for health

Male reproduction is a complex biological process, and male factor infertility is increasingly recognized as a biomarker for overall male health. Emerging data suggest associations between male reproduction and medical disease (genetic, infectious, chronic comorbid conditions), psychological disease, environmental exposures, dietary habits, medications and substances of abuse, and even socioeconomic factors. There is also evidence that a diagnosis of male fertility is associated with future disease risk including cancer, metabolic disease and mortality. As such, there is a growing view that the male fertility evaluation is an opportunity to improve a man's health beyond his immediate reproductive goals, and also highlights the necessity of a multidisciplinary approach.

Differential impacts of particulate air pollution exposure on early and late stages of spermatogenesis

BACKGROUND

Despite increasing evidence that particulate air pollution has adverse effects on human semen quality, few studies examine the impact of air pollution on clinically relevant thresholds used to diagnose male fertility problems. Furthermore, exposure is often assessed using average air pollution levels in a geographic area rather than individualized estimates. Finally, physiologically-informed exposure windows are inconsistent.

OBJECTIVES

We sought to test the hypothesis that airborne particulate exposures during early-phase spermatogenesis will have a differential impact on spermatogenic formation compared to late-phase exposures, using an individualized model of exposure to particulate matter ≤ 2.5 µm and ≤ 10 µm (PM_2.5 and PM₁₀, respectively).

METHODS

From an original cohort of 183 couples, we conducted a retrospective analysis of 130 healthy males seeking to become parents, using spermatogenesis-relevant exposure windows of 77-34 days and 37-0 days prior to semen collection to encompass sperm development stages of mitosis/meiosis and spermiogenesis, respectively. Individualized residential exposure to PM_2.5 and PM₁₀ was estimated by selecting multiple air pollution sensors within the same geographic air basin as participants and employing inverse distance weighting to calculate mean daily exposure levels. We used multiple logistic regression to assess the association between pollution, temperature, and dichotomized World Health Organization semen parameters.

RESULTS

During the early phase of spermatogenesis, air pollution exposure is associated with 1.52 (95% CI: 1.04-2.32) times greater odds of < 30% normal heads per 1-unit increase in IQR for PM_2.5. In the late phase of spermatogenesis, air pollution exposure is associated with 0.35 (95% CI: 0.10-0.74) times greater odds of semen concentration < 15 million/mL per 1-unit increase in IQR for PM_2.5, and 0.28 (95% CI: 0.07-0.72) for PM₁₀.

CONCLUSION

Particulate exposure has a differential and more deleterious impact on sperm during early-phase spermatogenesis than late-phase.

Lipid changes in extrapulmonary organs and serum of rats after chronic exposure to ambient fine particulate matter

Fine particulate matter (PM_2.5) is able to pass through the respiratory barrier to enter the circulatory system and can consequently spread to the whole body to cause toxicity. Although our previous studies have revealed significantly altered levels of phosphorylcholine-containing lipids in the lungs of rats after chronic inhalation exposure to PM_2.5, the effects of PM_2.5 on phosphorylcholine-containing lipids in the extrapulmonary organs have not yet been elucidated. In this study, we examined the lipid effects of chronic PM_2.5 exposure on various organs and serum by using a rat inhalation model followed by a mass spectrometry-based lipidomic approach. Male Sprague-Dawley rats were continuously exposed at the whole body level to nonfiltered and nonconcentrated ambient air from the outside environment of Taipei city for 8 months, while the control rats inhaled filtered air simultaneously. After exposure, serum samples and various organs, including the testis, pancreas, heart, liver, kidney, spleen, and epididymis, were collected for lipid extraction and analysis to examine the changes in phosphorylcholine-containing lipids after exposure. The results from the partial least squares discriminant analysis models demonstrated that the lipid profiles in the PM_2.5 exposure group were different from those in the control group in the rat testis, pancreas, heart, liver, kidney and serum. The greatest PM_2.5-induced lipid effects were observed in the testes. Decreased lyso-phosphatidylcholines (PCs) as well as increased unsaturated diacyl-PCs and sphingomyelins in the testes may be related to maintaining the membrane integrity of spermatozoa, antioxidation, and cell signaling. Additionally, our results showed that decreased PC(16:0/18:1) was observed in both the serum and testes. In conclusion, exposure to chronic environmental concentrations of PM_2.5 caused lipid perturbation, especially in the testes of rats. This study highlighted the susceptibility of the testes and suggested possible molecular events for future study.

