Purpose: To assess the effects passive smoking and heavy metal concentrations in the blood and follicular fluid on assisted reproductive technology outcome.Methods: A prospective study was conducted between March 2017 and January 2018 in population consisted of 75 female patients undergoing an In vitro fertilization (IVF) cycle at Dr. Faris Medical center for Infertility and Human Reproduction located on Heliopolis, Cairo, Egypt; with unexplained infertility who underwent intracytoplasmic sperm injection (ICSI) using GnRH-antagonist protocol. Concentrations of three toxic metals Cadmium (Cd), Lead (Pb) and Arsenic (As) were measured both in blood sera and follicular fluid specimens. Patients were evaluated in two groups both undergoing ICSI; the first group consisted of patients who does not smoke or exposed to smoking (n=28) and the group passive smoker females (n=47). Results: These three heavy metals were significantly higher in serum and follicular fluid of passive smoking females (P<0.05). Also, higher concentrations of Cd, Pb and As were found in follicular fluid of passive smoking patients in comparison with non-smoker females. However, concentrations of Cd and Pb were not significantly different between both serum and follicular fluid. Conclusion: Passive smoking could affect levels of Cd, Pb and As in serum and follicular fluid of females undergoing Intra Cytoplasmic Sperm Injection (ICSI).
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