Association between cigarette smoking behavior and infertility in women: a case-control study
DOI:
https://doi.org/10.15419/bmrat.v4i10.376Keywords:
Medicine, Cigarette, Infertility, Nicotine addiction, SmokingAbstract
Introduction: The effects of smoking on decreasing the chance of fertility in women have been acknowledged but some aspects, such as smoking behavior, are currently unclear. The present study aims to evaluate the relationship between smoking traits and infertility in women through a comparative study with fertile women.
Methods: This case-control study was conducted on 350 women (177 infertile and 173 fertile) in March-May 2014. Sampling was performed in two phases. Demographic and reproductive data were collected by questionnaires- for demographics and the Fagerstrom Test for Nicotine Dependence (FTND)). The total score of questionnaires was ten. The participants were divided into 3 groups: “Low Nicotine” dependency (0-4), “Moderate Nicotine” dependency (5) and “High Nicotine” dependency (6-10). To examine the relationship between smoking and infertility, both the chi-square test and logistic regression tests were used.
Results: Tobacco use in infertile women was greater than that for fertile women (23.7% vs. 16.1%, respectively, P = 0.012); in fact, 16.7% of tobacco consumers had high nicotine dependency. Medium and low nicotine dependency were seen in 5.6% and 77.8% of tobacco consumers, respectively. Positive history of smoking increased the odds of being infertile (OR 2.88; 95% CI: 1.56- 4.92) and risk for infertility was associated with low nicotine dependency (OR 3.12; 95% CI 1.16-8.09).
Conclusion: Low and high nicotine dependency increased the risk of infertility. Considering the physical, mental, social and economic effects of infertility in society, the negative effects of smoking on fertility should be considered and/or included in the training package for health service providers.
References
<ol>
<li class="show">Arabi, M., & Moshtaghi, H. (2005). Influence of cigarette smoking on spermatozoa via seminal plasma. Andrologia, 37(4), 119–124. <a href="https://doi.org/10.1111/j.1439-0272.2005.00664.x">https://doi.org/10.1111/j.1439-0272.2005.00664.x</a></li>
<li class="show">Cooper, A. R., & Moley, K. H. (2008). Maternal Tobacco Use and Its Preimplantation Effects on Fertility: More Reasons to Stop Smoking. Seminars in Reproductive Medicine, 26(02), 204–212. <a href="https://doi.org/10.1055/s-2008-1042959">https://doi.org/10.1055/s-2008-1042959</a></li>
<li class="show">de Jong, A. M. E., Menkveld, R., Lens, J. W., Nienhuis, S. E., & Rhemrev, J. P. T. (2014). Effect of alcohol intake and cigarette smoking on sperm parameters and pregnancy. Andrologia, 46(2), 112–117. <a href="https://doi.org/10.1111/and.12054 ">https://doi.org/10.1111/and.12054 </a></li>
<li class="show">Dechanet, C., Anahory, T., Mathieu Daude, J. C., Quantin, X., Reyftmann, L., Hamamah, S., . . . Dechaud, H. (2011). Effects of cigarette smoking on reproduction. Human Reproduction Update, 17(1), 76–95. <a href="https://doi.org/10.1093/humupd/dmq033">https://doi.org/10.1093/humupd/dmq033</a></li>
<li class="show">Delpisheh, A., Topping, J., Reyad, M., Tang, A.-W., & Brabin, B. J. (2007). Smoking exposure in pregnancy: Use of salivary cotinine in monitoring. British Journal of Midwifery, 15(4), 216–220. <a href="https://doi.org/10.12968/bjom.2007.15.4.23385">https://doi.org/10.12968/bjom.2007.15.4.23385</a></li>
<li class="show">Delpisheh, A., Topping, J., Reyad, M., Tang, A., & Brabin, B. J. (2008). Prenatal alcohol exposure, <em>CYP17</em> gene polymorphisms and fetal growth restriction. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 138(1), 49–53. <a href="https://doi.org/10.1016/j.ejogrb.2007.08.006">https://doi.org/10.1016/j.ejogrb.2007.08.006</a></li>
