Although smoking has been around for a long time, its negative effect on health is well-known. Both the male and female sexes are susceptible to decreased fertility if they smoke (not just tobacco, but that will be the focus of our article since it is the most common, accepted, and widespread substance). Concerningly, a significant proportion of women and men of reproductive age smoke.

The frequency of daily smoking, the duration of the habit over the years, and the consumption method impact how tobacco affects a person’s fertility. The more frequent and lasting the smoking, the worse the adverse impact. For example, even one-half pack per day decreases female fecundity.

Regarding consumption, tobacco can be burned or chewed. Regarding burned tobacco, it can be consumed by firsthand or secondhand smoking. Another way of smoking is using electronic cigarettes, which contain nicotine, concentrated flavors, humectant, and variable concentrations of nicotine. Regular cigarettes and electronic cigarettes have in them toxicants and carcinogens. Both are risk factors for impaired assisted reproduction outcomes, diminished ability to conceive naturally, adverse pregnancy developments and neonatal outcomes.

Exposure to tobacco in utero, during pregnancy, or throughout the reproductive years affects fertility. And other factors like age, ethnicity, education, employment, pre-pregnancy body mass index, and alcohol consumption are confounding influences.

1) Let’s start with the female-related smoking dangers to reproductive health. Evidence shows smoking is associated with:


  • Follicle-stimulating Hormone levels,
  • Testosterone levels,
  • accelerated follicular depletion,
  • prevalence of abnormal clomiphene citrate challenge test,
  • toxins found in the ovaries and follicular fluid,
  • alterations in uterine receptivity,
  • thickness of the zona pellucida,
  • speed of Anti-Mullerian Hormone levels drop,
  • adverse effects on ovarian reserve,
  • chances of getting bacterial vaginosis,
  • time to conception,
  • numbers of failed cycles,
  • pregnancy complications (e.g., fetal development),
  • preterm labor,
  • and spontaneous miscarriage in both natural and assisted-conception cycles.


  • menstrual cycle length,
  • peak estradiol levels,
  • gonadotropin-stimulated ovarian function,
  • serum estradiol concentrations,
  • numbers of retrieved oocytes,
  • implantation rate, and age to reach menopause.

2) Regarding the male side of reproductive health, smoking is associated with:


  • seminal oxidative stress,
  • serum estradiol concentrations,
  • Total and Free Serum T,
  • DNA damage,
  • risk of aneuploidy,
  • seminal leukocytes,
  • toxic materials in semen,
  • and alterations in seminal antioxidants.


  • Luteinizing Hormone levels,
  • Follicle-stimulating Hormone levels,
  • Prolactin levels,
  • sperm production,
  • sperm volume,
  • sperm count,
  • sperm motility,
  • sperm progressive motility,
  • sperm viability,
  • sperm normal morphology,
  • sperm density,
  • and overall fertilizing capacity.

How To Quit

Hearing professional advise

The good news is that the negative effect of smoking has a reversible nature, so quitting is the best choice. Research shows that any personalized advice, even a brief remark, from a healthcare professional you know and trust, like your GP, to quit results in higher abstinence rates. But this isn’t enough; each patient trying to quit should develop a quit plan with a healthcare professional.

Nicotine replacement therapy 

This therapy aims to reduce the drive to consume tobacco and decrease the withdrawal symptoms by giving less and less nicotine-concentrated products that don’t contain the other toxic component of cigarettes. These products can be gum, transdermal patch, nasal spray, oral inhaler, and tablets. This should be done after a consultation with an appropriate physician and should be regularly adjusted until you don’t need it.


Designing a quit plan

Part of this plan is setting a quit date within two weeks. Telling others about the plan creates accountability and a sense of obligation to stick to the plan. Another important part of this plan is to account for setbacks and challenges like negative moods, urges to smoke, and difficulty concentrating. The third major part of the plan includes removing tobacco products from their surroundings and avoiding places or situations where people smoke. Also, be aware of compensatory behaviors, which commonly include eating more. A problem can be turned into another problem – self-monitoring and remembering the purpose of your quest is key. In case of relapse, it shouldn’t be kept a secret, it should be discussed to assess what happened and elicit a re-commitment.

Psychological support 

Making the decision, taking the initiative to start, and enduring the long-term lifestyle changes, without feeling any withdrawal physical symptoms, social and psychological pressure, or emotional distress is almost impossible. Quitting also means a lot of changes that seem small but change day-to-day basic things, like break times and friend group activities. Therefore, some form of psychological support is recommended. Behavioral smoking counseling and positive psychotherapy are great sustainable tools to help you go through quitting smoking. A few examples of exercises that patients may be asked to try to include the Signature Strengths, Positive Service, Savoring Kindness, Three Good Things, Gratitude Visit, and Active/Constructive Responding.


  1. Smoking impairs your health and your fertility no matter your sex;
  2. Consuming tobacco can happen in various forms, not just smoking, and the frequency and amount you smoke has a direct influence on how your health is affected – the more the worse;
  3. Smoking alters your hormonal levels and sperm parameters, increases toxins in your body, and increases the time to conception;
  4. If you are interested in conceiving, quitting is the best way to go:

a. Contact a trustworthy healthcare professional to know their opinion on your smoking habits;a. Ask said professional about options to quit and whether nicotine replacement therapy would be a good thing for you;

b. Try writing your quit plan and share it with close people in your life;

c. Psychological support can help you, in the long run, to be relapse-free and desire-to-smoke-free.

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