Machine learning for sperm selection

Infertility rates and the number of couples seeking fertility care have increased worldwide over the past few decades. Over 2.5 million cycles of assisted reproductive technologies are being performed globally every year, but the success rate has remained at ~33%. Machine learning, an automated method of data analysis based on patterns and inference, is increasingly being deployed within the health-care sector to improve diagnostics and therapeutics. This technique is already aiding embryo selection in some fertility clinics, and has also been applied in research laboratories to improve sperm analysis and selection. Tremendous opportunities exist for machine learning to advance male fertility treatments. The fundamental challenge of sperm selection - selecting the most promising candidate from 10⁸ gametes - presents a challenge that is uniquely well-suited to the high-throughput capabilities of machine learning algorithms paired with modern data processing capabilities.

Semen quality and windows of susceptibility: A case study during COVID-19 outbreak in China

BACKGROUND

To evaluate the impact of air pollution exposure on semen quality parameters during COVID-19 outbreak in China, and to identify potential windows of susceptibility for semen quality.

METHODS

A retrospective observational study was carried out on 1991 semen samples collected between November 23, 2019 and July 23, 2020 (a period covering COVID-19 lock-down in China) from 781 sperm donor candidates at University-affiliated Sichuan Provincial Human Sperm Bank. Multivariate mixed-effects regression models were constructed to investigate the relationship between pollution exposure, windows of susceptibility, and semen quality, while controlling for biographic and meteorologic confounders.

RESULT(S)

The results indicated multiple windows of susceptibility for semen quality, especially sperm motility, due to ambient pollution exposure. Exposure to particulate matters (PM2.5 and PM10), O3 and NO2 during late stages of spermatogenesis appeared to have weak but positive association with semen quality. Exposure to CO late in sperm development appeared to have inverse relationship with sperm movement parameters. Exposure to SO2 appeared to influence semen quality throughout spermatogenesis.

CONCLUSION(S)

Potential windows of susceptibility for semen quality varied depending on air pollutants. Sperm motility was sensitive to pollution exposure. Findings from current study further elucidate the importance of sensitive periods during spermatogenesis and provide new evidence for the determinants of male fertility.

Elevated levels of nitrous dioxide are associated with lower AMH levels: a real-world analysis

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.

Paternal Biomass Smoke Exposure in Rats Produces Behavioral and Cognitive Alterations in the Offspring

Particular concern at the present stage is the health effects of wildfires’ smoke. The aim of the study was to determine the impact of paternal biomass-smoke exposure on offspring’s behavior and cognitive abilities. Male rats were exposed to biomass smoke for four hours/day, five days/week, for four weeks. Average concentration of carbon monoxide and particulate matter of 2.5 μm PM_2.5 in the chamber during exposure were 28.7 ± 5.3 mg/m³ and 1.9 ± 0.5 mg/m³, respectively. At the same time, high concentrations of furfural and acetaldehyde were detected in the air environment of the exposure chambers. Offspring was obtained by mating of experimental males with untreated females, immediately after the end of the exposure and after 60 days (long-term period). Offspring were tested by using the Morris water maze and open field at three months of age. Male and female offspring born by mating immediately after exposure demonstrated decreased exploratory behavior, locomotor activity, and spatial navigation, as well as increased anxiety levels. Locomotor and exploratory activity in rats of both sexes from progeny obtained after long-term exposure to smoke had no statistically significant differences when compared to the control; however, the females showed a high level of anxiety and impaired cognitive functions. The recovery period after biomass-smoke intoxication, comparable in duration of spermatogenesis in rats, was an important factor in reducing the risk of developing central nervous system (CNS) disorders in offspring.

Particulate Matter Exposure During Oocyte Maturation: Cell Cycle Arrest, ROS Generation, and Early Apoptosis in Mice

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 PM₁₀ (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 PM₁₀ and the phenotypes of the resulting toxic effects were investigated. Exposure to PM₁₀ 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 PM₁₀-treated oocytes during metaphase I to anaphase/telophase I transition. Moreover, PM₁₀ induced reactive oxygen species generation, mitochondrial dysfunction, DNA damage, and early apoptosis. Taken together, these results indicate that PM₁₀ exposure leads to a decline in oocyte quality and affects the subsequent embryonic development potential of mammalian oocytes.

