Air pollution leads to fall in IVF pregnancy rates

Air pollution dramatically reduces the odds that healthy women who are attempting to conceive via in vitro fertilization (IVF) will become pregnant, according to studies conducted in Europe , Australia, and right here in Atlanta.

Experts said it’s a concern for those living in the metro area, which is ringed by highways and subject to pollution that blows into Atlanta from farms, factories, and out-of-state forest fires .

“Atlanta is pretty representative of the U.S.,” said Audrey Gaskins, associate professor of epidemiology at the Rollins School of Public Health at Emory University. “Our air pollution levels aren’t great. We don’t have wildfires in Atlanta or Georgia per se, but we are affected by prescribed burns . That smoke in more rural areas of the state travels into metro Atlanta — and we are just now understanding the impacts on health.”

A study that Gaskins led at Emory looked at the impact of air pollution on young, healthy women residing in metro Atlanta while undergoing IVF treatments. It found that poorer IVF outcomes even occurred when levels of an extremely small type of air pollution known as particulate matter (PM) were below the United States Environmental Protection Agency (EPA) National Ambient Air Quality Standards limit.

Emissions from the burning of gasoline, oil, diesel fuel and wood generate the small particles known as “PM2.5″ pollution found in outdoor air. The particles are so small as to be invisible. But when their levels are high, the air becomes hazy and thick. The PM2.5 particles, which are 2.5 microns in diameter — 40 times smaller than a human hair — can even lodge deep in the lungs and travel through the human bloodstream . These particles were the focus of Gaskins’ study.

A similar study conducted over eight years in Perth, Australia, found that exposure to air pollution prior to the retrieval of eggs during IVF reduced the odds of achieving a live birth by 38%.

The U.S. and Australia have similar levels of PM2.5 air pollution, and have made significant progress in bringing down air pollution compared to France, Germany and many other countries in the European Union that are plagued by persistent poor air quality.

Still, 39% of people living in the U.S., some 131 million people, live in places with failing grades for unhealthy levels of ozone or particulate pollution, according to the American Lung Association.

In February, the Biden administration issued a more stringent standard for PM2.5 pollution that will go into effect gradually over the next decade. If the new limit went into effect today, parts of Georgia with heavy traffic or industry would not meet the standard, the AJC reported in February.

Moreover, the Emory study suggests that even when women undergoing IVF are exposed to air pollution at the new, lower level proposed by the Biden administration, their chances of IVF success might still be lower.

“We thought that the body had all of these filter systems, and that the ovaries were protected,” Gaskins said. “We like to think that young people are immune to environmental exposures, but that’s not really what’s playing out.”

Credit: Audrey Gaskins

An increase in forest fires throughout the U.S. appears to be undoing gains made from reducing air pollution from cars and other sources, according to researchers at the University of Washington.

When pregnant or ovulating women are exposed to air pollution from burning forests, traffic pollution or other sources, the results can be troubling. One study found that found black carbon from air pollution can accumulate in a woman’s ovaries. Another linked air pollution from diesel and gas cars, wildfires, and ambient air pollution to couples needing a longer time to conceive .

And air pollution has been linked to a number of illnesses, such as dementia, and to premature mortality, notes Armistead (Ted) Russell , a Professor of Civil and Environmental Engineering at Georgia Tech.

Though he is encouraged by the strides that the U.S. and Georgia have made in cutting air pollution from cars and trucks, he says pollution from other sources like cooking fumes, cooking oils, and the Atlanta airport contribute to elevated PM2.5 in the region.

The most recent data from the Georgia Environmental Protection Division (EPD) shows most of the state’s urban centers have PM2.5 concentrations above the new EPA limit, including Atlanta, Augusta, Columbus, and Georgia counties near Chattanooga. Rural Washington County, to the east of Macon and at the epicenter of the region’s kaolin clay mining industry, has the highest particle pollution concentrations, state data shows.

If the EPA determines that the state is not conforming to the requirements, the federal government could take other steps, like withholding transportation funding — as it once did in the late ‘90s when Atlanta’s air quality grew unsafe during a population boom.

A related study , also conducted by researchers at Emory, showed that the second most affected region by fire smoke is the Southeast — behind the Western states of California, Oregon and Washington.

Though giving women who are undergoing IVF procedures in-home high efficiency particulate air (HEPA) air filters and masks could be possible interventions, a better solution, Gaskins said, would be to reduce overall air pollution.

“We need to press regulators to decrease air pollution so the burden doesn’t fall on individuals who live near traffic or in areas where there are high exposure events,” she said.

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