Environmental PM2.5 Exposure and Socioeconomic Deprivation Are Independent Risk Factors for Impaired Semen Parameters

To evaluate the association between socioeconomic deprivation status and ambient fine particulate matter exposure and semen parameters.

We retrospectively evaluated men undergoing fertility evaluation with semen analysis testing between 2002 and 2020 at an integrated academic health system. Semen parameters at patients' index semen analysis including ejaculate volume, sperm concentration, sperm motility, sperm morphology, and total motile sperm count were assessed. Socioeconomic Deprivation Index and average particulate matter exposure during the 74 days prior to index semen analysis were determined by geographic location of patients' primary residence. Analysis of variance (ANOVA) was used to analyze differences in semen parameters between men with low, intermediate, and high SES. Univariate and multivariate logistic regression models were used to assess the association between socioeconomic deprivation status, PM2.5 exposure, and abnormal semen parameters.

Among 8446 patients, 1258 (14.9%) men had "moderate to hazardous" particulate matter exposure during spermatogenesis. These men had worse socioeconomic deprivation status (0.23 interquartile range [IQR 0.18-0.32] vs 0.22 [IQR 0.17-0.29], P = .001) and significantly lower ejaculate volume, sperm concentration, motility, and total motile sperm count (59.0 M [IQR 20.4-122.7 M] vs 72.0 M [IQR 30.1-126.9 M], P < .001). Men with high socioeconomic status had significantly greater total motile sperm count compared to men with low socioeconomic status (75.0 M [IQR 34.3-133.7 M] vs 62.6 M [IQR 22.7-118.1 M], P < .001). On multivariable analysis, when controlling for age, race/ethnicity, and body mass index, both Deprivation Index (OR 2.81 [95% CI 1.61-4.90], P < .001) and average daily particulate matter exposure (OR 1.05 [1.03-1.08], P < .001) were significantly associated with increased odds of decreased total motile sperm count.

Socioeconomic deprivation and higher particulate matter exposure were independently associated with poor semen quality. These findings underscore the need to consider environmental and socioeconomic factors in the management of male fertility.