SMOKING AND FERTILITY by Dr. Obieze Nwanna - Nzewunwa

Smoking has earned an infamous reputation which, ipso facto, is merited. There almost isn't any body part you can think of that smoking cannot damage. Today, we'll take a look at the effect(s) of smoking on pregnancy and fertility. It is important at this point to note that these effects apply to anyone who either smokes the cigarette or inhales the smoke from a cigarette/ cigar which someone else is smoking. Thus if you live with or work with people who smoke/ in a place (e.g. club/bar ) where people smoke, you may be at risk. You don't have be the one smoking to be a smoker or to suffer the adverse effects of smoking. The  effects of smoking on fertility applies to both sexes and is negative in both. 

SMOKING AND MALE FERTILITY

Smoking affects male fertility in a number of ways which includes:

1. Smoking DAMAGES THE SPERM CELLS

Smoking damages the quality and quantity of sperm.  I'm not sure any man would be glad to hear that. Considering the male preponderance on smokers. But don't be in a hurry to feel exempted just yet if you're not the one smoking the cigarettes yourself. If you're a second hand smoker you're also at risk. Especially if you love hanging out very often at spots/ clubs where people smoke. The harmful chemicals contained in cigarettes damages the sperm cells, which then leads to:

•  Low Sperm Count: The parts of the testis which is responsible for producing spermatozoa (sperm cells) is damaged by the cigarette toxins. Also the spermatozoa themselves are damaged. thus giving rise to a reduction in the amount of spermatozoa produced and the even the few produced are further reduced due to the same effect. There is an average 22% reduction in sperm count of males who smoke regularly.

• Reduced Sperm Motility: Normal spermatozoa swims at about 200 meters per hr. At this rate, it's obvious these guys wouldn't stand a chance against Michael Phelps at the next swimming Olympics but it's enough to get them to "the promise land".  Unfortunately, smoking reduces their motility and causes the sperm cells to be sluggish. 

In summary, smoking causes the sperm to be slow and scanty, definitely not slow and steady. Thereby reducing the likelihood of the sperm meeting and fertilizing a female's egg. This may be a cause of infertility.

2. Impotence/ Erectile Dysfunction

Some people believe that smoking makes them more manly or that it gives them that macho/ manly feeling. Well, it turns out that it does the exact opposite. It causes erectile dysfunction. Erectile dysfunction or impotence is the inability of a male to achieve and/ or maintain an erection that is sufficient for sexual intercourse. It does so by causing hardening of the blood vessels in the male penis, thereby restricting their ability to dilate (wide) which is what occurs during an erection. Now this is one adverse effect of smoking that is surely emasculating and I don't think most men know about this possible side effect before becoming smokers. This unadvertised side effect is surely not something most men would want to risk having. So if you're a smoker and you notice difficulty getting or maintaining an erection, you may want to consider quitting while you plan your trip to the clinic. 

3. Hormonal issues

Smoking has the tendency to harm the testis. If this occurs, some of the hormones which are normally produced by the testis are no more produce. This gives rise to hormonal imbalance and as such most of the hormone in the person’s body begins to tend towards an excess of feminine hormones. This, in extreme cases, may lead to the male having a feminine appearance, acting and sounding like a female. This happens when there is severe testicular damage. 

GOOD NEWS!!! Most of these damages are reversible if you quit smoking for 2-3 months. Much of these changes are reversed within 1 year of quitting. 

SMOKING AND FEMALE FERTILITY

With approximately 30% of women of reproductive age being smokers, smoking poses a significant threat to female fertility in various ways which may include:

1. Smoking damages the female eggs (ovum)

The toxic chemicals produced by cigarettes enter the body and damage the ovum and ovarian follicles especially before the reach maturity. The ovarian follicles consist of a group of cells which surround the ovum (egg) and are responsible for nourishing it as well as producing important female hormones like estrogen. The toxin cause depletion of the ovarian follicles and thus depletion in estrogen production. Giving rise to hormonal imbalance and a low egg count. Bear in mind that naturally a normal woman doesn't even have enough eggs to  spare. 

2. Smoking can delay conception

Research evidence shows that there is a 54% higher chance that female smokers of reproductive age will take a year (or more) longer before conceiving compared to nonsmokers. The delay in conception corresponds to the quantity of cigarettes smoked daily. So the more cigarettes smoked, the longer it takes to conceive.

3. Premature Menopause:

Due to the depletion of eggs, which may result in a low egg count, female smokers are more likely to run our of eggs at an earlier/ younger age. It is important to note that the availability of eggs is necessary for monthly/cyclical changes which occur in the menstrual cycle of a woman. In the absence of the eggs, menstruation ceases (menopause). Thus ovum depletion induced by smoking causes the woman to attain menopause at a much younger age than her nonsmoking contemporaries.

4. Damage to the Reproductive organs

Like every other part of the body, the reproductive system is not exempt from the harmful effects of smoking. This harm may range from mild/subtle undetected changes to obvious diseases like cancer. These diseases indirectly affect fertility and are well worth considering as causes of infertility.

Genetic Issues:

Smoking has been demonstrated to be a cause genetic damage. This is because the toxins contained in cigarettes have the ability to damage and alter the DNA and chromosomes.  When this happens to the ovum it may lead to abnormalities in the genetic information carried by these eggs and this when these bad eggs are fertilized it may lead to birth defects and chromosomal abnormalities. This can also occur in the male testis.

CONCLUSION

The facts are overwhelmingly discouraging for those who intend to smoke or are currently smokers. It is my  opinion, and that of a large number of medical experts, that smokers who wish to conceive, should quit smoking abut 2 months before they take in. This would improve their chances of getting pregnant or getting their spouse pregnant as well as reduce the chances of heir having a child with genetic abnormalities.
Remember also that smoking lowers the success rate of IVF.