<li class="show">Direkvand-Moghadam, A., Delpisheh, A., & Direkvand-Moghadam, A. (2015). Effect of Infertility on Sexual Function: A Cross-Sectional Study. Journal of Clinical and Diagnostic Research : JCDR, 9(5), QC01–QC3.</li>
<li class="show">Direkvand-Moghadam, A., Delpisheh, A., Montazeri, A., & Sayehmiri, K. (2016). Quality of Life in Infertile Menopausal Women; Development and Psychometric of an Instrument. Journal of Clinical and Diagnostic Research : JCDR, 10(6), IC01–IC5.</li>
<li class="show">Ernst, A., Kristensen, S. L., Toft, G., Thulstrup, A. M., Håkonsen, L. B., Olsen, S. F., & Ramlau-Hansen, C. H. (2012). Maternal smoking during pregnancy and reproductive health of daughters: A follow-up study spanning two decades. Human Reproduction (Oxford, England), 27(12), 3593–3600. <a href="https://doi.org/10.1093/humrep/des337">https://doi.org/10.1093/humrep/des337</a></li>
<li class="show">Håkonsen, L. B., Ernst, A., & Ramlau-Hansen, C. H. (2014). Maternal cigarette smoking during pregnancy and reproductive health in children: A review of epidemiological studies. Asian Journal of Andrology, 16(1), 39–49. <a href="https://doi.org/10.4103/1008-682X.122351">https://doi.org/10.4103/1008-682X.122351</a></li>
<li class="show">Harlev, A., Agarwal, A., Gunes, S. O., Shetty, A., & du Plessis, S. S. (2015). Smoking and Male Infertility: An Evidence-Based Review. The World Journal of Men’s Health, 33(3), 143–160. <a href="https://doi.org/10.5534/wjmh.2015.33.3.143">https://doi.org/10.5534/wjmh.2015.33.3.143</a></li>
<li class="show">Hatch, E. E., Troisi, R., Wise, L. A., Hyer, M., Palmer, J. R., Titus-Ernstoff, L., . . . Hoover, R. N. (2006). Age at Natural Menopause in Women Exposed to Diethylstilbestrol in Utero. American Journal of Epidemiology, 164(7), 682–688. <a href="https://doi.org/10.1093/aje/kwj257">https://doi.org/10.1093/aje/kwj257</a></li>
<li class="show">Hatch, E. E., Troisi, R., Wise, L. A., Titus-Ernstoff, L., Hyer, M., Palmer, J. R., . . . Kaufman, R. (2011). Preterm Birth, Fetal Growth, and Age at Menarche among Women Exposed Prenatally to Diethylstilbestrol (DES). Reproductive Toxicology (Elmsford, N.Y.), 31(2), 151–157. <a href="https://doi.org/10.1016/j.reprotox.2010.11.006">https://doi.org/10.1016/j.reprotox.2010.11.006</a></li>
<li class="show">Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerström, K. O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86(9), 1119–1127. <a href="https://doi.org/10.1111/j.1360-0443.1991.tb01879.x">https://doi.org/10.1111/j.1360-0443.1991.tb01879.x</a></li>
<li class="show">Louis, G. M. B., Schisterman, E. F., Sweeney, A. M., Wilcosky, T. C., Gore-Langton, R. E., Lynch, C. D., . . .. (2011). Designing prospective cohort studies for assessing reproductive and developmental toxicity during sensitive windows of human reproduction and development – the LIFE Study. Paediatric and Perinatal Epidemiology, 25(5), 413–424. <a href="https://doi.org/10.1111/j.1365-3016.2011.01205.x">https://doi.org/10.1111/j.1365-3016.2011.01205.x</a></li>
<li class="show">Moosazadeh, M., Ziaaddini, H., Mirzazadeh, A., Ashrafi-Asgarabad, A., & Haghdoost, A. A. (2013). Meta-analysis of Smoking Prevalence in Iran. Addiction & Health, 5(3-4), 140–153</li>
<li class="show">Oyeyipo, I. P., Raji, Y., & Bolarinwa, A. F. (2013). Nicotine alters male reproductive hormones in male albino rats: The role of cessation. Journal of Human Reproductive Sciences, 6(1), 40–44. <a href="https://doi.org/10.4103/0974-1208.112380">https://doi.org/10.4103/0974-1208.112380</a></li>
