Extreme heat events and fertility: a national study

极端高温事件与生育率：一项全国性研究

• 批准号: 10429519
• 负责人: Audrey Jane Gaskins
• 金额: $ 20.83万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10429519
• 关键词: Adverse effects; Affect; Age; Animals; Artificial Insemination; Assimilations; Assisted Reproductive Technology; Birth; Birth Rate; Characteristics; Clinical; Code; Communities; Competence; Country; Couples; Data; Data Set; Databases; Development; Embryo; Embryo Transfer; Embryonic Development; Endometrial; Ethnic Origin; Event; Exposure to; Female; Fertility; First Births; Frequencies; Future; Goals; Growth; Health; Heat Stress Disorders; Heat Waves; Hormones; Human; Humidity; Impairment; Individual; Induced Hyperthermia; Infertility; Intervention; Link; Literature; Live Birth; Mammals; Maternal Age; Mediating; Methodology; Modeling; Oocytes; Outcome; Ovarian Stimulations; Ovary; Ovulation; Pathway interactions; Patients; Phase; Physicians; Policies; Population Sizes; Pregnancy; Probability; Production; Public Health; Race; Regulation; Reproduction; Research; Resolution; Role; Spermatogenesis; Structure; Surface; System; Temperature; Testing; Weather; Woman; base; climate change; climate zone; community-level factor; corpus luteum; early pregnancy loss; embryo cryopreservation; experience; extreme heat; extreme weather; failure Implantation; folliculogenesis; follow-up; hazard; health warning; high risk; human model; implantation; male; meteorological data; motherhood; oocyte maturation; oocyte quality; oocyte retrieval; reproductive; reproductive outcome; sperm cell; sperm cryopreservation; success; trend; Adverse effects; Affect; Age; Animals; Artificial Insemination; Assimilations; Assisted Reproductive Technology; Birth; Birth Rate; Characteristics; Clinical; Code; Communities; Competence; Country; Couples; Data; Data Set; Databases; Development; Embryo; Embryo Transfer; Embryonic Development; Endometrial; Ethnic Origin; Event; Exposure to; Female; Fertility; First Births; Frequencies; Future; Goals; Growth; Health; Heat Stress Disorders; Heat Waves; Hormones; Human; Humidity; Impairment; Individual; Induced Hyperthermia; Infertility; Intervention; Link; Literature; Live Birth; Mammals; Maternal Age; Mediating; Methodology; Modeling; Oocytes; Outcome; Ovarian Stimulations; Ovary; Ovulation; Pathway interactions; Patients; Phase; Physicians; Policies; Population Sizes; Pregnancy; Probability; Production; Public Health; Race; Regulation; Reproduction; Research; Resolution; Role; Spermatogenesis; Structure; Surface; System; Temperature; Testing; Weather; Woman; base; climate change; climate zone; community-level factor; corpus luteum; early pregnancy loss; embryo cryopreservation; experience; extreme heat; extreme weather; failure Implantation; folliculogenesis; follow-up; hazard; health warning; high risk; human model; implantation; male; meteorological data; motherhood; oocyte maturation; oocyte quality; oocyte retrieval; reproductive; reproductive outcome; sperm cell; sperm cryopreservation; success; trend

PROJECT SUMMARY/ABSTRACT The frequency and intensity of heatwaves and other extreme weather events is increasing rapidly owing to climate change and is only projected to escalate in the coming decades. While the hazards of extreme heat on human health are widely recognized, including adverse effects on pregnancy and birth outcomes, little is known regarding ambient temperature and human fertility. Demographic studies suggest that hot weather causes a significant decline in birth rates 8 to 10 months later, yet the drivers of this association are unclear. The animal literature has also long documented a link between maternal hyperthermia induced by high ambient temperatures and reduced fertility, largely mediated through effects on oocyte developmental capacity; however, whether heat stress has a similar impact on follicular development in women is less clear. The proposed research seeks to use a large existing database and robust methodological approaches to test the overarching hypothesis that women exposed to extreme heat during folliculogenesis will have compromised oocyte quality and embryo development, higher risk of implantation failure, and lower probability of live birth. We also hypothesize that stronger effects will be observed following heat events of longer duration and greater intensity and that effects will vary by temporal-, spatial-, and individual-level attributes. To test this hypothesis, we will utilize data from over 2 million non-donor assisted reproductive technology (ART) cycles initiated in the US from 1996 to 2016 that are collected as part of the National ART Surveillance System. National weather data will be integrated using publicly available data from the High Resolution Land Data Assimilation System– a national 1 km resolution dataset of near-surface temperature and humidity that spans 1981-2016. Women undergoing ART represent an ideal setting to investigate the hypothesis that extreme heat affects fertility through adverse effects on the ovary as we can determine exact periods of extreme heat exposure and directly observe early reproductive outcomes that would never be observed in couples conceiving without assistance. By restricting our analysis to cycles using donor sperm and frozen embryo transfers, we can also uniquely examine the effects of extreme heat exposure during folliculogenesis on ART outcomes independent from heat exposures to the male partner and during the implantation window. Given the parallel trends of rising temperatures and the increasing number of women delaying motherhood until 35 years and older, understanding the effects of extreme heat on fertility is becoming increasingly important. Our findings can greatly inform targeted regulations, policies, public health warning systems, and interventions with the ultimate goal of reducing infertility and early pregnancy loss.

项目摘要/摘要 热浪和其他极端天气事件的频率和强度正在迅速增加 气候变化，只有预计在未来几十年才升级。而极热的危害 人类健康是广泛认可的，包括对怀孕和出生结果的不利影响，几乎没有 有关环境温度和人类生育的已知。人口研究表明天气炎热 8到10个月后，出生率显着下降，但该关联的驱动因素尚不清楚。 该动物文献长期以来还记录了高高引起的母体高温之间的联系 环境温度和降低的生育能力，在很大程度上通过对卵母细胞发育的影响进行介导 容量;但是，热应激是否对女性的卵泡发育有相似的影响。 拟议的研究试图使用大型现有数据库和强大的方法论方法进行测试 总体假设，即在卵泡发生过程中暴露于极端热量的女性将具有 卵母细胞质量和胚胎发育损害，植入失败的风险较高，概率较低 活出生。我们还假设在持续时间更长的热事件之后将观察到强烈的效果 更大的强度和这种影响会因临时，空间和个体级别属性而异。测试这个 假设，我们将利用超过200万个非供体辅助生殖技术（ART）周期的数据 从1996年到2016年在美国启动，这些启动是作为国家艺术监视系统的一部分收集的。 国家天气数据将使用高分辨率土地数据中的公开数据集成 同化系统 - 跨度温度和湿度的全国1公里分辨率数据集 1981- 2016年。接受艺术的妇女代表了调查极热的假设的理想环境 通过对卵巢的不利影响影响生育能力，因为我们可以确定精确的极热周期 暴露并直接观察到夫妻中永远不会观察到的早期生殖结果 在没有帮助的情况下受孕。通过使用供体精子和冷冻胚胎将我们的分析限制为周期 转移，我们还可以唯一检查卵泡发生过程中极端热暴露对艺术的影响 结果独立于与男性伴侣和植入窗口期间的热暴露。鉴于 温度上升的平行趋势以及延迟母性的妇女人数的增加到35年 越来越旧，了解极热对生育的影响变得越来越重要。我们的 调查结果可以极大地为有针对性的法规，政策，公共卫生警告系统以及干预措施 减少不育和早期妊娠丧失的最终目标。