How Does Smoking Affect Fertility?

When most people think of smoking, what comes to mind are the risks of lung cancer, heart disease, and pregnancy complications. But smoking also plays a significant and often overlooked role in fertility. Both men and women who smoke may face challenges in conceiving, higher risks of complications, and poorer outcomes in fertility treatments. The good news is that quitting can make a measurable difference. Let’s explore how smoking affects reproductive health and what benefits come from stopping.

Effects of Smoking on Male Fertility

For men, smoking has a clear negative impact on semen quality. Studies consistently show that men who smoke have lower sperm counts, reduced motility (how well sperm move), and abnormal morphology (shape). The more a person smokes, the stronger these effects tend to be.
The biological reasons behind this are complex but well understood. Chemicals in cigarette smoke generate oxidative stress in the body, which damages sperm membranes and DNA. Damaged DNA can lower the chances of fertilization and also increase the risk of miscarriage if conception does occur. In addition, toxins from smoking interfere with hormone balance, which can disrupt normal sperm production.
The impact is not limited to natural conception. Men who smoke also tend to see lower success rates in assisted reproductive technologies like IVF or ICSI. For couples undergoing fertility treatment, a man’s smoking habit can reduce the likelihood of achieving a successful pregnancy.

Effects of Smoking on Female Fertility

Women are equally affected, though in different ways. Smoking accelerates the natural decline of a woman’s egg supply, leading to earlier loss of fertility and even earlier menopause. Women who smoke often take longer to conceive and have a higher chance of infertility compared with non-smokers.
Cigarette smoke damages ovarian follicles and can compromise the quality of eggs. It also affects the function of the fallopian tubes and uterus, increasing the likelihood of problems such as ectopic pregnancy or miscarriage. Even in IVF treatment cycles, female smokers tend to have lower implantation rates and lower chances of a successful ongoing pregnancy.
Another area of growing concern is vaping and the use of e-cigarettes. While research is still developing, there is evidence that nicotine exposure in any form can negatively affect ovarian reserve and reproductive potential. This suggests that switching to vaping may not fully eliminate reproductive risks.

Long-Term Risks to Reproductive Health

Smoking doesn’t just influence short-term fertility. Over the long term, women who smoke tend to experience menopause several years earlier than non-smokers, which significantly shortens the window for conception. Smoking also raises the risk of reproductive tract diseases that can further complicate fertility.
For men, tobacco exposure has been linked with epigenetic changes in sperm — subtle alterations in how genes are expressed — which may affect not only fertility but also the health of future children. Research is still emerging in this area, but it underscores how smoking can have ripple effects beyond the immediate smoker.
Secondhand smoke is another important factor. A non-smoking partner’s fertility can be affected if they are regularly exposed to smoke in the home. Couples in which one partner smokes often face reduced chances of conception, even if the other partner has never smoked.

Benefits of Quitting for Fertility

The encouraging news is that many of these effects are at least partially reversible. Quitting smoking can improve fertility outcomes for both men and women.
For men, stopping smoking often leads to better semen quality. It can reduce oxidative stress, improve sperm motility, and decrease DNA fragmentation. Because it takes around three months for new sperm to develop, improvements can often be seen within a few months of quitting.
For women, quitting smoking can slow down the pace of ovarian aging and increase the chances of both natural conception and success in fertility treatments. Women who stop smoking before IVF often achieve pregnancy rates similar to those of women who have never smoked.
Beyond fertility itself, quitting also reduces the risks of complications during pregnancy, such as miscarriage, preterm birth, and low birth weight. These benefits extend to both the parents’ health and the well-being of their future children.

Practical Steps for Prospective Parents

If you are planning to start or grow your family, the single most effective step you can take for reproductive health is to quit smoking. Here are a few practical guidelines:

• Quit as early as possible: The sooner you stop, the more your body can recover before conception.
• Seek support: Counseling, support groups, and medically supervised nicotine replacement can double or triple the chances of quitting successfully.
• Encourage both partners to quit: Fertility outcomes are best when both partners are smoke-free, reducing risks for conception and pregnancy.
• Reduce secondhand exposure: Even if one partner doesn’t smoke, their fertility can still be affected by exposure to the other’s habit.
• Think long-term: Stopping smoking is not just about conceiving, but about giving your child the healthiest start possible.

Conclusion

Smoking has profound effects on fertility for both men and women. It lowers sperm quality, reduces ovarian reserve, increases risks of infertility and miscarriage, and complicates fertility treatment outcomes. Long-term risks include earlier menopause for women and potential impacts on children through epigenetic changes.
The silver lining is that quitting makes a real difference. By stopping smoking — ideally well before trying to conceive — couples can improve their chances of a healthy pregnancy and a healthy child. While quitting may not erase every risk, it is one of the most powerful steps prospective parents can take for their reproductive future.

References

1. Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette Smoking and Semen Quality: A Systematic Review and Meta-analysis. Fertil Steril. 2016; (meta-analysis summarizing reduced sperm count and motility). PubMed
   
   
2. Harlev A, Peretz M, Agarwal A. Smoking and Male Infertility: An Evidence-Based Review. Asian J Androl. 2015; (review on mechanisms including oxidative stress and sperm DNA damage). PMC
   
   
3. Kovac JR, Pastuszak AW, Lamb DJ. The Effects of Cigarette Smoking on Male Fertility. Postgrad Med. 2015; (clinical review recommending smoking cessation to improve outcomes). PMC+1
   
   
4. Dhage VD, et al. A Narrative Review on the Impact of Smoking on Female Fertility. 2024. (recent review covering ovarian, tubal, and uterine effects). PMC
   
   
5. Augood C, Duckitt K, Templeton A. Smoking and Female Infertility: A Systematic Review and Meta-analysis. Hum Reprod. 1998; (meta-analysis showing increased odds of infertility in women smokers). PubMed
   
   
6. Van Voorhis BJ, et al. The effects of smoking on ovarian function and fertility. Fertil Steril. 1996; (early study showing reduced implantation and pregnancy rates in smokers undergoing IVF). PubMed
   
   
7. Osadchuk L, et al. Effects of cigarette smoking on semen quality, reproductive hormones and oxidative stress indicators. 2023. (recent study describing declines in semen parameters among smokers). PMC
   
   
8. He S, et al. Associations between smoking status and infertility: a cross-sectional study. 2023. (evidence for impact on female reproductive function). PMC
   
   
9. U.S. Public Health Service. The Health Benefits of Smoking Cessation. 2020. (authoritative resource summarizing cessation benefits including reproductive health). NCBI
   
   
10. American Society for Reproductive Medicine (ASRM). Practice guidance: Tobacco or marijuana use and infertility. (clinical guidance noting associations and recommending cessation). asrm.org

Additional recent news and research items (e.g., vaping and AMH studies reported in 2024) that raise concern about non-combustible nicotine exposure and ovarian reserve. The Guardian+1