Human Reproduction, Vol 13, 1506-1513, Copyright © 1998 by Oxford University Press
KA Joesbury, WR Edirisinghe, MR Phillips and JL Yovich
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.
ARTICLES
Evidence that male smoking affects the likelihood of a pregnancy following IVF treatment: application of the modified cumulative embryo score
PIVET Medical Centre, Leederville (Perth), Western Australia.
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