Although air pollution, particularly particulate matter (PM), is recognized to harm semen quality, the critical windows of susceptibility during sperm development, the combined effects with gaseous pollutants, and the role of potential modifiers remain poorly understood. We aimed to determine whether exposure to particulate matter (PM_2.5 and PM₁₀) at different stages of sperm development is linked to changes in semen quality. A Cross-sectional study conducted from February 1, 2024, to January 31, 2025, at the Andrology Clinic of Foshan Fosun Chancheng Hospital. To determine whether exposure to PM_2.5 and PM₁₀ during different stages of sperm development is associated with changes in semen quality and to assess the potential modifying effects of socioeconomic status and lifestyle factors. After adjusting for potential confounders, our study found that increased exposure to PM_2.5 and PM₁₀ during the 61-90-day lag period was associated with changes semen quality, with odds ratios (ORs) of 1.02 (95% CI: 1.00-1.04) for PM_2.5 and 1.01 (95% CI: 1.00–1.02) for PM₁₀. In two-pollutant models, significant associations were observed between semen quality and combined exposure to PM_2.5 and CO (OR=1.05, 95% CI: 1.01–1.08), PM₁₀ and NO2 (OR=1.03, 95% CI: 1.00–1.07), PM₁₀ and CO (OR=1.02, 95% CI: 1.01–1.04), as well as PM_2.5 and SO₂ during the 0–90-day lag period (OR=1.06, 95% CI: 1.01–1.12). A nonlinear relationship was also observed between semen quality and exposure to PM alone and in combination with gaseous pollutants over the 0–90-day period. Subgroup analyses did not reveal any statistically significant interactions between PM exposure and factors such as age, education level, occupation, BMI, income, sleep duration, smoking, alcohol consumption, exercise, sugar-sweetened beverage intake, cola or coffee consumption, or hyperuricaemia (P > 0.05). This study indicates that exposure to PM is significantly associated with alterations in semen quality, particularly the spermatogonial phase. A synergistic effect was observed when PM coexisted with gaseous pollutants such as CO, NO₂, and SO₂, highlighting the importance of reducing PM exposure for the protection of male reproductive health.

Infertility, Particulate Matter, Reproductive Health, Semen Quality