{"paper_id":"2064b039-a6d0-41a0-91ea-43bafb47d963","body_text":"ABSTRACT\nAir pollution has reproductive toxicity, while green space could lessen such harmful consequences. However, the current research on the link between air pollution/green space, and endometriosis remains scarce. Therefore, we investigated the separate and interactive relationships between air pollution, green space and endometriosis-related infertility. We collected data on 20,981 women from a large assisted reproductive center in Anhui, China, of whom 1,201 were diagnosed with endometriosis-related infertility. air pollution (PM2.5, PM10, NO2, CO, and SO2) and Green space (quantified using the normalized difference vegetation index [NDVI]) were evaluated using spatiotemporal models developed from satellite data. We employed multivariable logistic regression to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI). Per interquartile range (IQR) increase in exposure was associated with elevated odds of endometriosis prevalence for PM2.5 (aOR = 1.20, 95%CI:1.11–1.30), PM10 (1.17, 1.08–1.27), SO2 (1.12, 1.02–1.24), NO2 (1.18, 1.08–1.38), and CO (1.12, 1.05–1.19). Conversely, each IQR increase in NDVI500 m showed protective effects (0.72, 0.63–0.83). Notably, an additive antagonistic effect was observed between NDVI500 m and CO. Our findings indicated that air pollution could potentially increase the risk of endometriosis, while green space is its protective factor. Besides, green space might attenuate the negative impact of air pollution on endometriosis.\nAcknowledgements\nThe authors thank the participants who made this study possible and gratefully acknowledge the role of the staff and volunteers in collecting the data. Acknowledgment for the data support from National Earth System Science Data Center, National Science & Technology Infrastructure of China. (http://www.geodata.cn).\nDisclosure statement\nNo potential conflict of interest was reported by the author(s).\nData availability statement\nThe authors do not have permission to share data. Code was available from the corresponding author on reasonable request.\nCRediT authorship contribution statement\nYongzhen Peng: Writing – review & editing, Writing – original draft, Visualization, Validation, Software, Resources, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Lanlan Fang and Chunyan Wang: Software, Methodology, Data curation, Conceptualization. Guosheng Wang: Writing – review & editing, Resources, Data curation. Cong Ma: Visualization, Investigation, Formal analysis, Data curation. Xu Zhang and Jianpin Ni: Methodology, Investigation, Formal analysis, Data curation. Yubo Ma, Xuyang Chen, and Guoqi Cai: Validation, Software, Data curation. Faming Pan and Huifen Xiang: Writing – review & editing, Supervision, Methodology, Funding acquisition.\nSupplementary material\nSupplemental data for this article can be accessed online at https://doi.org/10.1080/09603123.2025.2504611","source_license":"public-domain-us","license_restricted":false}