SMOKING REPRODUCTION More Than 60 Published Studies In

SMOKING & REPRODUCTION More Than 60 Published Studies In Medical Literature

SMOKING & FEMALE INFERTILITY Meta analysis (25 studies) - Smoking reduce the natural fertility - Earlier menopause(average 2 years) Damage of ovarian reserve increase with smoking - Increase in risks for ectopic pregnancy and spontaneous abortion

SMOKING & FEMALE INFERTILITY Women who quit smoking before or during pregnancy reduce the risk for adverse reproductive outcomes, including Difficulties in becoming pregnant. - Infertility - PROM - Preterm delivery - Low birth weight

SMOKING & MALE INFERTILITY (ASRM=AFS 2001) Heavy smoking countributes to - Development of impotence Abnormal semenogram - Decreased spermy count alteration in motility and increase in the abnormal forms

SMOKERS & ART A prospective cohort study (Zitzman et al 2001) q High basal and post cc serum FSH q Weak ovarian response to stim q Need higher doses of GN q Impaired fertilization and delayed conception resulted from - Interference with gametogenesis - Failure of implantation - Early miscarriage

HOW SMOKING AFFECT FERTILITY q. Maternal smoking affects - In utro ovary female fetuses - Reduced Semen Quality and Testis Size in Adulthood (Jensen 2004) q. Increase ROS inside Graafian follicle q. Affect meiotic maturation of human oocytes

HOW SMOKING AFFECT FETILITY q Interfere with estrogen synthesis q Endothelial abnormalities (atherogenic and thrombotic problems) q Oocytes (pre-zygotic genetic damage) q Sperm DNA damage (substances in smoke)

UPDATE METERNAL SMOKING q Increases the risk of asthma during the first 7 years of life(Laurberg P. 2004) q Impairment of iodine Nutrition in Breast-Fed Infants (Nohr , 2004) q Increased risk for sudden infant death syndrome (SIDS)

In their meta-analysis, Waylen et. al. evaluadet 17 studies end showed in aggregate significantly lower odds of live birth per cycle (OR 0. 54, 95% CI 0. 300. 99), and significantly higher odds of spontaneous miscarriage (OR 2. 65, 95% CI 1. 53 -5. 30 ) in women who smoked. Human Reprod update 2009; 15

Benedict et al measured cotinine, a nicotine metabolite, in follicular fluid collected during 3270 IVF treatment cycles from 1909 nonsmoking women between 1994 and 2003 to examine the relationship between secondhand tobacco smoke exposure and implantation failure. They reported a 52% in- crease in the risk of implantation failure among women exposed to STS compared with those unexposed. They also found a 25% decrease in the odds for a live birth among STS-exposed women Hum Reprod 2011; 26

The summary point is that women trying to get pregnant should stop smoking, but non-smoking women, too, should remove themselves from chronic exposure to secondhand smoke. Fertil Steril 2012; 97