Smoking and female infertility: a systematic review and meta-analysis
Abstract
The high prevalence of smoking among women in their reproductive years continues to be a matter of concern. The negative effects of smoking on general health are well known, but smoking may also affect fertility. The objective of the present study was to perform a systematic review of the literature to determine whether there is an association between smoking and risk of infertility in women of reproductive age, and to assess the size of this effect. In the 12 studies used for this meta-analysis, the overall value of the odds ratio (OR) for risk of infertility in women smokers versus non-smokers was 1.60 [95% confidence interval (CI) 1.34-1.91]. Studies of subfertile women undergoing in-vitro fertilization (IVF) treatment also show a reduction in fecundity among women smokers. A meta-analysis of nine studies found an OR of 0.66 (95% CI 0.49-0.88) for pregnancies per number of IVF-treated cycles in smokers versus non-smokers. Despite the potential limitations of meta-analyses of observational studies, the evidence presented in this review is compelling because of the consistency of effect across different study designs, sample size and types of outcome. However, continued reassurance is needed that the calculated overall effect is not in fact due to confounding variables.
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Active and passive tobacco smoking is associated with lower fertility and reduced chance of a healthy live birth in the general population and in couples with infertility.
“Analysis of the literature indicates that active and passive (second-hand) smoking of tobacco is associated with decreased fertility and reduced chance of a healthy, live birth both in the general population and among couples with infertility (Augood 1998, Hyland 2016, Practice Committee 2018, Radin 2014, Sharma 2016, Waylen 2008).”
From Preconception lifestyle advice for people with infertility (2021) · cites this paper as Augood 1998
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- Authors
- Augood, C., Duckitt, K., & Templeton, A. A.
- Affiliations
- Royal College of Obstetricians and Gynaecologists (GB)
- Aberdeen Maternity Hospital (GB)
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-06-01
- Volume
- 13
- Issue
- 6
- Pages
- 1532-1539
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2169182570
- Cited by
- 510
- References
- 56
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 18 · 2023: 18 · 2022: 19 · 2021: 18 · 2020: 67 · 2019: 15 · 2018: 25 · 2017: 24 · 2016: 24 · 2015: 20 · 2014: 21 · 2013: 21 · 2012: 22
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- smoking, female infertility, female fertility, in vitro fertilization, fecundity, subfertility, women of reproductive age, confounding
- MeSH terms
- Adult, Female, Humans, Infertility, Female, Risk Factors, Smoking
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