Upload
angelica-tyler
View
220
Download
1
Embed Size (px)
Citation preview
More Than 60 Published
Studies InMedical Literature
SMOKING & REPRODUCTION
SMOKING & FEMALE INFERTILITY
Meta analysis (25 studies)- Smoking reduce the natural fertility- Earlier menopause(average 2 years) Damage of ovarian reserve increase with smoking- Increase in risks for ectopic
pregnancy and spontaneous abortion
SMOKING & FEMALE INFERTILITY
Women who quit smoking before or duringpregnancy reduce the risk for adversereproductive outcomes,including
Difficulties in becoming pregnant.- Infertility- PROM- Preterm delivery- Low birth weight
SMOKING & MALE INFERTILITY(ASRM=AFS 2001)
Heavy smoking countributes to- Development of impotence
Abnormal semenogram- Decreased spermy count
alteration in motility and increase in the abnormal forms
SMOKERS & ART A prospective cohort study (Zitzman et al 2001)
High basal and post cc serum FSHWeak ovarian response to stimNeed higher doses of GNImpaired fertilization and delayed conception
resulted from- Interference with gametogenesis- Failure of implantation- Early miscarriage
HOW SMOKING AFFECT FERTILITY
Maternal smoking affects- In utro ovary female fetuses- Reduced Semen Quality and Testis Size in
Adulthood (Jensen 2004)
Increase ROS inside Graafian follicle
Affect meiotic maturation of human oocytes
HOW SMOKING AFFECTFETILITY
Interfere with estrogen synthesis
Endothelial abnormalities (atherogenic and thrombotic problems)
Oocytes (pre-zygotic genetic damage)
Sperm DNA damage (substances in smoke)
UPDATE METERNAL SMOKING
Increases the risk of asthma during the first 7 years of life(Laurberg P.2004)
Impairment of iodine Nutrition in Breast-Fed Infants (Nohr ,2004)
Increased risk for sudden infant death syndrome (SIDS)
In their meta-analysis, Waylen et. al. evaluadet 17 studies end showed in aggregate significantly lower odds of live birth per cycle (OR 0.54,95% CI 0.30-0.99), and significantly higher odds of spontaneous miscarriage (OR 2.65, 95% CI 1.53-5.30 ) in women who smoked.
Human Reprod update 2009;15
Benedict et al measured cotinine, a nicotine metabolite, in follicular fluid collected during 3270 IVF treatment cycles from 1909 non-smoking women between 1994 and 2003 to examine the relationship between secondhand tobacco smoke exposure and implantation failure. They reported a 52% in- crease in the risk of implantation failure among women exposed to STS compared with those unexposed. They also found a 25% decrease in the odds for a live birth among STS-exposed women
Hum Reprod 2011;26
The summary point is that women trying to get pregnant should stop smoking, but non-smoking women, too, should remove themselves from chronic exposure to secondhand smoke.
Fertil Steril 2012;97