Potentially destructive

A combination of an already existing addiction, quarantine, boredom, anxiety, and depression have contributed to an increase in unhealthy coping behaviours, writes Dr Chandrika Kulkarni

That cigarette smoking is injurious to health is well known but it is important to understand that it becomes even more dangerous when you’re on your way to start a family. Not only does smoking damage your lungs and respiratory organs it also systematically spreads its tentacles across your body, eroding overall bodily function. It may come as no surprise to many that cigarette smoking has increased during the pandemic and this can deter a couple from conceiving a baby and severely impair their reproductive graph.

Smoking out your fertility

The toxins inhaled from cigarette smoke can affect fertility by causing damage to reproductive organs, eggs and sperm.

Infertility rates in both male and female smokers are about twice the rate of infertility found in non-smokers

Smoking may decrease the total number of eggs a woman has in her ovaries (decreased ovarian reserve measured by the hormone AMH) and cause the ovaries to age prematurely.

The risk for fertility problems increases with the number of cigarettes smoked daily.

An increasing delay in conception correlates with increasing daily numbers of cigarettes smoked.

Smoking can hamper the female reproductive system by presenting an array of fertility problems such as depleting the quality of egg cells by causing premature ageing and damage to lower levels of quality eggs hosted in the ovarian reserve. Not only does this upset your ovulation cycle, but it can also catalyse the onset of menopause ahead of the usual menopausal stage.

This premature ageing of the ovaries and decrease in eggs may lead to earlier menopause.

Menopause occurs one to four years earlier in smoking women than in non-smokers.

Smoking can also impair the fallopian tubes, hampering conception. Blemished tubes may increase the chances of an ectopic pregnancy, a condition where the foetus begins to develop outside the uterus. They can also lead to pre-term labour, intrauterine growth restriction, pre-eclampsia, intrauterine foetal death and antepartum bleeding.

Increased risk of miscarriage.

Cervical changes lead to an increased risk of developing cervical cancer.

Toxins like nicotine, cyanide, and carbon monoxide in cigarettes may lead to DNA damage of the ovarian follicles, which contain the eggs.

Hormonal abnormalities are also seen in women who smoke. Mean basal FSH levels are significantly higher in young smokers than in non-smokers.

Female smokers need more ovarian-stimulating medications during IVF and still have fewer eggs at retrieval time and have 30% lower pregnancy rates compared with IVF patients who do not smoke.

Smoking during pregnancy

Smoking during pregnancy is associated with miscarriage, birth defects, low birth weight, and premature birth. A study found that babies of smokers were more likely to have two or more congenital (birth) defects when compared to the babies of non-smokers. Smokeless tobacco also leads to increased miscarriage rates. Women exposed to passive smoking also suffer all the above health risks. Children whose parents smoke are at increased risk for sudden infant death syndrome (SIDS) and for developing asthma.

Male smokers, beware!

Male smokers can suffer from decreased sperm quality, low sperm count (numbers of sperm) and motility (sperm’s ability to move) and increased numbers of abnormally shaped (poor morphology) sperm. Smoking may also lead to sexual incompetence due to the thinning of penile blood vessels.

(The author is a consultant obstetrician & gynaecologist and fertility specialist.)