EFFECT OF SMOKING ON OVARIAN RESERVE AND OVARIAN STIMULATION IN IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER

The effect of cigarette smoking on ovarian reserve as measured by basa l serum follicle stimulating hormone (FSH) concentrations, and by the response to a standard ovarian stimulation protocol, was examined retr ospectively in 173 consecutive women (108 non-smokers and 65 smokers) undergoing in-vitro fertilization (IVF) and embryo transfer treatment. Women who smoked had a higher mean basal serum FSH concentration (P l ess than or equal to 0.0001), in particular younger (<36 years) women, and required a statistically significantly higher mean dosage of gona dotrophins for ovarian stimulation than the non-smokers (48.1 +/- 15.6 versus 38.9 +/- 13.6 ampoules, 75 IU/ampoule; P < 0.0001), A lower me an number of oocytes was obtained in smokers than non-smokers (6.2 +/- 3.4 versus 11.1 +/- 6.3, oocytes P less than or equal to 0.0001) and the rate of abandoned cycles (18.5 versus 8.5%) and total fertilizatio n failure (18.5 versus 8.5%) was higher. The clinical pregnancy rate p er cycle in smokers was 16.9% versus 21.3% in non-smokers but this was not statistically significant. In conclusion, cigarette smoking in wo men appears to significantly reduce their ovarian reserve and lead to poor response to ovarian stimulation at an earlier age.