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Smoking and fertility are closely connected. Smoking is a significant lifestyle factor that can impact fertility and reproductive health in both women and men and can create serious risks for both the mother and the baby. Even secondhand smoke can affect fertility, sometimes almost as much as active smoking.
Research suggests that up to 13% of female infertility cases may be linked to smoking, and smokers may be up to 60% more likely to experience infertility compared to non-smokers.
Yet, despite these risks, smoking is common — about 175 million women worldwide aged 15 and older still smoke, either daily or occasionally.
So how exactly does smoking affect fertility and reproductive health? Let’s take a closer look.
Key Takeaways
- Smoking and fertility are closely linked in both men and women.
- Smoking can lower the chances of getting pregnant or may delay conception.
- People who smoke have a higher risk of fertility issues than nonsmokers.
- Smoking during pregnancy is linked to higher risks of preterm delivery, underweight babies, and birth defects.
- Cigarette smoke contains harmful chemicals that can affect reproductive health.
- Smoking can damage eggs, sperm DNA, and hormone balance.
- In men, smoking is linked to reduced sperm quality and erectile dysfunction.
- Secondhand smoke exposure can impact fertility almost as much as smoking.
What’s Actually in Cigarette Smoke?
Cigarette smoke contains about 4,000 chemicals. Some of the worst include:
- Nicotine
- Carbon monoxide
- Radioactive polonium
- Aromatic hydrocarbons
- Cadmium
- Tar
Nicotine is the key addictive ingredient in tobacco. Once in your body, it doesn’t stay the same for long. Your body breaks it down into cotinine and another compound called 3HC.
These substances travel through your bloodstream and reach organs throughout the body, including the reproductive system. Over time, they can mess with hormone balance, blood flow, and even cellular health — which may cause infertility and other reproductive health issues.
How Does Smoking Affect Female Fertility?
Many people don’t realize how much smoking can affect fertility. The chemicals in cigarette smoke travel through your bloodstream and can interfere with many parts of the reproductive system that are important for ovulation, fertilization, and a healthy pregnancy.
Here’s a simple breakdown:
Parts of the Female reproductive system | What can happen to the women’s reproductive system from smoking |
Ovary | Lower egg count, early menopause |
Hormones | Hormone imbalance |
Fallopian tubes | Slower egg/embryo movement, higher risk of ectopic pregnancy |
Menstrual cycle | Irregular or more painful periods |
Impact on egg supply
Smoking can lower ovarian reserve — the number of eggs a woman has — by around 20%.
Women who smoke also tend to have lower AMH levels, a key marker of egg supply. This means that eggs may decline faster than normal.
Studies also show smokers may have higher FSH levels and may respond less well to ovarian stimulation during IVF treatment.
Hormone disruption
Chemicals in cigarette smoke can interfere with hormone production. In women who smoke, estrogen may drop while testosterone may rise, which can affect fertility.
Some chemicals can also act like estrogen or block it, sending mixed signals in the body and disrupting hormone balance over time.
Egg supply, quality, and ovulation
Chemicals in cigarette smoke can lower estrogen and progesterone, hormones needed for eggs to mature.
This means fewer eggs may develop, and the eggs may be of lower quality. In some cases, smoking can also damage the DNA in eggs, which may increase the risk of miscarriage or birth defects.
Menstrual cycle changes
Women who smoke may be more likely to have irregular or less frequent periods, especially in their 40s. Smoking has also been linked to more painful periods.
Fallopian tube function
The fallopian tubes move the fertilized egg from the ovary to the uterus. Smoking can slow this process, which may lead to problems.
Women who smoke also have a higher risk of ectopic pregnancy, where implantation of the embryo occurs outside the uterus.
Reduced uterus readiness
For pregnancy to begin, the uterus must be ready to support the embryo. Smoking can make the uterus less receptive, which can make implantation harder. Studies show heavy smokers may have lower chances of getting pregnant, even when egg quality isn’t the main issue.
Delays in implantation
Smoking can also delay implantation, when the embryo attaches to the uterus. This can negatively affect the chances of a successful pregnancy.
Studies from IVF treatments show smokers often have lower fertilization, implantation, and egg retrieval rates, and a higher risk of miscarriage than non-smokers.
Harder and slower to get pregnant
Women who smoke may be about 54% more likely to take over a year to conceive.
Research also shows smoking can lower fertility overall, making it harder to get pregnant and carry a pregnancy to term.
Does Smoking Affect Fertility Treatments?
Yes. Smoking —and even secondhand smoke— can lower the success of fertility treatments like IVF. It’s linked to lower pregnancy and live birth rates and a higher risk of miscarriage and ectopic pregnancy.
Does Smoking Increase the Risk of Miscarriage?
The short answer: yes.
Smoking causes a higher risk of miscarriage, ectopic pregnancy, preterm labor, and preterm birth. One reason is that smoking can slow the movement of the embryo through the fallopian tubes, which raises the risk of ectopic pregnancy.
