Ovarian function and cigarette smoking

Abstract

Summary 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, follicle-stimulating 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.

Cigarette smoke condensate exposure delays follicular development and function in a stage-dependent manner

“…Briefly, follicle attachment was characterized by the formation of the theca cell monolayer. Follicles were recorded as [1] ''follicular,'' when the oocyte remained closely connected to its granulosa cells, which were then surrounded by a basal membrane and adjacent thecal cells (Fig. 1A); [2] ''diffused,'' when granulosa cells increased in number and outgrew the surrounding basal membrane (Fig.…”

“…Cigarette smoking is a well-recognized health hazard that also affects reproductive health and fertility (1)(2)(3)(4)(5)(6)(7)(8). In women attempting spontaneous conception, cigarette smoking increased time to pregnancy (9) and accelerated depletion of ovarian follicles, causing early menopause (10)(11)(12).…”

Systematic and Meta-Analytic Review of Research Examining the Impact of Menstrual Cycle Phase and Ovarian Hormones on Smoking and Cessation

“…Smoking in women is associated with dysmenorrhea and menstrual irregularity 9,82 and altered ovarian cycle and hormone levels. 83,84 Compared to female nonsmokers, female smokers demonstrate changes in estrogen metabolism and lower circulating estrogen, 85,86 a shorter reproductive lifespan, 9,87,88 lower ovarian reserve, 89,90 and quicker entry into all stages of the menopausal transition. 91,92 Pregnancy-related smoking consequences include infertility, spontaneous abortion, preterm delivery, and perinatal mortality.…”

The association between cadmium, lead and mercury blood levels and reproductive hormones among healthy, premenopausal women

“…This was based upon the hypothesized acute effect of metals as described above, and the potential fluctuation of cadmium and mercury levels over time caused by sporadic exposures to cigarette smoke and fish consumption. All cycles were standardized to a 28-day cycle as described by Whitcomb et al (2010). FSH and E 2 levels quantified during the early follicular phase (standardized Day 2) were used as measures of ovarian reserve, and follicular growth and maturation.…”