COTININE, A MAJOR METABOLITE OF NICOTINE, IS DETECTABLE IN FOLLICULARFLUIDS OF PASSIVE SMOKERS IN IN-VITRO FERTILIZATION THERAPY

Objective: To assess cotinine, a metabolite of nicotine, in follicular fluids (FF) of women who smoke either actively or passively or not al l. Design: Controlled clinical study. Setting: Infertile patients in a hospital IVF-ET program. Patients: One hundred eleven women classifie d by smoking habits: active smokers (n = 44), passive smokers (n = 17) , or nonsmokers (n = 50). Interventions: Ovarian hyperstimulation. Mai n Outcome Measure: Cotinine levels in FF. Results: A strong correlatio n between number of cigarettes smoked and levels of FF cotinine was fo und. The levels of FF cotinine were: active smokers 710.4 +/- 128.2, p assive smokers 76.3 +/- 56.5, and nonsmokers 4.2 +/- 2.0 ng/mL (mean /- SEM). The level in active smokers was significantly greater than in other groups. The levels of FF cotinine in passive smokers differed s ignificantly from nonsmokers. Eighty-four percent of nonsmokers actual ly were exposed to nicotine, with a mean value of 5.0 ng/mL. Conclusio ns: Cotinine was detectable in a dose-dependent manner in active and p assive smokers. It was detected in all active smokers and in a majorit y of passive smokers and self-reported nonsmokers. A strong interindiv idual variation suggests differences in metabolism and smoking habits. Follicular fluid cotinine assessments are useful for infertility stud ies.