{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:59:37Z","timestamp":1780981177674,"version":"3.54.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Air pollution is associated with impaired oocyte and embryo development, but the modifying effects of large-scale societal disruptions remain unclear. The aim of this study was to examine whether\n                      <jats:italic>in vitro<\/jats:italic>\n                      fertilization (IVF)-related mature oocyte, fertilization, and pregnancy rates differ across the periods before, during, and after the coronavirus disease 2019 (COVID-19) pandemic. We further evaluated whether ambient environmental exposures modified these differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed oocyte retrieval cycles performed at a single tertiary infertility center in Seoul, South Korea (2018\u20132024). Complete-case analyses included 1, 871 cycles for mature oocyte rate, 1, 234 cycles for fertilization rate, and 662 cycles for clinical pregnancy. Environmental exposures (PM\n                      <jats:sub>2<\/jats:sub>\n                      .\n                      <jats:sub>5<\/jats:sub>\n                      , PM\n                      <jats:sub>10<\/jats:sub>\n                      , NO\n                      <jats:sub>2<\/jats:sub>\n                      , O\n                      <jats:sub>3<\/jats:sub>\n                      , CO, SO\n                      <jats:sub>2<\/jats:sub>\n                      , temperature, humidity) were assessed over follicular-phase, 90-day, and 365-day windows. Beta regression (mature oocyte and fertilization rates) and logistic regression (pregnancy) models were fitted with cluster-robust standard errors, adjusting for maternal age, AMH (except pregnancy), treatment indication, controlled ovarian stimulation protocol, fertilization method, and total motile sperm count.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mature oocyte rate was significantly lower in the during-COVID (\u03b2 = \u22120.32, 95% CI \u22120.45 to \u22120.19, p &amp;lt; 0.001) and post-COVID (\u03b2 = \u22120.45, 95% CI \u22120.59 to \u22120.31, p &amp;lt; 0.001) groups than in the pre-COVID reference. The fertilization rate was higher in the post-COVID group than in the pre-COVID group in the regression model (\u03b2 = 0.22, 95% CI 0.02 to 0.42, p = 0.030), whereas the during-COVID comparison was not significant (p = 0.637). Pregnancy rate did not differ significantly across the three periods (Wald \u03c7\u00b2 = 2.12, p = 0.346). Long-term (365-day) exposures exhibited significant Env \u00d7 COVID interactions on the Likelihood Ratio Test for mature oocyte rate (O\n                      <jats:sub>3<\/jats:sub>\n                      : LRT p = 0.002; CO: LRT p = 0.008; NO\n                      <jats:sub>2<\/jats:sub>\n                      : LRT p = 0.009). No environmental interactions were significant for fertilization rate. For clinical pregnancy, five Env \u00d7 COVID interactions reached nominal significance, including SO\n                      <jats:sub>2<\/jats:sub>\n                      \u00d7 90-day (LRT p = 0.014), temperature \u00d7 365-day (p = 0.013), and O\n                      <jats:sub>3<\/jats:sub>\n                      \u00d7 365-day (p = 0.020).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IVF outcomes varied across COVID-19 pandemic periods, and long-term ambient environmental exposures modified these effects, particularly for oocyte maturation. Recent and long-term environmental exposures should be considered when evaluating IVF success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1796050","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:28:47Z","timestamp":1780979327000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in ambient environmental conditions correspond to variations in in vitro fertilization outcomes during the COVID-19 pandemic"],"prefix":"10.3389","volume":"17","author":[{"given":"Heeyon","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]},{"name":"Institute of Women\u2019s Life Medical Science, Yonsei University College of Medicine","place":["Seoul, Republic of 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Kyung","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]},{"name":"Institute of Women\u2019s Life Medical Science, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yebon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Computing, Imperial College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeongmi","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chungsoon","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics 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