Identifying critical exposure windows for ambient air pollution and semen quality in Chinese men

Emerging studies documented the association between ambient air pollution exposure and semen quality, but the critical exposure windows have not been comprehensively studied. To identify susceptible windows for associations of exposure to ambient respirable particulate matter (PM₁₀), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and ozone (O₃) with sperm concentration, sperm count, total motility, and progressive motility, we recruited 1061 men attending an infertility clinic in Wuhan, China, between 2011 and 2013. We used a distributed lag multivariate linear regression to assess the exposure-lag-response relationship between semen quality and weekly air pollution exposure. The critical exposure windows were during the 6th to 12th sperm development weeks for PM₁₀, 10th to 11th weeks for O₃, and 0 to 5th weeks for SO₂. Over the entire 12 weeks of spermatogenesis period, an interquartile range increase (IQR) increase in PM₁₀ was associated with declined sperm concentration [-45.64% (95% CI: -59.97%, -26.18%) percent decrease], declined sperm count [-49.42% (95% CI: -64.42%, -28.09%) percent decrease], reduced total motility [-12.42 (95% CI: -20.47, -4.37)], and reduced progressive motility [-8.81 (95% CI: -16.00, -1.61)], SO₂ per IQR increase was associated with reduced sperm concentration [-39.73% (95% CI: -55.96%, -17.51%) percent decrease] and total motility [-8.64 (95% CI: -16.90, -0.38)], but NO₂ and O₃ were not associated with any of the four sperm quality parameters. Our findings suggest that exposure to PM₁₀ during spermatidogenesis period, exposure to SO₂ during spermatocytogenesis period, and exposure to O₃ during spermiogenesis period were associated with impaired semen quality, which implies air pollutants impair semen quality through varied pathways.

Effects of PM2.5 on Third Grade Students' Proficiency in Math and English Language Arts

Fine particulate air pollution is harmful to children in myriad ways. While evidence is mounting that chronic exposures are associated with reduced academic proficiency, no research has examined the frequency of peak exposures. It is also unknown if pollution exposures influence academic proficiency to the same degree in all schools or if the level of children's social disadvantage in schools modifies the effects, such that some schools' academic proficiency levels are more sensitive to exposures. We address these gaps by examining the percentage of third grade students who tested below the grade level in math and English language arts (ELA) in Salt Lake County, Utah primary schools (n = 156), where fine particulate pollution is a serious health threat. More frequent peak exposures were associated with reduced math and ELA proficiency, as was greater school disadvantage. High frequency peak exposures were more strongly linked to lower math proficiency in more advantaged schools. Findings highlight the need for policies to reduce the number of days with peak air pollution.

Sperm quality and ambient air pollution exposure: A retrospective, cohort study in a Southern province of China

BACKGROUND

Abnormal semen quality is one of the common causes of infertility. The relationship between exposure to air pollutants and semen quality is unclear.

OBJECTIVES

To evaluate the impact of ambient air pollutant exposures on semen quality.

METHODS

We analyzed 3797 semen samples from Guangdong Human Sperm Bank between May 28, 2018 and March 31, 2019. The inverse distance weighted interpolation method was used to estimate the personal exposures to CO, SO₂, NO₂, O₃, PM₁₀ and PM_2.5 during the entire period (0-90 lag days) and key periods (0-9, 10-14, 70-90 lag days) of sperm development. Linear mixed models were used to evaluate the exposure-response relationships between air pollutants and semen quality, including sperm concentration, sperm count and sperm motility, after adjusting for other covariates. The regression coefficients and 95% confidence intervals (CIs) associated with each interquartile range (IQR) increase in pollutant concentrations were estimated for each semen quality parameter.

RESULTS

Overall, we observed a significant association of decreased sperm count with the exposure to PM₁₀ (-0.2466; -0.4443, -0.0489) and PM_2.5 (-0.2910; -0.5401, -0.0419). Among the sperm quality parameters assessed, sperm count was observed more frequently to be negatively associated with ambient air pollutants (CO, NO₂, O₃, PM₁₀ and PM_2.5), especially for the period during 10-14 lag days. In addition, motility decline was significantly associated with O₃ in the late stage of sperm development. Sensitivity analyses for subgroup population yielded similar results. No significant association was found between all pollutants and sperm concentration (all P > 0.05).

CONCLUSIONS

Our results indicate that ambient air pollutants exposures during sperm development may have an adverse effect on semen quality, especially for sperm count and motility. The findings emphasize the potential to improve semen quality by reducing ambient air pollutant exposures, and the importance of taking into account the critical period of sperm development when protective measures are implemented.

