Lifestyle Management

Smoking and Fertility

Effect on Male Fertility

• Smoking reduces the male hormones
• More importantly….There is a higher rate of impotence in men who smoke
• Male smokers have decreased sperm quality and increased presence of fragmented DNA

Effect on Female Fertility

• May affect follicular microenvironment (egg growth and rupture).
• Alter hormone levels and thereby increase chance of no ovulation and miscarriage.
• Increased thickness of zona pellucida(membrane covering the egg) leading to difficulty in sperm penetration.
• Increased thickness of zona pellucida(membrane covering the egg) leading to difficulty in sperm penetration.
• Smoking women need more time to become pregnant, are less likely to do so spontaneously and have a higher risk of miscarriage in the first trimester
• Smoking women are also found to reach menopause a few years earlier.
• The risk of infertility may be twice as high for smokers when compared with non-smokers.
• Importantly, the impact of passive smoking on women’s natural fertility is only slightly less than that of active smoking.
• Studies show that following IVF clinical pregnancy rates are around 20% in smokers as compared to around 40% in non smokers.

Results after Stopping smoking

• Sperm analysis after smoking cessation revealed a distinctive improvement in sperm concentration, fast spermatozoa (≥35 μm/s) & sperm vitality.
• Cessation of smoking for at least two months before attempting IVF significantly improved chances for conception.
• Although long-term cigarette smoking can have an irreversible effect on ovarian function, the harmful effect on treatment outcome may, in part, be reversed if smoking is discontinued.

Alcohol and Fertility

• Alcohol is known to be teratogenic and its consumption has been reported to reduce fertility. Induces rise in E2
• Reduces FSH
• Impairs folliculogenesis
• May directly affect ovulation, blastocyst development and implantation
• Reduced conception has been reported already at doses as low as one drink per week.
• The scarce data suggest that female alcohol consumption prior to the IVF attempt adversely affects oocyte retrieval and leads to lower pregnancy and higher miscarriage rates
• Male drinking leads to more miscarriages and lower live birth rates.
• Reportedly prolongs time to pregnancy

Caffeine and fertility

• May target ovulation and corpus luteal function
• Higher early follicular E2
• A diet abundant in caffeine may result in delayed conception, infertility and increased risk of osteoporosis, cardiovascular disease and cancer later in life.
• For the female partner, common exposures associated with a decrease in fertility are cigarette smoking, alcohol consumption of 4 drinks per week, and caffeine intake of >250 mg daily.