<li class="show">Oyeyipo, I. P., Raji, Y., & Bolarinwa, A. F. (2014). Antioxidant profile changes in reproductive tissues of rats treated with nicotine. Journal of Human Reproductive Sciences, 7(1), 41–46. <a href="https://doi.org/10.4103/0974-1208.130823">https://doi.org/10.4103/0974-1208.130823</a></li>
<li class="show">Oyeyipo, I. P., Raji, Y., Emikpe, B. O., & Bolarinwa, A. F. (2011). Effects of Nicotine on Sperm Characteristics and Fertility Profile in Adult Male Rats: A Possible Role of Cessation. Journal of Reproduction & Infertility, 12(3), 201–207</li>
<li class="show">Sarvari, A., Naderi, M., Heidari, M., Zarnani, A., Jeddi-Tehrani, M., Sadeghi, M., . . .. (2010). Effect of Environmental Risk Factors on Human Fertility. Journal of Reproduction & Infertility, 11(4), 211–226.</li>
<li class="show">Sépaniak, S., Forges, T., & Monnier-Barbarino, P. (2006). Cigarette smoking and fertility in women and men. Gynecologie, Obstetrique & Fertilite, 34(10), 945–949.</li>
<li class="show">Sezgin, H., Hocaoglu, C., & Guvendag-Guven, E. S. (2016). Disability, psychiatric symptoms, and quality of life in infertile women: A cross-sectional study in Turkey. Shanghai Jingshen Yixue, 28(2), 86–94.</li>
<li class="show">Strohsnitter, W. C., Hatch, E. E., Hyer, M., Troisi, R., Kaufman, R. H., Robboy, S. J., . . . Noller, K. L. (2008). The Association between In Utero Cigarette Smoke Exposure and Age at Menopause. American Journal of Epidemiology, 167(6), 727–733. <a href="https://doi.org/10.1093/aje/kwm351">https://doi.org/10.1093/aje/kwm351</a></li>
<li class="show">The Practice Committee of the American Society for Reproductive Medicine (2008). Smoking and infertility. Fertility and Sterility, 90(5), S254–S9. <a href="https://doi.org/10.1016/j.fertnstert.2008.08.035">https://doi.org/10.1016/j.fertnstert.2008.08.035</a></li>
<li class="show">Uzumcu, M., Zama, A. M., & Oruc, E. (2012). Epigenetic Mechanisms in the Actions of Endocrine‐disrupting Chemicals: Gonadal Effects and Role in Female Reproduction. Reproduction in domestic animals, 47(s4), 338-347.</li>
<li class="show">Weigert, M., Hofstetter, G., Kaipl, D., Gottlich, H., Krischker, U., Bichler, K., . . . Feichtinger, W. (1999). The Effect of Smoking on Oocyte Quality and Hormonal Parameters of Patients Undergoing In Vitro Fertilization–Embryo Transfer. Journal of Assisted Reproduction and Genetics, 16(6), 287–293. <a href="https://doi.org/10.1023/A:1020496330424">https://doi.org/10.1023/A:1020496330424</a></li>
</ol>
<li class="show">Arabi, M., & Moshtaghi, H. (2005). Influence of cigarette smoking on spermatozoa via seminal plasma. Andrologia, 37(4), 119–124. <a href="https://doi.org/10.1111/j.1439-0272.2005.00664.x">https://doi.org/10.1111/j.1439-0272.2005.00664.x</a></li>
<li class="show">Cooper, A. R., & Moley, K. H. (2008). Maternal Tobacco Use and Its Preimplantation Effects on Fertility: More Reasons to Stop Smoking. Seminars in Reproductive Medicine, 26(02), 204–212. <a href="https://doi.org/10.1055/s-2008-1042959">https://doi.org/10.1055/s-2008-1042959</a></li>
<li class="show">de Jong, A. M. E., Menkveld, R., Lens, J. W., Nienhuis, S. E., & Rhemrev, J. P. T. (2014). Effect of alcohol intake and cigarette smoking on sperm parameters and pregnancy. Andrologia, 46(2), 112–117. <a href="https://doi.org/10.1111/and.12054 ">https://doi.org/10.1111/and.12054 </a></li>
<li class="show">Dechanet, C., Anahory, T., Mathieu Daude, J. C., Quantin, X., Reyftmann, L., Hamamah, S., . . . Dechaud, H. (2011). Effects of cigarette smoking on reproduction. Human Reproduction Update, 17(1), 76–95. <a href="https://doi.org/10.1093/humupd/dmq033">https://doi.org/10.1093/humupd/dmq033</a></li>