Ambient ozone pollution is associated with decreased semen quality: longitudinal analysis of 8945 semen samples from 2015 to 2018 and during pollution-control period in Beijing, China

Previous studies suggest that air pollution has a negative effect on semen quality. However, most studies are cross-sectional and the results are controversial. This study investigated the associations between air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃) and semen quality among sperm donation candidates, especially when the air pollution was artificially controlled in Beijing, China. We analyzed 8945 semen samples in the human sperm bank of Peking University Third Hospital (Beijing, China) from October 2015 to May 2018. Air pollution data during the entire period (0–90 days prior) and key stages (0–9, 10–14, and 70–90 days prior) of sperm development were collected from the China National Environmental Monitoring Centre. The association between air pollutants and semen parameters (sperm concentration and progressive motility) was analyzed by a mixed model adjusted for age, abstinence duration, month, and average ambient temperature. Only O₃ during key stages of 0–9 days and 10–14 days and the entire period was negatively associated with sperm concentration between 2015 and 2018 (P < 0.01). During the period of air pollution control from November 2017 to January 2018, except for the increase in O₃ concentration, other five pollutants’ concentrations decreased compared to those in previous years. In this period, the sperm concentration decreased (P < 0.001). During the pollution-control period, O₃ exposure 10–14 days prior was negatively associated with sperm concentration (95% CI: −0.399–−0.111; P < 0.001). No significant association was found between the other five pollutants and semen quality during that period. Our study suggested that only O₃ exposure was harmful to semen quality. Therefore, O₃ should not be neglected during pollution control operation.

Potential causes of male and female infertility in Qatar

A steady decline in the fertility rate has been observed in Qatar during the past fifty years. Therefore, infertility is considered a national priority in Qatar, a pronatalist society. This review article summarises the potential causes of infertility that are particularly prevalent in the Qatari population. The high rate of consanguinity leading to genetic abnormalities, the high incidence of metabolic disease, environmental contamination due to the rapid urbanization and oil and natural gas extraction procedures are discussed. In addition, the particular lifestyle of the Qatari population and the influence of religion and culture on sexual and reproductive behavior in an Arab/Islamic society are considered. The active response of the state of Qatar in implementing ways to mitigate the effects of these factors to protect fertility are also presented.

Patterns of distributive environmental inequity under different PM2.5 air pollution scenarios for Salt Lake County public schools

Previous studies have cataloged social disparities in air pollution exposure in US public schools with respect to race/ethnicity and socioeconomic status. These studies rely upon chronic, averaged measures of air pollution, which fosters a static conception of exposure disparities. This paper examines PM_2.5 exposure disparities in Salt Lake County (SLC), Utah public schools under three different PM_2.5 scenarios-relatively clean air, a moderate winter persistent cold air pool (PCAP), and a major winter PCAP-with respect to race/ethnicity, economic deprivation, student age, and school type. We pair demographic data for SLC schools (n = 174) with modelled PM_2.5 values, obtained from a distributed network of sensors placed through a community-university partnership. Results from generalized estimating equations controlling for school district clustering and other covariates reveal that patterns of social inequality vary under different PM_2.5 pollution scenarios. Charter schools and schools serving economically deprived students experienced disproportionate exposure during relatively clean air and moderate PM_2.5 PCAP conditions, but those inequalities attenuated under major PCAP conditions. Schools with higher proportions of racial/ethnic minority students were unequally exposed under all PM_2.5 pollution scenarios, reflecting the robustness of racial/ethnic disparities in exposure. The findings speak to the need for policy changes to protect school-aged children from environmental harm in SLC and elsewhere.

Ambient air pollution and male fecundity: A retrospective analysis of longitudinal data from a Chinese human sperm bank (2013-2018)

Ambient air pollution has adverse effects on human health and reproduction. A number of studies have suggested a significant association between ambient air pollution and human fecundity, with most studies focusing on cross-sectional data from the general male population with single semen samples. We conducted a retrospective study in China using longitudinal analysis of repeated semen samples to investigate the association between environmental exposure parameters (e.g., PM_2.5, PM₁₀, SO₂, NO₂, CO, ground temperature, and relative humidity) and sperm quality parameters (e.g., semen volume, sperm concentration, forward motility concentration, and percentage of progressive rate) during different exposure windows (current day, 90-day preceding). Data from 686 males and 4841 semen samples collected between 2013 and 2018 at Sichuan Provincial Sperm Bank were included in a mixed-effects model analysis. The study population was young, healthy, and well-educated. The results indicate that 90-day average concentrations of PM_2.5, PM_10, and CO were negatively associated with sperm concentration and forward motility concentration, whereas 90-day average concentration of O₃ was positively associated with forward motility concentration. Between-subject variability played the dominant role in overall model variance. Our results suggest that chronic exposure to particulate matter and CO may interfere with spermatogenesis.

