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: 10613567
• 负责人: Audrey Jane Gaskins
• 金额: $ 23.51万
• 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 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10613567
• 关键词: Adverse effects; Affect; Age; Animals; Antral; Artificial Insemination; Assisted Reproductive Technology; Birth; Birth Rate; Characteristics; Clinical; 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; Stress; Structure; Surface; System; Temperature; Testing; Weather; Woman; 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; ovulation time; reproductive; reproductive outcome; sperm cell; 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.

项目概要/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 气候变化预计只会在未来几十年内加剧，而极端高温的危害仍然存在。 人类健康已被广泛认识，包括对怀孕和分娩结果的不利影响，但很少有人认识到这一点。 关于环境温度和人类生育能力的已知人口统计研究表明，炎热的天气。 导致 8 至 10 个月后出生率显着下降，但这种关联的驱动因素尚不清楚。 动物文献也早已记录了高温引起的母体体温过高之间的联系。 环境温度和生育能力下降，主要是通过对卵母细胞发育的影响介导的 然而，热应激是否对女性卵泡发育有类似的影响尚不清楚。 拟议的研究旨在使用现有的大型数据库和强大的方法论来测试 总体假设是，在卵泡发生期间暴露于极端高温的女性会出现 卵母细胞质量和胚胎发育受损，植入失败的风险更高，概率更低 我们还认为，持续时间较长的高温事件会观察到更强的影响。 和更大的强度，效果会因时间、空间和个体层面的属性而异。 假设，我们将利用超过 200 万个非捐赠者辅助生殖技术 (ART) 周期的数据 1996 年至 2016 年在美国发起，作为国家 ART 监控系统的一部分收集。 国家天气数据将使用高分辨率土地数据中的公开数据进行整合 同化系统——国家近地表温度和湿度的 1 公里分辨率数据集，跨越 1981 年至 2016 年，接受 ART 的女性是研究极端高温假设的理想环境。 通过对卵巢的不利影响影响生育能力，因为我们可以确定极端高温的确切时期 暴露并观察早期生殖结果，而这在夫妇中永远不会直接观察到 通过将我们的分析限制在使用捐赠者精子和冷冻胚胎的周期中。 转移，我们还可以独特地检查卵泡发生过程中极端高温暴露对 ART 的影响 结果与男性伴侣的热暴露和植入窗口期间无关。 气温上升和越来越多的妇女将生育推迟到 35 岁的平行趋势 随着年龄的增长，了解极端高温对生育能力的影响变得越来越重要。 研究结果可以为有针对性的法规、政策、公共卫生预警系统和干预措施提供重要信息 最终目标是减少不孕症和早孕流产。