<li class="show">Delpisheh, A., Topping, J., Reyad, M., Tang, A.-W., & Brabin, B. J. (2007). Smoking exposure in pregnancy: Use of salivary cotinine in monitoring. British Journal of Midwifery, 15(4), 216–220. <a href="https://doi.org/10.12968/bjom.2007.15.4.23385">https://doi.org/10.12968/bjom.2007.15.4.23385</a></li>
<li class="show">Delpisheh, A., Topping, J., Reyad, M., Tang, A., & Brabin, B. J. (2008). Prenatal alcohol exposure, <em>CYP17</em> gene polymorphisms and fetal growth restriction. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 138(1), 49–53. <a href="https://doi.org/10.1016/j.ejogrb.2007.08.006">https://doi.org/10.1016/j.ejogrb.2007.08.006</a></li>
<li class="show">Direkvand-Moghadam, A., Delpisheh, A., & Direkvand-Moghadam, A. (2015). Effect of Infertility on Sexual Function: A Cross-Sectional Study. Journal of Clinical and Diagnostic Research : JCDR, 9(5), QC01–QC3.</li>
<li class="show">Direkvand-Moghadam, A., Delpisheh, A., Montazeri, A., & Sayehmiri, K. (2016). Quality of Life in Infertile Menopausal Women; Development and Psychometric of an Instrument. Journal of Clinical and Diagnostic Research : JCDR, 10(6), IC01–IC5.</li>
<li class="show">Ernst, A., Kristensen, S. L., Toft, G., Thulstrup, A. M., Håkonsen, L. B., Olsen, S. F., & Ramlau-Hansen, C. H. (2012). Maternal smoking during pregnancy and reproductive health of daughters: A follow-up study spanning two decades. Human Reproduction (Oxford, England), 27(12), 3593–3600. <a href="https://doi.org/10.1093/humrep/des337">https://doi.org/10.1093/humrep/des337</a></li>
<li class="show">Håkonsen, L. B., Ernst, A., & Ramlau-Hansen, C. H. (2014). Maternal cigarette smoking during pregnancy and reproductive health in children: A review of epidemiological studies. Asian Journal of Andrology, 16(1), 39–49. <a href="https://doi.org/10.4103/1008-682X.122351">https://doi.org/10.4103/1008-682X.122351</a></li>
<li class="show">Harlev, A., Agarwal, A., Gunes, S. O., Shetty, A., & du Plessis, S. S. (2015). Smoking and Male Infertility: An Evidence-Based Review. The World Journal of Men’s Health, 33(3), 143–160. <a href="https://doi.org/10.5534/wjmh.2015.33.3.143">https://doi.org/10.5534/wjmh.2015.33.3.143</a></li>
<li class="show">Hatch, E. E., Troisi, R., Wise, L. A., Hyer, M., Palmer, J. R., Titus-Ernstoff, L., . . . Hoover, R. N. (2006). Age at Natural Menopause in Women Exposed to Diethylstilbestrol in Utero. American Journal of Epidemiology, 164(7), 682–688. <a href="https://doi.org/10.1093/aje/kwj257">https://doi.org/10.1093/aje/kwj257</a></li>
<li class="show">Hatch, E. E., Troisi, R., Wise, L. A., Titus-Ernstoff, L., Hyer, M., Palmer, J. R., . . . Kaufman, R. (2011). Preterm Birth, Fetal Growth, and Age at Menarche among Women Exposed Prenatally to Diethylstilbestrol (DES). Reproductive Toxicology (Elmsford, N.Y.), 31(2), 151–157. <a href="https://doi.org/10.1016/j.reprotox.2010.11.006">https://doi.org/10.1016/j.reprotox.2010.11.006</a></li>
<li class="show">Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerström, K. O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86(9), 1119–1127. <a href="https://doi.org/10.1111/j.1360-0443.1991.tb01879.x">https://doi.org/10.1111/j.1360-0443.1991.tb01879.x</a></li>
<li class="show">Louis, G. M. B., Schisterman, E. F., Sweeney, A. M., Wilcosky, T. C., Gore-Langton, R. E., Lynch, C. D., . . .. (2011). Designing prospective cohort studies for assessing reproductive and developmental toxicity during sensitive windows of human reproduction and development – the LIFE Study. Paediatric and Perinatal Epidemiology, 25(5), 413–424. <a href="https://doi.org/10.1111/j.1365-3016.2011.01205.x">https://doi.org/10.1111/j.1365-3016.2011.01205.x</a></li>
