A reduced pregnancy rate was associated with male smoking possibly through pre-zygotic genetic damage.

Posted December 22nd, 2008 by rayrubio
research: Cigarette Smoking, Clinical Outcomes of ART
Effects of cigarette smoking upon clinical outcomes of assisted reproduction: a meta-analysis
A.L. Waylen1,6, M. Metwally2, G.L. Jones3, A.J. Wilkinson4 and W.L. Ledger51 University of Sheffield School of Medicine and Biomedical Sciences, Beech Hill Road, Sheffield S10 2RX, UK 2 Department of Reproductive Medicine, Sheffield Teaching Hospitals, The Jessop Wing, Tree Root Walk, Sheffield S10 2TJ, UK 3 Health Services Research Section, ScHARR, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK 4 School of Health and Related Research, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK 5 Academic Unit of Reproductive and Developmental Medicine, Jessop Wing Hospital, Tree Root Walk, Sheffield S10 2TJ, UK
6 Correspondence address. E-mail:
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mda03aw@sheffield.ac.uk
BACKGROUND: The aim of this meta-analysis was to investigate whether any difference exists in success rate of clinical outcomes of assisted reproductive technologies (ART) between women who actively smoke cigarettes at the time of treatment and those who do not.
METHODS: An intensive computerized search was conducted on published literature from eight databases, using search terms related to smoking, assisted reproduction and outcome measures. Eligible studies compared outcomes of ART between cigarette smoking patients and a control group of non-smoking patients and reported on live birth rate per cycle, clinical pregnancy rate per cycle, ectopic pregnancy rate per pregnancy or spontaneous miscarriage rate per pregnancy, and 21 studies were included in the meta-analyses. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for the data, and statistical heterogeneity was tested for using 2 and I2 values. A systematic review examined the effect of smoking upon fertilization rates across 17 studies.
RESULTS: Smoking patients demonstrated significantly lower odds of live birth per cycle (OR 0.54, 95% CI 0.30–0.99), significantly lower odds of clinical pregnancy per cycle (OR 0.56, 95% CI 0.43–0.73), significantly higher odds of spontaneous miscarriage (OR 2.65, 95% CI 1.33–5.30) and significantly higher odds of ectopic pregnancy (OR 15.69, 95% CI 2.87–85.76). A systematic literature review revealed that fertilization rates were not significantly different between smoking and non-smoking groups in most studies.
CONCLUSIONS: This meta-analysis provides compelling evidence for a significant negative effect of cigarette smoking upon clinical outcomes of ART and should be presented to infertility patients who smoke cigarettes in order to optimize success rates.
Key words: assisted reproduction / cigarette / IVF / meta-analysis / smoking
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Male Smoking Affects Likelihood of Pregnancy following IVF
On December 23rd, 2008 Ryan says:
Evidence that male smoking affects the likelihood of a pregnancy following IVF treatment: application of the modified cumulative embryo score
KA Joesbury, WR Edirisinghe, MR Phillips and JL YovichPIVET Medical Centre, Leederville (Perth), Western Australia.
Female cigarette smoking has been implicated as having a detrimental effect on in-vitro fertilization (IVF) outcomes mediated through: (i) a diminished ovarian reserve (DOR), and (ii) an elevated pregnancy loss. Research is sparse regarding the effect of male smoking. The objective of this retrospective cohort study was to investigate the effect of male and female smoking on: (i) the collective quality of embryos selected for uterine transfer, and (ii) the likelihood of achieving an ongoing pregnancy at 12 weeks.
A total of 498 consecutive IVF treatment cycles were analysed. Female smokers were significantly younger (P < 0.05) and achieved a better modified cumulative embryo score (mCES) (P < 0.05) than female non-smokers. Female age correlated inversely with the number of oocytes collected (r = -0.42, P < 0.01) and the number of oocytes in turn was important in terms of predicting mCES. The decreasing number of oocytes aspirated with increasing age was of a significantly stronger magnitude for female smokers than for female non- smokers (P < 0.05). Multiple logistic regression was used to determine whether smoking affected the likelihood of achieving a 12-week pregnancy. The mCES, tubal infertility and male smoking were found to be significant.
Male smoking interacted with male age (P = 0.0164), indicating for male smokers a decrease of 2.4% in the likelihood of achieving a 12-week pregnancy with every 1-year increase in age. This is the first study to show that male smoking has a deleterious effect on pregnancy outcome among IVF patients.
Our study supports the increased risk of DOR but fails to support the elevated incidence of pregnancy loss among female smokers.
A reduced pregnancy rate was associated with male smoking possibly through pre-zygotic genetic damage. The growing realization of a paternal component of reproductive impairment suggests that studying the male is necessary.