Association Between Cigarette Smoking and Ovarian Reserve Among Women Seeking Fertility Care (original) (raw)
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Active smoking compromises IVF outcome and affects ovarian reserve
Reproductive Biomedicine Online, 2008
Although the association between smoking and female infertility is now largely demonstrated, the proportion of smokers in women of reproductive age remains important. Tobacco contains numerous toxicants that could affect ovarian reserve and lead to poor prognosis in assisted reproductive techniques. To investigate the effect of female active smoking on ovarian reserve and IVF outcome, smoking status, hormonal status, i.e. serum FSH, oestradiol and anti-Müllerian hormone (AMH), ovarian response to hyperstimulation, i.e. mature oocytes retrieved, and IVF outcome, i.e. clinical pregnancy, were retrospectively analysed in 111 women undergoing IVF-embryo transfer cycles. Compared with non-smokers (n = 71), active smoking women (n = 40) had decreased ovarian response (12.12 ± 5 versus 8.62 ± 4 mature oocytes retrieved) to hyperstimulation and lower clinical pregnancy rate (29.6 versus 10.0%). Serum AMH concentrations were lower in the smoker group (3.86 ± 1.92 versus 3.06 ± 1.68 µg/l) and had no predictive value for ovarian response, inversely to non-smokers. In conclusion, active smoking is associated with poor prognosis in assisted reproduction cycles, i.e. ovarian response and pregnancy, and leads to altered ovarian reserve, as reflected by decreased serum AMH concentrations.
Association between cigarette smoking behavior and infertility in women: a case-control study
Biomedical Research and Therapy
Introduction: The effects of smoking on decreasing the chance of fertility in women have been acknowledged but some aspects, such as smoking behavior, are currently unclear. The present study aims to evaluate the relationship between smoking traits and infertility in women through a comparative study with fertile women. Methods: This case-control study was conducted on 350 women (177 infertile and 173 fertile) in March-May 2014. Sampling was performed in two phases. Demographic and reproductive data were collected by questionnaires- for demographics and the Fagerstrom Test for Nicotine Dependence (FTND)). The total score of questionnaires was ten. The participants were divided into 3 groups: “Low Nicotine” dependency (0-4), “Moderate Nicotine” dependency (5) and “High Nicotine” dependency (6-10). To examine the relationship between smoking and infertility, both the chi-square test and logistic regression tests were used. Results: Tobacco use in infertile women was greater than that ...
Human Reproduction, 1998
The effect of cigarette smoking on ovarian reserve as measured by basal serum follicle stimulating hormone (FSH) concentrations, and by the response to a standard ovarian stimulation protocol, was examined retrospectively in 173 consecutive women (108 non-smokers and 65 smokers) undergoing in-vitro fertilization (IVF) and embryo transfer treatment. Women who smoked had a higher mean basal serum FSH concentration (P ≤ 0.0001), in particular younger (<36 years) women, and required a statistically significantly higher mean dosage of gonadotrophins for ovarian stimulation than the non-smokers (48.1 ⍨ 15.6 versus 38.9 ⍨ 13.6 ampoules, 75 IU/ampoule; P < 0.0001). A lower mean number of oocytes was obtained in smokers than non-smokers (6.2 ⍨ 3.4 versus 11.1 ⍨ 6.3, oocytes P ≤ 0.0001) and the rate of abandoned cycles (18.5 versus 8.5%) and total fertilization failure (18.5 versus 8.5%) was higher. The clinical pregnancy rate per cycle in smokers was 16.9% versus 21.3% in non-smokers but this was not statistically significant. In conclusion, cigarette smoking in women appears to significantly reduce their ovarian reserve and lead to poor response to ovarian stimulation at an earlier age.
The association between smoking and female infertility as influenced by cause of the infertility
Fertility and Sterility, 1987
Smoking histories were compared in 901 women with infertility of different types and 1264 women admitted for delivery at seven collaborating hospitals. The relative risk for infertility associated with cigarette smoking prior to the infertility diagnosis for nulliparous cases or first live birth for controls was calculated using a multivariate logistic-regression model to control for potential confounding factors, including center, age, religion, education, number of sexual partners, and contraceptive use. The adjusted risk for infertility attributed primarily to cervical factor (n = 96) was 1.7 (P = 0.04), to tubal disease unrelated to endometriosis (n = 225) was 1.6 (P = 0.009), to ovulatory factor (n = 389) was 1.0 (not significant [NS)), and to endometriosis (n = 191) was 0.9 (NS). The authors conclude that cigarette smoking is significantly associated only with certain types of primary female infertility. Fertil Steril 48:377, 1987
Ovarian function and cigarette smoking: Ovarian function and cigarette smoking
Paediatric and Perinatal Epidemiology, 2010
Cigarette smoking has been implicated in reproductive outcomes including delayed conception, but mechanisms underlying these associations remain unclear. One potential mechanism is the effect of cigarette smoking on reproductive hormones; however, studies evaluating associations between smoking and hormone levels are complicated by variability of hormones and timing of specimen collection. We evaluated smoking and its relationship to reproductive hormones among women participating in the BioCycle study, a longitudinal study of menstrual cycle function in healthy, premenopausal, regularly menstruating women (n=259). Fertility monitors were used to help guide timing of specimen collection. Serum levels of estradiol, progesterone, folliclestimulating hormone (FSH), luteinizing hormone (LH) and total sex-hormone binding globulin (SHBG) across phases of the menstrual cycle were compared between smokers and nonsmokers. We observed statistically significant phase-specific differences in hormone levels between smokers and nonsmokers. Compared to nonsmokers, smokers had higher levels of FSH in the early follicular phase higher LH at menses after adjusting for potential confounding factors of age, race, BMI, nulliparity, vigorous exercise, and alcohol and caffeine intake through inverse probability of treatment weights. No statistically significant differences were observed for estradiol, progesterone or SHBG. These phase-specific differences in levels of LH and FSH in healthy, regularly menstruating women who are current smokers compared to nonsmokers reflect one mechanism by which smoking may impact fertility and reproductive health.