Impacts of Outdoor Air Pollution on Human Semen Quality: A Meta-Analysis and Systematic Review

Introduction

Several studies have explored the association between outdoor air pollution and semen quality. However, the results were inconsistent. We performed the current meta-analysis to evaluate the role of outdoor air pollution in semen quality. Material and Methods. Databases including PubMed, Web of Science, and Embase were searched to identify relevant studies. Relative data in participants under higher exposure and lower exposure to air pollution were extracted. Pooled weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were utilized to assess the effects of outdoor air pollution on semen quality. In addition, trial sequential analyses (TSAs) were performed to obtain a more comprehensive assessment of analyses.

Results

A total of 11 studies with 4562 males were enrolled in the current meta-analysis. Higher air pollution levels were associated with significant decreases in semen volume (WMD: -0.16, 95% CI: -0.27 to -0.05), sperm concentration (WMD: -5.52, 95% CI: -9.88 to -1.16), progressive motility (WMD: -6.23, 95% CI: -11.64 to -0.81), total motility (WMD: -7.65, 95% CI: -14.09 to -1.20), and normal sperm morphology rate (WMD: -3.71, 95% CI: -5.59 to -1.82). In addition, the DNA fragmentation index significantly increased (WMD: 4.11, 95% CI: 1.94 to 6.29).

Conclusions

Air pollution is associated with decreased semen volume, sperm concentration, motility, and normal morphology rate.

The association between ambient temperature and sperm quality in Wuhan, China

BACKGROUND

Few epidemiological investigations have focused on the influence of environmental temperature on human sperm quality. Here, we evaluated the potential association between ambient temperature and human sperm quality in Wuhan, China, and examined the interactive effect of particulate matter (PM_2.5) and temperature.

METHODS

1780 males who had been living in Wuhan for no less than three months and received semen analysis at the Department of Reproductive Medicine in Renmin Hospital of Wuhan University between April 8, 2013 and June 30, 2015 were recruited. Daily mean meteorological data and air pollution data (PM_2.5, O₃ and NO₂) in Wuhan between 2013 and 2015 were collected. A generalized linear model was used to explore the associations between ambient temperature and sperm quality (including sperm concentration, percentage of normal sperm morphology, and progressive motility) at 0-9, 10-14, 15-69, 70-90, and 0-90 days before semen examination, and the interaction between temperature and PM_2.5.

RESULTS

The associations between ambient temperature and sperm quality were an inverted U-shape at five exposure windows, except for a lag of 0-9 days for sperm concentration. A 1 °C increase in ambient temperature above the thresholds was associated with a 2.038 (1.292 ~ 2.783), 1.814 (1.217 ~ 2.411), 1.458 (1.138 ~ 1.777), 0.934(0.617 ~ 1.251) and 1.604 (1.258 ~ 1.951) decrease in the percentage of normal sperm morphology at lag 0-9, lag 10-14, lag 15-69, lag 70-90, and lag 0-90 days, respectively. The interaction p-values of PM_2.5 and temperature were mostly less than 0.05 at five exposure windows. When ambient temperature exposure levels were above the thresholds, a 0.979 (0.659-1.299) and 3.559 (0.251 ~ 6.867) decrease in percentage of normal sperm morphology per 1 °C increase in temperature at lag 0-90 days was observed in the PM_2.5 ≤ P₅₀ group and PM_2.5 > P₅₀ group, respectively.

CONCLUSIONS

Our results indicate that exposure to ambient temperature has a threshold effect on sperm quality, and PM_2.5 enhances the effect of temperature on sperm quality when temperatures are above the threshold.

Effects of particulate matter exposure on semen quality: A retrospective cohort study

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 PM_2.5 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, PM_2.5 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. PM_2.5 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.

