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Does Smoking Cause Infertility? What Tobacco Users Must Know

July 21, 2022
By Pivot
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Can smoking make you infertile?

The medical evidence says yes, pointing to an irrefutable connection between smoking and reproductive health. But how bad is the situation? Does smoking affect fertility differently in men versus in women? How about vaping? 

Find out how a nicotine habit may be impacting your future – and your family’s – and what you might want to do about it.

What is infertility?

According to the American Society for Reproductive Medicine, infertility is the inability to achieve pregnancy after one year of regular sexual intercourse. About 15% of all couples struggle with infertility, with about half of cases attributable to issues with the male partner, and a half to the female.

How does smoking affect male fertility?

Smoking lowers sperm count and semen volume. One study of men who smoked less than 20 cigarettes per day found that their sperm concentration was down 19% compared with non-smokers – and that the more cigarettes a man smoked per day, the more his concentration dropped. Testosterone levels dropped too, and sperm swam slower, making them less likely to succeed in fertilizing an egg. In addition, scientists have found that smoking actually damages sperm, making them less able to survive harmful free radicals in the seminal fluid.

Does smoking affect female fertility?

The answer is yes. Women who smoke six or more cigarettes a day face increased risks of miscarriage, damaged eggs, blocked fallopian tubes, ectopic pregnancies, and cervical cancer. These risks rise for every additional cigarette smoked per day.

The long-term situation for women is equally grim. Unlike men, women are born with all the eggs they will ever have and don’t produce new ones, meaning their bodies cannot replace any eggs damaged by smoking, which reduces their chances of getting pregnant. Other studies show that female smokers go through menopause up to four years earlier than non-smokers, since smoking causes premature aging in the female organs, shortening possible child-bearing years.

The dangers of smoking while pregnant

When women smoke during pregnancy, there’s the potential for a higher incidence of birth defects, according to a major study, including malformed hearts, limbs, eyes, faces, and skulls; missing fingers or toes, hernias, cleft lips and palates, clubfeet, hernias, gastrointestinal issues, or undescended testicles. 

Infants of mothers who smoke are also more likely to have two or more of these defects at the same time. According to the CDC, more than 1,000 babies die every year because their mothers smoked while pregnant. And surprising as it may be, smoking can also affect a woman’s ability to have grandchildren. If a woman was to have a son, they would also run the risk of potential increased incidence of infertility.

Is infertility stemming from tobacco use really a major problem?

It’s a huge issue, with both financial and emotional costs.

About 13% of American adults smoke cigarettes – 14% of them are men and 11% are women. A full 20% of American women of childbearing age smoke. Of the nation’s 31 million smokers (not including those who vape or use all other forms of tobacco), over 16 million suffer from a smoking-related disease, and about 20% of all deaths in the United States are caused by smoking. In fact, smoking is the leading cause of preventable disease, disability, and death.

Consider the national price tag for fertility treatments and caring for children with tobacco-related birth defects. These could be drastically reduced if would-be parents quit smoking.

Smoking-related infertility is an often unforeseen problem, though. Only 20% of smokers understand the link between smoking and infertility, and even fewer realize the impact of smoking on early onset menopause. Unwittingly, both male and female smokers struggling with fertility may be experiencing the side effects of tobacco on the body.  

 Can secondhand smoke cause infertility?

One study found that women who were exposed to someone else’s exhaled tobacco smoke released fewer eggs during in-vitro fertilization (IVF) treatment. In general, secondhand smoke is detrimental to anyone’s health. The CDC says that “there is no risk-free level of exposure to secondhand smoke.”  

Is chewing tobacco less harmful than smoking to fertility?

No. In fact, the infertility rates of those who chew tobacco, whether male or female, are double those of non-smokers. We also know that heavy usage of chewing tobacco harms the concentration, shape, and viability of a man’s sperm.

 Is vaping safer than smoking in terms of fertility? 

No. Research shows that vaping is just as detrimental to fetal development as cigarette smoking. A study at Oregon State University found similar impacts on lung function in pregnancies of mothers who vape and/or smoke. And men who vape tend to have low sperm quality and sperm counts, just like men who smoke do.

Does quitting smoking increase fertility?

For men, sperm counts go back up after quitting smoking, although it takes a while. A study in Environmental Epidemiology reported a return to normal sperm quality one year after quitting. About half of men who suffer from erectile dysfunction see improvements six months after getting off cigarettes.

Similarly, it takes about a year for a women’s reproductive system to recover from tobacco-related infertility. If women quit smoking before or during their first trimester of pregnancy, they virtually eliminate the risk of giving birth prematurely. Even quitting as late as the third trimester reduces the incidence of low birth weight, contributing to a healthier child. 

What can those who smoke and/or vape do to improve their fertility?

There’s a simple answer - wean yourself off of any tobacco or nicotine products of any form. Of course, this is easier said than done - nicotine is one of the most addictive substances known to man. But that’s exactly why a great tobacco cessation program can be so important.

Visualizing a happier future with children of your own can be a motivator for quitting smoking, vaping, or chewing tobacco. Use your dreams of having a family to improve your health, relationships, and life expectancy, making this the time you kick the habit once and for all.

FAQs About Smoking and Infertility

Can smoking lead to infertility?
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Yes, smoking can lead to infertility in both men and women. It impacts male fertility by lowering sperm count, semen volume, and testosterone levels and causes damage to sperm. For women, smoking can lead to miscarriages, damaged eggs, blocked fallopian tubes, and a shortened child-bearing period due to premature menopause.

How does smoking affect fertility differently in men and women?
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In men, smoking primarily affects sperm health, reducing count, concentration, and swimming speed. It also damages sperm DNA and lowers testosterone levels. Women, however, experience various reproductive issues from smoking, including damaged eggs, blocked fallopian tubes, increased risks of miscarriage, and early onset menopause. Women can't replace damaged eggs, leading to decreased fertility.

Is secondhand smoke harmful to fertility?
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Yes, secondhand smoke can also harm fertility. Studies have shown that women exposed to secondhand smoke released fewer eggs during in-vitro fertilization treatment. According to the CDC, there is no risk-free level of exposure to secondhand smoke.

Does vaping affect fertility like smoking does?
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Yes, research shows that vaping can be just as detrimental to fertility as smoking. It similarly impacts fetal development and lowers sperm quality and counts in men.

Can quitting smoking increase fertility?
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Yes, quitting smoking can improve fertility. For men, sperm counts can return to normal about a year after quitting. In women, the reproductive system can recover from tobacco-related infertility within about a year. Quitting smoking during pregnancy also significantly reduces the risk of premature birth and low birth weight.

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