Smoking and infertility: a committee opinion
Fertility and Sterility, 2012
Approximately 30% of women of reproductive age and 35% of men of reproductive age in the United States smoke cigarettes. Substantial harmful effects of cigarette smoke on fecundity and reproduction have become apparent but are not generally appreciated. This document replaces the 2008 ASRM Practice Committee document of the same name.
Tobacco control, 2015
Several studies have investigated the association of tobacco use with infertility and age at natural menopause, yet few have explored secondhand smoke (SHS) exposure with these outcomes. This study offers a comprehensive, quantified secondary data analysis of these issues using the Women's Health Initiative Observational Study (WHI OS). This study examines associations between lifetime tobacco exposure-active smoking and SHS-and infertility and natural menopause (before age 50). Information on smoking, lifetime fertility status, and age at natural menopause was collected and available from 93 676 postmenopausal women aged 50-79 enrolled in the WHI OS from 1993 to 1998 at 40 centres in the USA. Multivariate-adjusted regression models were used to estimate ORs and 95% CI according to levels of active smoking and SHS exposure, and trends were tested across categories. Overall, 15.4% of the 88 732 women included in the analysis on infertility met criteria for the condition. 45% of t...
Human reproduction (Oxford, England), 2014
Do women with polycystic ovary syndrome (PCOS) seeking fertility treatment report smoking accurately and does participation in infertility treatment alter smoking? Self-report of smoking in infertile women with PCOS is accurate (based on serum cotinine levels) and smoking is unlikely to change over time with infertility treatment. Women with PCOS have high rates of smoking and it is associated with worse insulin resistance and metabolic dysfunction. Secondary study of smoking history from a large randomized controlled trial of infertility treatments in women with PCOS (N = 626) including a nested case-control study (N = 148) of serum cotinine levels within this cohort to validate self-report of smoking. Women with PCOS, age 18-40, seeking fertility who participated in a multi-center clinical trial testing first-line ovulation induction agents conducted at academic health centers in the USA. Overall, self-report of smoking in the nested case-control study agreed well with smoking sta...
Effects of female and male smoking on success rates of IVF and gamete intra-Fallopian transfer
Human Reproduction, 2001
BACKGROUND: Smoking by both male and female partners may play a significant role in the success rates of assisted reproductive technologies. The objective of this 5-year prospective study was to investigate the influence of cigarette smoking by the wife, husband, and couple at various time points (e.g. lifetime, week prior, or during the procedures) on different biological parameters of IVF and gamete intra-Fallopian transfer (GIFT). METHODS AND RESULTS: A total of 221 couples, aged >20 years, of Caucasian, Black, Asian or Hispanic descent were recruited from seven infertility clinics located in Southern California. Couples (i.e. either female or male or both) who ever smoked compared with non-smokers, had adjusted relative risks (RR) of 2.41 (95% CI 1.07-5.45, P ⍧ 0.03) of not achieving a pregnancy, and 3.76 (95% CI 1.40-10.03, P < 0.01) of not having a live birth delivery, while adjusting for potential confounders. For couples who smoked for >5 years, there was an adjusted RR ⍧ 4.27 of not achieving a pregnancy (95% CI l.53-11.97, P ⍧ 0.01). The number of oocytes retrieved decreased by 40% for couples (smokers, n ⍧ 6) and by 46% for men who smoked during the week of the visit for IVF or GIFT. Women who smoked in their lifetime had adjusted risks of 2.71 of not achieving a pregnancy (95% CI 1.37-5.35, P < 0.01), and 2.51 (95% CI 1.11-5.67, P < 0.03) of not having a live birth delivery. CONCLUSIONS: There is compelling evidence that couples should be made aware that smoking years before undergoing IVF and GIFT can impact treatment outcome. This study may also provide insight into the timing and effects of male and female smoking on natural reproduction.