The association between iodine intake and semen quality among fertile men in China

BACKGROUND

Iodine intake is essential in the production of thyroid hormone but very few foods are rich in it. Iodine deficiency or excess iodine level may both lead to thyroid disorders, which further affects human fertility function. The objective of this study is to investigate the relationship between iodine intake and seminal parameters among fertile men in China.

METHODS

A total of 1098 couples were recruited by trained physicians at different family planning service stations in 2015. Semen and iodine samples were obtained from male respondents. A questionnaire survey inquired about demographic information from couples. The main outcome variables of semen quality were semen volume, semen concentration, semen motility, and sperm count, and time to pregnancy. Urinary iodine concentration (UIC) was used to measure iodine levels for male respondents. Ordinary least squared regressions and logistic regressions were performed to estimate the association between iodine intake level and semen quality parameters.

RESULTS

Male respondents with deficient or excess iodine levels had a 5% higher semen volume relative to those with optimal iodine intake (p < 0.1). Suboptimal iodine intake was negatively associated with semen concentration and semen counts (p < 0.01). Longer time of pregnancy was observed in iodine deficiency and excess group than those in the optimal group (p < 0.01).

CONCLUSION

In general, iodine deficiency and excess were both associated with decreasing semen quality parameters in male respondents.

Some of the Factors Involved in Male Infertility: A Prospective Review

Infertility is defined as the inability of couples to have a baby after one year of regular unprotected intercourse, affecting 10 to 15% of couples. According to the latest WHO statistics, approximately 50-80 million people worldwide sufer from infertility, and male factors are responsible for approximately 20-30% of all infertility cases. The diagnosis of infertility in men is mainly based on semen analysis. The main parameters of semen include: concentration, appearance and motility of sperm. Causes of infertility in men include a variety of things including hormonal disorders, physical problems, lifestyle problems, psychological issues, sex problems, chromosomal abnormalities and single-gene defects. Despite numerous efforts by researchers to identify the underlying causes of male infertility, about 70% of cases remain unknown. These statistics show a lack of understanding of the mechanisms involved in male infertility. This article focuses on the histology of testicular tissue samples, the male reproductive structure, factors affecting male infertility, strategies available to find genes involved in infertility, existing therapeutic methods for male infertility, and sperm recovery in infertile men.

Concentrated ambient PM2.5 exposure affects mice sperm quality and testosterone biosynthesis

Background

Studies suggested that PM_2.5 exposure could lead to adverse reproductive effects on male animals. However, the underlying mechanism is still not clear. Besides, animals in the majority of previous studies were exposed to PM_2.5 through intratracheal instillation which should be improved. In addition, limited amount of research has been conducted in China where the PM_2.5 concentration is higher and the PM_2.5 components are different. The aim of this work is to explore the effects of concentrated ambient PM_2.5 (CAP) on mice sperm quality and testosterone biosynthesis.

Methods

A total of 12 male C57BL/6 mice were exposed to filtered air (FA) or CAP for 125 days using the Shanghai Meteorological and Environmental Animal Exposure System. The mice sperm concentration, sperm motility, DNA fragmentation index, high DNA stainability and plasma testosterone were analyzed. Testicular histology and sperm morphology were observed through optical microscope. Testosterone biosynthesis related gene expressions were analyzed using real-time PCR, including cytochrome P450 CHOL side-chain cleavage enzyme (P450scc), steroidogenic acute regulatory protein (StAR), 3β-hydroxysteroid dehydrogenase (3β HSD), 17β-hydroxysteroid dehydrogenase, cytochrome P450 aromatase (P450arom), estrogen receptor (ER), androgen receptor (AR) and follicle stimulating hormone receptor (FSHR).

Results

Exposure to CAP resulted in disturbance of various stages of spermatogenesis and significant higher percentage of abnormal sperm (FA vs. CAP: 24.37% vs. 44.83%) in mice testis. CAP exposure significantly decreased sperm concentration (43.00 × 10⁶ vs. 25.33 × 10⁶) and motility (PR: 63.58% vs. 55.15%; PR + NP: 84.00% vs. 77.08%) in epididymis. Plasma testosterone concentration were significantly declined (0.28 ng/ml vs. 0.69 ng/ml) under CAP exposure. Notably, the levels of testosterone biosynthesis related genes, StAR, P450scc, P450arom, ER and FSHR were significantly decreased with CAP exposure.

Conclusion

Concentrated ambient PM_2.5 exposure altered mice sperm concentration, motility and morphology, which might be mediated primarily by the decline in testosterone concentration and testosterone biosynthesis process.