Lifestyle and Environment Environmental Exposures

Ambient air pollution during developmental windows of spermatogenesis and semen quality among an infertility treatment seeking population

Russo LM, Pilsner JR, Canty TP, Perkins NJ, Mendola P, Schliep K, Shaaban M, Hemmert RB, Singh A, Ring AM, Peterson CM, Rabeya K, Schisterman EF, Mumford SL, Nobles C

Published September 15, 2025 Ecotoxicology and environmental safety, 303, 118955
DOI 10.1016/j.ecoenv.2025.118955 PMID 40886599 PMC PMC12413662

RRM Academy Synopsis

Higher ozone exposure is linked to lower normal sperm morphology

In this cohort analysis of 1,965 men from couples seeking infertility treatment in Utah, higher ozone exposure was associated with a lower percentage of normally shaped sperm. A regional model estimated exposure in the 74 days before each sample. Ozone in the final 10 days was also associated with lower sperm count.

Study at a glance, cohort analysis of 1,965 men: Higher ozone exposure linked to lower normal sperm shape
Study at a glance, cohort analysis of 1,965 men: Higher ozone exposure linked to lower normal sperm shape. Source: Russo LM et al., 2025, PMID 40886599.

Key Findings

  • Across the 74-day sperm development window, a 5 ppb increase in ozone was associated with 6.09% lower percent normal sperm morphology (95% CI −10.00, −2.02), which held after multiple-comparison correction.
  • In multi-pollutant models, a 5 ppb increase in ozone during meiosis I+II was associated with 6.73% lower normal morphology (95% CI −9.82, −3.54), and during spermiogenesis with 3.83% lower.
  • A 5 ppb increase in ozone during spermiation, the 0 to 10 days before sample collection, was associated with 3.66% lower sperm count (95% CI −7.10, −0.09).
  • Per 5-unit increase, fine particulate matter during spermiation showed a trend toward lower sperm concentration (% difference −3.46, 95% CI −7.32, 0.56) and lower progressive motility (−0.53, 95% CI −1.09, 0.04).
  • In single-pollutant models, fine particulate matter was associated with higher percent normal morphology (9.52%, 95% CI 4.32, 14.99). The estimate was attenuated after adjusting for ozone.

Interpretation

This cohort study followed 1,965 men. All were enrolled in a trial of folic acid and zinc. A regional air model estimated ozone levels near each man's home during key windows of sperm development. Single-pollutant models linked some pollutants to better semen measures and others to worse. When the pollutants were modeled together, only the ozone link to sperm shape held up after correction for multiple testing. The authors note that most participants had moderate to high income and were mostly non-Hispanic white. The findings support larger studies of ozone exposure and semen quality in more diverse groups.

RRM Context

Restorative reproductive medicine evaluates both partners. It searches for the underlying cause of reduced fertility. Sperm take about 74 days to develop. A cause-based evaluation treats an abnormal semen analysis as a finding with a possible cause, including environmental exposures. In this study, ozone during that window was linked to sperm shape.

Abstract

Prior studies have observed impacts of air pollution on semen quality, but timing of exposure during developmental windows of spermatogenesis and impacts of low-to-moderate air pollution is less well understood. We examined the relation between air pollution and semen quality in the Folic Acid and Zinc Supplementation Trial (2013-2018), which enrolled male partners of couples seeking infertility treatment in the Salt Lake City, Utah region (n = 2015). Semen quality parameters were assessed at baseline, 2-, 4-, and 6-months follow-up. Measures of daily air pollutants at each participant's residence were abstracted from Community Multiscale Air Quality models (fine particulate matter: PM2.5, sulfur dioxide, nitrogen dioxide, and ozone: O3), linked to participants' residential addresses, and averaged across the 74-day spermatogenesis window prior to the sample collection date for each study visit, and across four developmental windows of spermatogenesis (mitosis, meiosis I-II, spermiogenesis, and spermiation). Generalized linear mixed models considered four repeated semen sample measures per participant and adjusted for co-pollutants, age, season, and income. In multi-pollutant models, O3 during early-to-mid spermatogenesis (meiosis I+II and spermiogenesis) was related to lower percent normal morphology (% difference -6.73, 95 % CI -9.82, -3.54 and % difference -3.83, 95 % CI -7.51, 0.00, respectively). Additionally, PM2.5 and O3 during late spermatogenesis (spermiation) were associated with lower count and concentration, and PM2.5 with lower progressive motility. These findings suggest that exposure to low-to-moderate levels of air pollution may negatively impact semen quality and indicate that exposure to O3 during meiosis and spermiogenesis may particularly affect normal sperm morphological development.

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Lifestyle and Environment › Environmental Exposures › Air and Water Quality · Male Fertility › Male Factor Causes › Lifestyle and Environment
Lindsey M Russo, J Richard Pilsner, Timothy P Canty, Neil J Perkins, Pauline Mendola, Karen Schliep, May Shaaban, Rachael B Hemmert, Akanksha Singh, Allison M Ring, C Matthew Peterson, Kaniz Rabeya, Enrique F Schisterman, Sunni L Mumford, Carrie Nobles
L Russo, Tim Canty, T Canty, N Perkins, P Mendola, K Schliep, M Shaaban, R Hemmert, A Singh, A Ring, K Rabeya, E Schisterman, S Mumford, C Nobles
PMID 40886599 40886599 DOI 10.1016/j.ecoenv.2025.118955 10.1016/j.ecoenv.2025.118955 Russo et al. 2025, Russo 2025