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Exposure to Fine Particulate Matter and Ovarian Reserve Among Women from a Fertility Clinic

Gaskins, Audrey J.a,b; Mínguez-Alarcón, Lidiac; Fong, Kelvin C.c; Abdelmessih, Sarahc; Coull, Brent A.d; Chavarro, Jorge E.a,b,e; Schwartz, Joelc,e; Kloog, Itaif; Souter, Ireneg; Hauser, Russc,e,g; Laden, Francineb,c,e

doi: 10.1097/EDE.0000000000001029
Air Pollution

Background: An increasing number of studies have linked air pollution to decreased fertility. Whether this is due to an effect on ovarian reserve is unknown.

Method: Our study included 632 women attending the Massachusetts General Hospital Fertility Center (2004–2015) who had a measured antral follicle count. Validated spatiotemporal models estimated daily particulate matter <2.5 µg/m3 (PM2.5) (based on residential address) for the 3 months before the antral follicle count. We analyzed associations with Poisson regression.

Results: Every 2 µg/m3 increase in estimated PM2.5 exposure was associated with a −7.2% (95% confidence interval = −10.4%, −3.8%) lower antral follicle count adjusting for age, body mass index, smoking status, and year and season of the count. The association of PM2.5 with antral follicle count was stronger among women with female factor infertility (−16.3% per 2 µg/m3).

Conclusions: Among women from an infertility clinic, higher PM2.5 exposure was associated with lower ovarian reserve, raising concern that air pollution may accelerate reproductive aging.

aDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA

bChanning Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA

cDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA

dDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA

eDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA

fDepartment of Environmental Geography, Ben Gurion University of the Negev, Beersheva, Israel

gVincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Submitted November 2, 2018; accepted April 2, 2019.

Supported by grants ES009718, ES022955, ES000002, and K99ES026648 from the National Institute of Environmental Health Sciences (NIEHS). This publication was also made possible by the U.S. Environmental Protection Agency (U.S. EPA): RD-834798 and RD-83587201. Its contents are solely the responsibility of the grantee and do not necessarily represent the official views of the U.S. EPA. Further, the U.S. EPA does not endorse the purchase of any commercial products or services mentioned in the publication.

The authors report no conflicts of interest.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (

Data are not publicly available to protect human subjects’ confidentiality. Code for the statistical analysis is available from the authors by request.

Correspondence: Audrey Gaskins, 665 Huntington Avenue, Building II, 3rd Floor, Boston, MA 02115. E-mail:

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.