Association between ambient air temperature, ovarian reserve, and outcomes of ovarian stimulation among oocyte donors Restricted; Files Only

Abstract

Objective: To examine the relation of ambient temperature with ovarian reserve and outcomes of ovarian stimulation among young, healthy females.

Methods: We included 589 oocyte donors who underwent 943 ovarian stimulation cycles at a fertility clinic in Atlanta, Georgia, USA (2008-2020). Daily residential ambient temperatures were estimated from a spatially refined gridded climate data set beginning three months prior to ovarian stimulation through oocyte retrieval. Antral follicle count (AFC) was assessed with transvaginal ultrasonography and mature oocyte count was assessed following oocyte retrieval. Poisson regression models with robust standard errors were used to estimate the associations of ambient temperature with AFC and oocyte count adjusted for age, education level, race, state of residence, year of retrieval, month of retrieval, and body mass index (BMI).

Results: The mean (standard deviation) age of donors was 25.2 (2.8) years and 27% were racial/ethnic minorities. Overall, there were no statistically significant associations between average ambient temperature exposures (average, maximum, minimum, or apparent) in the 2 weeks, 1 month, or 3 months prior to scan and AFC. While there was a suggestion of a negative association between higher ambient temperatures in the 3 months prior and lower AFC, particularly for maximum temperature (% change: -2.6 per interquartile range increase, 95% CI -9.3, 4.6), the association was not significant. The observed associations of average ambient temperature with total and mature number of oocytes retrieved were also negative across all three time points; however, confidence intervals were imprecise. For instance, an interquartile range increase in average maximum temperature in the 3 months prior, one month prior, and two weeks of ovarian stimulation was associated with -4.2% (95% CI -11.7%, 3.9%), -3.8% (95% CI -9.2%, 2.1%) and -3.4% (95% CI -8.2%, 1.8%) fewer mature oocytes retrieved, respectively.

Conclusions: In our cohort of young, healthy women residing in the Southeastern United States, we found little evidence for an association of ambient temperatures with ovarian reserve and outcomes of ovarian stimulation. Although the effect estimates were small in magnitude and imprecise, they were most commonly negative which may indicate a potentially harmful effect of ambient temperatures on ovarian function. 

Table of Contents

Introduction. 1

Study Population. 2

Exposure Assessment 3

Outcome Assessment 4

Covariate Assessment 5

Statistical Analysis. 5

Results. 6

Discussion. 13

References. 17

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Climate Change Health Sciences, Obstetrics and Gynecology
Keyword	ambient temperature exposure fertility extreme heat antral follicle count
Committee Chair / Thesis Advisor	Audrey Gaskins, Emory University

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