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The Effect of Smoking on Oocyte Quality and Hormonal Parameters of Patients Undergoing In Vitro Fertilization–Embryo Transfer

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Abstract

Purpose: The aim of the present study was to investigate the influence of smoking on different parameters such as oocyte count, embryo score, and basal hormone values within the scope of in vitro fertilization–embryo transfer (IVF-ET).

Methods: Eight hundred thirty-four women undergoing IVF-ET treatment were classified as smokers or nonsmokers on the basis of questionnaires. Additionally, we divided them into three groups according to their stimulation protocol—“combined stimulation” [I; clomiphene citrate plus human menopausal gonadotropin (hMG)], “ultrashort” [II; gonadotropin releasing hormone agonist (GnRHa) plus hMG or follicle-stimulating hormone (FSH)], and “long downregulation protocol” (III)—and further classified again as smokers or nonsmokers within the groups.

Results: In general, smoking patients were significantly (P = 0.0195) younger than nonsmokers and showed a significantly (P = 0.0379) lower embryo score and a tendency (P = 0.0931) to produce fewer oocytes. There was no significant difference concerning the number of normally or pathologically fertilized and transfered oocytes and embryos suitable for cryopreservation. Women who smoked had significantly (P = 0.0112) higher basal 17-β-estradiol (E 2 ), luteinizing hormone (LH) (P = 0.0001), and dehydroepiandrosteronesulfate (DHEAS) (P = 0.0039) levels, but their basal human prolactin (HPRL) levels were significantly (P = 0.0033) lower than those of nonsmokers. According to the stimulation protocol used, we found the following results. Smoking patients in group I showed a significantly (P = 0.023) lower embryo score and produced fewer oocytes (P = 0.0113), with fewer of them being fertilized (P = 0.0072) and transferred (P = 0.0067). Women who smoked had significantly (P = 0.0002) higher basal LH levels, but their HPRL levels were significantly (P = 0.031) lower than those of nonsmokers. Furthermore, they had a thinner endometrium on the day of embryo transfer (P = 0.0366). In group II we measured significantly elevated basal E 2 levels (P = 0.0089) and higher LH values (P = 0.0092) in smokers. Group III showed a trend (P = 0.0565) toward lower HPRL values in smokers.

Conclusions: Although the fertilization rate of oocytes and the pregnancy rate were not significantly different between smokers and nonsmokers, we found significantly alterated hormonal parameters and negatively influenced oocyte parameters, particularly after clomiphene stimulation. So we might consider using only GnRHa protocols for smoking patients. Additionally, we advise our patients to stop smoking before an IVF-ET treatment because of the complex effects of smoking on the reproductive and hormonal system.

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REFERENCES

  1. Jick H, Porter J, Morrison AS: Relation between smoking and age of natural menopause. Lancet 1977;1:1354-1355

    Google Scholar 

  2. Baird DD, Wilcox AJ: Cigarette smoking associated with delayed conception. JAMA 1985;253:2979-2983

    Google Scholar 

  3. Howe G, Westhoff C, Vessey M, Yeates D: Effects of age, cigarette smoking, and other factors on fertility: Findings in a large prospective study. Br Med J 1985;290:1697-1700

    Google Scholar 

  4. Feichtinger W, Papalambrou K, Poehl M, Krischker U, Neumann K: Smoking and in vitro fertilization: A meta-analysis. J Assist Reprod Genet 1997;14:596-599

    Google Scholar 

  5. Remmer H, Schindler AE: Prävention in Gynäkologie und Geburtshilfe. Terramed Überlingen 1986;XX:243-265

    Google Scholar 

  6. Macnamee CM, Howles CM, Edwards RG, Taylor PJ, Elder KT: Short luteinizing hormone-releasing agonist treatment: Prospective trial of a novel ovarian stimulation regimen for in-vitro fertilization. Fertil Steril 1989;19:89-92

    Google Scholar 

  7. Tan SL, Kingsland C, Campell S, Mills C, Bradfield J, Alexander N, Yovich J, Jacob HS: The long protocol of administration of gonadotropin-releasing hormone agonist is superior to the short protocol for ovarian stimulation for in-vitro fertilization. Fertil Steril 1992;57:810-814

    Google Scholar 

  8. Kemeter P, Feichtinger W: Experience with a new fixed-stimulation protocol without hormone derterminations for programmed oozyte retrieval for in-vitro fertilization. Hum Reprod 1989;4:53-58

