AUTHOR=Zupo Roberta , Castellana Fabio , Nawrot Tim S. , Lampignano Luisa , Bortone Ilaria , Murgia Ferdinando , Campobasso Gianluca , Gruszecka Kosowska Agnieskza , Giannico Orazio Valerio , Sardone Rodolfo 

TITLE=Air pollutants and ovarian reserve: a systematic review of the evidence

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1425876

DOI=10.3389/fpubh.2024.1425876

ISSN=2296-2565

ABSTRACT=Background: Growing evidence pointed to an association between ambient air pollution and decreased human reproductive potential. This study aimed to systematically review the association between air pollutants and female ovarian reserve.
Methods: The literature was searched in six electronic databases through June 2024. Screening of the 136 articles retrieved for inclusion criteria resulted in the selection of 15 human observational studies that evaluated the effect of environmental pollutants on markers of ovarian reserve. The study protocol was registered on PROSPERO (registration code  CRD42023474218).
Results: The study design of selected studies was found to be cross-sectional (2 of 15), retrospective cohort (10 of 15), prospective cohort (2 of 15), and case-control (1 of 15). The study population was distributed as follows: Asians (53%, 8 studies), Americans (33%, 5 studies), and Europeans (14%, two studies). The main findings showed a higher body of evidence for the environmental pollutants PM2.5, PM10, and NO2, while a low body of evidence for PM1, O3, SO2, and a very low body of evidence for benzene, formaldehyde, and benzo(a)pyrene, yet consistently showing significant inverse association data. The overall methodological quality of the selected studies was rated moderated across the 14 domains of the NIH toolkit. 
Conclusion: Increased exposure to air pollutants seems to be associated with reduced ovarian reserve with evidence being strongest for pollutants such as PM2.5, PM10, and NO2. More evidence is needed to draw conclusions about causality.