<li class="show">Moosazadeh, M., Ziaaddini, H., Mirzazadeh, A., Ashrafi-Asgarabad, A., & Haghdoost, A. A. (2013). Meta-analysis of Smoking Prevalence in Iran. Addiction & Health, 5(3-4), 140–153</li>
<li class="show">Oyeyipo, I. P., Raji, Y., & Bolarinwa, A. F. (2013). Nicotine alters male reproductive hormones in male albino rats: The role of cessation. Journal of Human Reproductive Sciences, 6(1), 40–44. <a href="https://doi.org/10.4103/0974-1208.112380">https://doi.org/10.4103/0974-1208.112380</a></li>
<li class="show">Oyeyipo, I. P., Raji, Y., & Bolarinwa, A. F. (2014). Antioxidant profile changes in reproductive tissues of rats treated with nicotine. Journal of Human Reproductive Sciences, 7(1), 41–46. <a href="https://doi.org/10.4103/0974-1208.130823">https://doi.org/10.4103/0974-1208.130823</a></li>
<li class="show">Oyeyipo, I. P., Raji, Y., Emikpe, B. O., & Bolarinwa, A. F. (2011). Effects of Nicotine on Sperm Characteristics and Fertility Profile in Adult Male Rats: A Possible Role of Cessation. Journal of Reproduction & Infertility, 12(3), 201–207</li>
<li class="show">Sarvari, A., Naderi, M., Heidari, M., Zarnani, A., Jeddi-Tehrani, M., Sadeghi, M., . . .. (2010). Effect of Environmental Risk Factors on Human Fertility. Journal of Reproduction & Infertility, 11(4), 211–226.</li>
<li class="show">Sépaniak, S., Forges, T., & Monnier-Barbarino, P. (2006). Cigarette smoking and fertility in women and men. Gynecologie, Obstetrique & Fertilite, 34(10), 945–949.</li>
<li class="show">Sezgin, H., Hocaoglu, C., & Guvendag-Guven, E. S. (2016). Disability, psychiatric symptoms, and quality of life in infertile women: A cross-sectional study in Turkey. Shanghai Jingshen Yixue, 28(2), 86–94.</li>
<li class="show">Strohsnitter, W. C., Hatch, E. E., Hyer, M., Troisi, R., Kaufman, R. H., Robboy, S. J., . . . Noller, K. L. (2008). The Association between In Utero Cigarette Smoke Exposure and Age at Menopause. American Journal of Epidemiology, 167(6), 727–733. <a href="https://doi.org/10.1093/aje/kwm351">https://doi.org/10.1093/aje/kwm351</a></li>
<li class="show">The Practice Committee of the American Society for Reproductive Medicine (2008). Smoking and infertility. Fertility and Sterility, 90(5), S254–S9. <a href="https://doi.org/10.1016/j.fertnstert.2008.08.035">https://doi.org/10.1016/j.fertnstert.2008.08.035</a></li>
<li class="show">Uzumcu, M., Zama, A. M., & Oruc, E. (2012). Epigenetic Mechanisms in the Actions of Endocrine‐disrupting Chemicals: Gonadal Effects and Role in Female Reproduction. Reproduction in domestic animals, 47(s4), 338-347.</li>
<li class="show">Weigert, M., Hofstetter, G., Kaipl, D., Gottlich, H., Krischker, U., Bichler, K., . . . Feichtinger, W. (1999). The Effect of Smoking on Oocyte Quality and Hormonal Parameters of Patients Undergoing In Vitro Fertilization–Embryo Transfer. Journal of Assisted Reproduction and Genetics, 16(6), 287–293. <a href="https://doi.org/10.1023/A:1020496330424">https://doi.org/10.1023/A:1020496330424</a></li>
</ol>
Downloads
Published
2017-10-28
Issue
Section
Original Research
License
Copyright The Author(s) 2017. This article is published with open access by BioMedPress. This article is distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0) which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
How to Cite
Association between cigarette smoking behavior and infertility in women: a case-control study. (2017). Biomedical Research and Therapy, 4(10), 1705-1715. https://doi.org/10.15419/bmrat.v4i10.376