Can Smoking Make Menopause Earlier?
Research shows women who smoke have about a 33% higher chance of reaching menopause earlier than nonsmokers.
Smoking cigarettes can lower estrogen levels, increase androgen levels, and create anti-estrogen effects in the body. These changes can speed up the decline of ovarian function. As a result, women who smoke tend to reach menopause about 1–4 years earlier than nonsmokers.
Can Smoking During Pregnancy Harm the Baby?
Absolutely. Smoking during pregnancy can cause serious health issues for babies, including:
- Low birth weight
- Premature birth
- Poor growth in the womb
- Birth defects
- Perinatal mortality
- Sudden infant death syndrome (SIDS)
Over the past 50 years, more than 100,000 infants have died from SIDS or other smoking-related conditions.
One reason is carbon monoxide in tobacco smoke, which reduces the oxygen reaching the baby. Smoking can also damage the baby’s lungs and brain, and some effects may last into childhood.
Does Smoking Cause Birth Defects?
Yes. Smoking while pregnant increases the risk of birth defects. Women who smoke in the early stages of pregnancy are more prone to having babies with cleft lip or cleft palate, where the lip or roof of the mouth doesn’t fully form.
Smoking has also been linked to a higher chance of chromosomal problems, like Down syndrome, compared with pregnancies in non-smokers.
How Does Smoking Affect Male Fertility?
Smoking can also harm male reproductive health. Studies link smoking to several problems, including:
- Lower sperm count
- Poor sperm movement
- Sperm DNA damage
- Erectile dysfunction
Interferes with sperm production and function
Sperm need time to mature in the epididymis, where they gain the ability to become motile and fertilize an egg. Smoking can disrupt this process, affecting sperm quality and movement.
Smoking may also affect glands like the prostate and seminal vesicles, which produce the fluid that helps protect and carry sperm.
Testicular and hormonal damage
Smoking can harm the testes, which need good oxygen levels to make healthy sperm. Tobacco smoke may reduce oxygen and damage sperm-producing cells, leading to poorer sperm quality.
Smoking may also interfere with reproductive hormones, though some studies suggest the biggest damage may happen directly in the reproductive tissues.
Can cause erectile dysfunction
About 18 million men over age 20 experience erectile dysfunction (ED) and research shows smoking as a contributing cause. Cigarette smoke damages blood vessels and reduces the blood flow needed for an erection. Both active and secondhand smoke increase this risk, but quitting can help improve ED over time.
Damage to sperm DNA and genetics
Chemicals in tobacco smoke can damage sperm DNA and chromosomes. This can lead to genetic changes that may affect fertility, and in some cases, the damage may be passed on to the embryo.
Swollen testicular veins
Varicoceles (swollen veins in the scrotum) can already affect sperm health. But when smoking is added, fertility problems can get worse.
Men who smoke with varicoceles may have up to 10 times higher risk of low sperm count compared to nonsmokers with the condition.
Is Secondhand Smoke Bad for Fertility?
Yes. Secondhand smoke during pregnancy has also been associated with infertility and earlier menopause later in life. It can also cause changes in the genes of eggs and sperm.
Kids exposed to secondhand smoke may have problems with normal reproductive development. Some studies also suggest that a father’s smoking may lower egg supply in daughters, affecting their future fertility.
How Can You Quit Smoking for Good?
Quitting smoking isn’t easy — but it’s possible. And even quitting early in pregnancy can greatly improve a baby’s health.
Here are a few simple steps that can help:
- Set a quit date. Pick a day and commit to it.
- Know your triggers. Stress, coffee, or social situations can cause cravings. Replace smoking with a walk, gum, or deep breathing.
- Manage stress. Exercise, good sleep, and relaxation can help reduce cravings.
- Get support. Tell friends or family, or join a support group.
- Celebrate progress. Every smoke-free day counts. If you slip, don’t give up. Many people try a few times before quitting for good.
Conclusion
Smoking and fertility are closely linked for both men and women. It can damage eggs and sperm, disrupt hormones, delay conception, and raise the risk of miscarriage and pregnancy problems. Even secondhand smoke can affect future reproductive health.
The good news? Quitting smoking can improve fertility and support healthier pregnancies. Avoiding tobacco is one of the best ways to preserve your fertility and future family.
FAQs
It can. Smoking is known to increase the risk of infertility in both women and men.
Cigarette smoke can damage egg DNA, reduce ovarian reserve, and disrupt hormones.
Some doctors recommend quitting at least three months before trying to conceive.
It can be. Smokers have a higher risk of delayed conception compared to non smokers.
The most important step is to quit immediately to protect your unborn baby.
It’s strongly discouraged. Smoking can affect early embryo development.
Smoking in the early stages of pregnancy increases the risk of miscarriage and birth defects.
Nicotine replacement therapy under medical guidance is safer than continued smoking.
Some providers may test levels in certain situations.
Smoking before knowing you’re pregnant still exposes the embryo to tobacco smoke. Quitting reduces further risks.
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