    Google Scholar 

  9. Steer CV, Mills CL, Tan SL: The cumulative embryo score: A predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme. Hum Reprod 1992;117-119

  10. Bodis J, Hanf V, Torok A, Tinneberg H-R: Smoking and corpus luteum function. Fertil Steril 1996;4:810-814

    Google Scholar 

  11. Evers J, Slaats P, Land J, Dumoulin J, Dunselman G: Elevated levels of basal estradiol-17β predict poor response in patients with normal basal levels of follicle stimulating hormone undergoing in vitro fertilization. Fertil Steril 1998;69:1010-1014

    Google Scholar 

  12. Berta L, Fortunati N, Gennari P, Appendino M, Casella A, Frairia R: Influence of cigarette smoking on pituitary and sex hormone balance in healthy premenopausal women. Fertil Steril 1991;56:788-789

    Google Scholar 

  13. Leidenberg FA: Klinische Endokrinologie für Frauenärzte. Berlin, Heidelberg, Springer Verlag, 1992, pp 57-58

    Google Scholar 

  14. Huber J: Endokrine Gynäkologie. Zürich, Wien, Verlag Maudrich, 1998, p 23

    Google Scholar 

  15. Trapp M, Kemeter P, Feichtinger W: Smoking and in-vitro fertilization. Hum Reprod 1986;6:357-358

    Google Scholar 

  16. Zenzes MT, Krishnan S, Krishnan B, Zhang H, Casper RF: Cadmium accumulation in follicular fluid of women in in-vitro fertilization-embryo transfer is higher in smokers. Fertil Steril 1995;64:599-603

    Google Scholar 

  17. Zenzes MT, Reed TE, Wang P, Klein J: Cotinine, a major metabolite of nicotine, is detectable in follicular fluid of women in in-vitro fertilization therapy. Fertil Steril 1996;66:614-619

    Google Scholar 

  18. Elenbogen A, Lipitz S, Mashiach S, Dor J, Levran D, Ben-Rafael Z: The effect of smoking on the outcome of in-vitro fertilization-embryo transfer. Hum Reprod 1991;6:242-244

    Google Scholar 

  19. Rosevar SK, Holt PW, Lee TD, Ford WC, Wardle PG, Hull MG: Smoking and decreased fertilization rates in-vitro. Lancet 1992;340:1195-1196

    Google Scholar 

  20. Harrison K, Breen T, Henessey J: The effect of patient smoking on the outcome of IVF and GIFT treatment. Aust NZ J Obstet Gynaecol 1990;30:340-343

    Google Scholar 

  21. Hughes E, Yeo J, Claman P, YoungLai E, Sagle M, Daya S, Collins J: Cigarette smoking and the outcome of in vitro fertilization: measurement of effect size and levels of action. Fertil Steril 1994;62:807-814

    Google Scholar 

  22. Sterzik K, Strehler E, De Santo M, Trumpp N, Abt M, Rosenbusch B: Influence of smoking on fertility in women attending an in-vitro fertilization program. Fertil Steril 1996;4:810-814

    Google Scholar 

  23. Pattinson HA, Taylor PJ, Pattinson MH: The effect of cigarette smoking on ovarian function and early pregnancy outcome of in-vitro fertilization treatment. Fertil Steril 1991;55:780-783

    Google Scholar 

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University of Vienna, Vienna, Austria

    Monika Weigert, Gerda Hofstetter, Daniela Kaipl, Heimo Gottlich, Ursula Krischker, Katharina Bichler, Michaela Poehl & Wilfried Feichtinger

  2. Institut für Sterilitätsbetreuung, Trauttmansdorffgasse 3A, A-1130, Wien, Austria

    Wilfried Feichtinger

Authors
  1. Monika Weigert
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  2. Gerda Hofstetter
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  3. Daniela Kaipl
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  4. Heimo Gottlich
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  5. Ursula Krischker
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  6. Katharina Bichler
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  7. Michaela Poehl
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  8. Wilfried Feichtinger
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Weigert, M., Hofstetter, G., Kaipl, D. et al. The Effect of Smoking on Oocyte Quality and Hormonal Parameters of Patients Undergoing In Vitro Fertilization–Embryo Transfer. J Assist Reprod Genet 16, 287–293 (1999). https://doi.org/10.1023/A:1020496330424

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  • DOI: https://doi.org/10.1023/A:1020496330424

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