Cigarette Smoking and IVF

Sérgio R. Soares; Marco A. Melo


Expert Rev of Obstet Gynecol. 2008;3(4):555-563. 

In This Article

Expert Commentary

The impact of cigarette smoking on human health is vast and complex. In the reproductive field, our knowledge has increased in the last few decades. Tobacco smoke exposure may negatively interfere with the probability of a spontaneous pregnancy and is also detrimental to pregnancy development. It is now known that many of the negative effects of tobacco constituents on reproductive function are of relevance in the context of IVF cycles.

Oxidative stress determined by tobacco constituents may damage every cellular component. The cellular membrane, microtubules, proteins and DNA may have their integrity compromised. The male gamete may have its IVF capacity affected and chromosome number and the DNA molecule integrity altered; therefore, the quality of embryos generated and their implantation potential are reduced in smokers. Sperm DNA damage is also associated with the risk of diseases, such as cancer, in the progeny of male smokers.

Tobacco constituents also affect the process of follicular and oocyte maturation in many aspects; steroidogenesis and follicle growth are affected by these substances. Ovarian aging is accelerated in smokers and ovarian response in IVF cycles tends to be poorer. The incidence of abnormalities in meiosis resumption is higher in female smokers and clinical outcomes of IVF cycles are worse.

Endometrial receptiveness is altered by tobacco smoke. Endometrial decidualization may be compromised in smokers. Paradoxically, the incidence of twin gestations is higher among heavy smokers, as if in a subset of smoking women endometrial receptiveness were increased; this fact needs further clarification.


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