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Smoking and Fertility

Smoking has an interesting relationship with fertility, and most smokers start in their teens or as young adults when looking older, sexier and more sophisticated is part of the appeal.

They weren’t entirely wrong as smoking not only makes people look older, it also physically ages them as chemicals in the smoke damage cells and accelerate their death. In time, and with the inevitable accumulation of toxins from smoking, the “look and feel” of being an older person mounts up:

  • Men who smoke can expect to live (on average) 13.2 years less than non-smokers
  • Women who smoke can expect to live (on average) 14.5 years less than non-smokers i

The reality is that most lifelong smokers die more than a decade early due to their smoking, and this is a big issue for fertility as around 35% of men and 30% of women of reproductive age smoke cigarettes. ii-iii When smokers are trying for a baby, they should understand that smoking reduces fertility, smokers are more likely to be infertile, and simply being a passive smoker increases the time it takes women to conceive.

Female smokers

Smoking significantly accelerates the ageing process, and women who smoke reach menopause earlier than non-smokers, iv mainly due to the chemicals in the smoke increasing oxidative damage to eggs and follicles. Anything that encourages eggs to die speeds up ovarian decline, and one study found smokers were about 2.5x more likely to have low ovarian reserve than non-smoking women of the same age. v

While smoking increases a woman’s risk of infertility (by 1.6x), it also raises the chances of: vi

  • Ectopic pregnancy
  • Chromosomal abnormalities in the child
  • Miscarriage
  • Pre-term birth

It can get expensive, too, as women who smoke will need nearly twice as many IVF cycles to get pregnant, and there are higher levels of toxic heavy metals and nicotine derivatives in the follicles of women who smoke. As expected, the longer someone smokes, the bigger the effect on fertility, with it taking an average of 9% more IVF cycles to get pregnant for each year of smoking, so smoking for ten years almost doubles the number of IVF cycles! vii 

Male smokers

Cigarette smoke men directly harm a man’s sperm and DNA, but this isn’t the only way smoking affects male fertility, as semen samples are usually worse for smokers, typically with lower values for:

  • Sperm numbers
  • Sperm concentration
  • Motility
  • Morphology
  • Semen volume
  • Capacity to fertilise eggs viii

Cigarette smoking also alters a man’s hormone balance; increasing levels of the “female” hormone estradiol, which reduces fertility and increases female characteristics, as well as increasing the chances of:

  • Wasting of the testes (testicular atrophy)
  • Erectile dysfunction due to reduced circulation
  • Inflammation of the testes from higher oxidative stress levels ix

Effects on the child

Smoking by either parent around the time of conception can have significant effects on the health of their children:

  • Smoking by mothers increases the risk of low birth weight and congenital disabilities in their children x
  • When a father smokes 20 or more a day, it increases his child’s risk of childhood leukaemia xi and reduces the reproductive lifespan of his daughters xii

Things that help

Smoking reduces everyone’s fertility and has long-term consequences, and couples planning on having children should appreciate why smoking isn’t good for them or their families. Stopping smoking brings improvements in sperm health after about three months, and a year of non-smoking is even better for a man’s health and fertility. It’s never too soon to stop smoking.

There’s evidence both honey xiii and pot marigold (Calendula officinalis) extracts have protective functions for men who smoke, and it’s possible that Calendula raises antioxidant levels in the testes. xiv Whether it has the same effect on women is unknown, as it’s a lot harder to test egg health than sperm (as with drugs).

There are many support organisations helping people stop smoking, and having a strong focus on positive outcomes (rather than on feeling denied or failing) is important. Exercising is great for reducing stress, boost endorphins, stay positive and distracting yourself from cravings!


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