Smoking and Infertility: How Quitting Smoking Can Boost Your Fertility

In short: Smoking of every kind, from cigarettes to e-cigarettes and water pipes, harms the fertility of both partners. In women it lowers the number and quality of eggs, doubles the time needed to conceive and reduces IVF success. In men it lowers the sperm count by 13–17% and weakens movement. The good news: fertility improves within 3–12 months of stopping.

Smoking has been increasing worldwide across all age groups, and research consistently shows that smoking can have a significant impact on fertility for both men and women. The good news is that quitting smoking may help improve your chances of conceiving naturally or through fertility treatment.

When we talk about the effects of smoking on fertility, this also includes vaping, shisha, and marijuana.

First, let’s look at how smoking affects female fertility:

• Smoking significantly affects the number and quality of eggs
• Smoking increases DNA fragmentation and decreases fertilization rates
• Smoking decreases the quality of embryos and may lead to recurrent miscarriages
• Smoking can harm the endometrium and impair embryo implantation
• Smoking may lead to early menopause; women who start smoking at an early age (before 18 years old) appear to be three times more prone to menopause before they reach 40 years old
• Nicotine and other chemicals interfere with the production of estrogen, which can lead to irregular menstrual cycles; multiple studies suggest that toxic substances in cigarettes such as nicotine or anabasine affect estrogen synthesis, production, or efficacy
• Smoking is linked to pregnancy complications such as preterm birth and placental disease
• Smoking affects fallopian tube function by impairing the cilial motility of its lining, reducing the ability to transfer the egg and increasing the risk of ectopic pregnancy
• It should also be mentioned that there appears to be a strong relationship between smoking and the risk of pelvic inflammatory disease — at least 70% higher than in non-smokers
• Toxic substances in cigarettes may affect sperm through changes in vaginal and cervical secretions

Studies have shown that smokers may take twice as long to get pregnant compared to non-smokers.

How does female smoking affect fertility treatments and IVF?

• Lowers the number of eggs retrieved and increases chromosomal abnormalities in the eggs
• Leads to poorer embryo quality
• Decreases implantation rates

[Success rate of IVF for smokers tends to be clearly lower compared to non-smokers — on average, women who smoke need nearly twice as many IVF attempts to become pregnant.

Smoking, with all its toxic components, is associated with an increase in FSH levels, which may reduce the chances of IVF success or increase the risk of failure.

• According to a study by Dr. Jonathan Tilly and colleagues on mice, toxic substances in cigarettes, especially polycyclic aromatic hydrocarbons, were found to damage eggs at early stages of development. Since the stages of follicular maturation are similar in humans, this offers useful evidence of how smoking may affect ovarian tissue. Even female fetuses of mothers who smoke may be born with a lower ovarian reserve and appear more prone to early menopause and premature ovarian failure.

In addition, smoking has been associated with the following effects on babies:

• Low birth weight
• Small for gestational age
• Stillbirth
• Sudden neonatal death
• More incidences of respiratory problems

Effects of smoking on male fertility:

• Increased DNA fragmentation, reducing the sperm’s ability to fertilize the egg
• Poorer sperm quality
• Impaired sperm motility and speed
• An increased number of sperm with abnormal shape, particularly affecting the sperm head
• Reduced sperm count (concentration) — smokers tend to have a lower sperm count, by at least 13-17%. Smoking also increases damage to the DNA inside the sperm, which has been linked to a lower chance of pregnancy and a higher risk of miscarriage
• Smokers tend to show an increased number of white and red blood cells, creating a picture similar to infection in the genital area, which can affect sperm motility and transport through the seminiferous tubules
• Smoking can damage blood vessels, affecting blood flow to the penis and potentially leading to erectile dysfunction and impaired sexual performance
• Smoking interferes with testosterone production, generally lowering its levels, which may reduce libido and affect sperm formation
• Some birth defects may occur when fertilization happens with damaged sperm

When the male partner smokes, this can contribute to poorer-quality embryos, less favorable pregnancy outcomes, and recurrent miscarriages.

How does male smoking affect IVF treatment success?

It has been observed that IVF success tends to be lower when the male partner is a smoker.

Does secondhand smoke affect fertility?

Yes, it can affect fertility in both men and women.

How long does it take for female fertility to improve after stopping smoking?

• Ovarian function may take around 3 months to improve
• Hormone balance may take around 3 months to improve
• Better pregnancy outcomes are generally seen after around 12 months

How long does it take for male fertility to improve after stopping smoking?

• Sperm count may take around 3 months to improve (since the sperm production cycle is about 72 days)
• Sperm motility may take around 2-3 months to improve
• Hormonal effects may take around 2-3 months to improve
• DNA damage may need around 3-6 months to improve

Some studies suggest that certain vitamins may help support fertility recovery after quitting smoking:

• Vitamin C
• Vitamin E
• Omega 3
• Folic acid (recommended for every woman trying to conceive); vitamin A supplements should be avoided by women who may become pregnant, as high doses can harm the baby

Are there any natural ways to help support your body’s recovery from smoking?

Yes:

• Stay well hydrated
• Engage in regular aerobic exercise
• Follow a diet rich in antioxidants, such as fruits, vegetables, nuts, and leafy greens

If you are a smoker, please consider quitting. If not for yourself, consider doing it for your future family and the generations to come. It’s also important for medical institutions, especially fertility centers, to run serious awareness campaigns to help people quit smoking. If you have concerns about how smoking may be affecting your fertility, the team at Dr. Layyous’s clinic is here to help guide you through your options.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist