Abstract
BACKGROUND: The impact of climate change on human health is well established; however, its effect on the prevalence of female infertility is poorly understood. In this study, we aimed to investigate the association between ambient temperature changes and the prevalence of female infertility. METHODS: In this ecological study, 174 countries and regions were included. We utilized 2000-2019 data on the age-standardized prevalence rate (ASPR) of female infertility and temperature data from Global Burden of Disease, ERA5 (fifth generation European Centre for Medium-Range Weather Forecasts atmospheric reanalysis for the global climate), and Coupled Model Intercomparison Project Phase 6 databases. Temperature over 12 months was averaged to express the annual temperature estimates, and the deviance percentage of temperature (DPT) was calculated based on the 20-year average temperature. Three-node restricted cubic spline curves were used to evaluate the association between temperature and the ASPR of female infertility. Linear mixed-effects models, with country code as a random effect, were used to estimate the effect size (β) and 95% confidence interval (CI) for DPT and the ASPR of female infertility. Adjusted linear mixed-effects models were used to predict the impact of future temperature changes (2020-2030) on the ASPR of female infertility. RESULTS: Between 2000 and 2019, a U-shaped relationship was observed between temperature and the ASPR of female infertility, with the lowest ASPR occurring at 15 ℃. Increased DPT was associated with an increased ASPR of female infertility, with an adjusted β (95% CI) of 78.952 (10.514, 147.710). Future temperature increases will further elevate the ASPR of female infertility. CONCLUSION: Globally, temperature changes may be associated with an increase in the ASPR of female infertility.