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. 2022 Dec 13;17(12):e0278998.
doi: 10.1371/journal.pone.0278998. eCollection 2022.

Association between cigarette smoking and ovarian reserve among women seeking fertility care

Islamiat Oladipupo  1 , T'shura Ali  1 , David W Hein  2 , Kelly Pagidas  3 , Henry Bohler  3 , Mark A Doll  2 , Merry Lynn Mann  3 , Adrienne Gentry  3 , Jasmine L Chiang  3 , Rebecca C Pierson  3 , Sashia Torres  1 , Emily Reece  1 , Kira C Taylor  1
Affiliations

Association between cigarette smoking and ovarian reserve among women seeking fertility care

Islamiat Oladipupo et al. PLoS One. .

Abstract

Introduction: This study examined the association of smoking with ovarian reserve in a cross-sectional study of 207 women enrolled in the Louisville Tobacco Smoke Exposure, Genetic Susceptibility, and Infertility (LOUSSI) Study and assessed effect modification by NAT2 acetylator phenotype.

Methods: Information on current smoking status was collected using a structured questionnaire and confirmed by cotinine assay. Serum anti-Müllerian hormone (AMH) levels were used to assess ovarian reserve. Diminished ovarian reserve (DOR) was defined as AMH <1ng/mL. Single nucleotide polymorphisms in the NAT2 gene, which metabolizes toxins found in cigarette smoke, were analyzed to determine NAT2 acetylator status. Linear and logistic regression were used to determine the effects of smoking on ovarian reserve and evaluate effect modification by NAT2. Regression analyses were stratified by polycystic ovary syndrome (PCOS) status and adjusted for age.

Results: Current smoking status, either passive or active as measured by urinary cotinine assay, was not significantly associated with DOR. For dose-response assessed using self-report, the odds of DOR increased significantly for every additional cigarette currently smoked (Odds ratio, OR:1.08; 95% confidence interval, 95%CI:1.01-1.15); additionally, every 1 pack-year increase in lifetime exposure was associated with an increased odds of DOR among women without PCOS (OR: 1.08 95%CI: 0.99-1.18). These trends appear to be driven by the heavy or long-term smokers. Effect modification by NAT2 genotype was not established.

Conclusion: A history of heavy smoking may indicate increased risk of diminished ovarian reserve.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Population flow diagram.
See this image and copyright information in PMC

References

    1. Freour T, Masson D, Mirallie S, Jean M, Bach K, Dejoie T, et al.. Active smoking compromises IVF outcome and affects ovarian reserve. Reprod Biomed Online. 2008;16(1):96–102. doi: 10.1016/s1472-6483(10)60561-5 - DOI - PubMed
    1. Freour T, Masson D, Dessolle L, Allaoua D, Dejoie T, Mirallie S, et al.. Ovarian reserve and in vitro fertilization cycles outcome according to women smoking status and stimulation regimen. Archives of gynecology and obstetrics. 2012;285(4):1177–82. doi: 10.1007/s00404-011-2172-7 - DOI - PubMed
    1. El-Nemr A, Al-Shawaf T, Sabatini L, Wilson C, Lower AM, Grudzinskas JG. Effect of smoking on ovarian reserve and ovarian stimulation in in-vitro fertilization and embryo transfer. Hum Reprod. 1998;13(8):2192–8. doi: 10.1093/humrep/13.8.2192 - DOI - PubMed
    1. Radin RG, Hatch EE, Rothman KJ, Mikkelsen EM, Sorensen HT, Riis AH, et al.. Active and passive smoking and fecundability in Danish pregnancy planners. Fertil Steril. 2014;102(1):183–91.e2. doi: 10.1016/j.fertnstert.2014.03.018 - DOI - PMC - PubMed
    1. White AJ, Sandler DP, D’Aloisio AA, Stanczyk F, Whitworth KW, Baird DD, et al.. Antimullerian hormone in relation to tobacco and marijuana use and sources of indoor heating/cooking. Fertil Steril. 2016;106(3):723–30. - PMC - PubMed

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