Effect of smoking on ovarian reserve and ovarian stimulation in in- vitro fertilization and embryo transfer

Abstract

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 < or = 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 < or = 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.

Influence of smoking on outcome of COH and IUI in subfertile couples

“…This observation is in accordance with other studies showing an association between smoking and an increased gonadotropin requirement during COH for IVF [15,19,20]. However, the lower peak E2 levels [21,22] and recruitment of fewer follicles and oocytes [7,13,15,21,23,24] in smokers that were reported in earlier studies were not observed in our population, in which milder and less vigorous stimulation was required.…”

“…However, the lower peak E2 levels [21,22] and recruitment of fewer follicles and oocytes [7,13,15,21,23,24] in smokers that were reported in earlier studies were not observed in our population, in which milder and less vigorous stimulation was required.…”

“…Surprisingly, however, despite the widespread studies of the effect of smoking on reproductive outcome after IVF treatment [6,[13][14][15][16], there is no information in the literature on the influence of smoking on COH and IUI.…”

Diminished Ovarian Reserve, Causes, Assessment and Management

“…Mean basal follicle-stimulating hormone (FSH) levels are significantly higher in young smokers than in nonsmokers. 9 Urinary estrogen excretion during the luteal phase in smokers is only about one-third that observed in non-smokers, possibly because constituents of tobacco smoke inhibit granulosa cell aromatase. 10 Current smoking is also associated with lower anti-mullerian hormone (AMH) levels; mean gonadotropin dose requirements for smokers receiving stimulation for in vitro fertilization (IVF) are higher when compared with those of nonsmoking women.…”

Benzo[a]pyrene and Human Embryo

“…The mechanism of B[a]P-mediated ovotoxicity may be indirect (Fig 2), since oocytes at all stages of development are surrounded by follicular cells (Hombach-Klonisch et al, 2005). A loss in integrity of this follicular wall by B[a]P may compromise its ability to maintain oocyte viability (El Nemr et al, 1998). Extensive damages of ovarian follicles would also impair steroid hormone production which, in turn, affects the endocrine balance and results in ovarian failure (Shiverick and Salafa, 1999).…”