Pregnancy and Urban Environment (PRUNE) Cohort Profile and Built Environment in Infertile Couples

Background: Addressing the association between the perceived physical environment and human fertility is necessary to understand the impact of the built environment on reproductive health and develop effective interventions to improve human fertility. We assessed the association between perceived built environment and pregnancy in infertility patients. Methods: We constructed a prospective cohort study (Pregnancy and Urban Environment, PRUNE) recruiting 778 eligible infertility patients who visited one of the two university affiliated infertility centers for infertility treatment between 2019 and 2022. Using a mobile survey, we collected the information of demographic, clinical characteristics, residential address, perceived proximity to neighborhood green and blue space, and environmental noise. Adjusted risk ratios (aRR) were calculated for the achievement of pregnancy within three months of survey participation. Results: In the 728 infertility patients, 445 completed the second round of survey. Median age of women and men was 39 and 40 years, respectively. Most reported they have green (91%) and blue space (67%) within a 10-min walking distance. A fourth of patients (26%) had an annoying environmental noise. Probability of pregnancy within three months was higher for those who had green space within walking distance (aRR = 1.18, 95% confidence interval: 1.06, 1.32). The association with pregnancy was close null for blue space and annoying environmental noise. The aRR for women and for men was comparable (p for interaction = 0.875). Conclusions: We observed a positive association between living close to green space and pregnancy. This finding would provide evidence of the potential impact of built environment on human fecundity in infertility couples. Clinical Trial Registration: This study is registered in the Clinical Research Information Service (https://cris.nih.go.kr, CRIS number: KCT0003560).