Is smoking really that bad for my fertility?

By Charmaine Dennis, Naturopath.

The hard facts about the effects of smoking on your fertility might be difficult to hear. If you are a smoker your brain will have been rewired to demand the reward that nicotine gives. Over time, this becomes a powerful force that is very difficult to resist. Research indicates that simply stopping is merely abstaining from addiction and the real key to recovery is to replace the addiction with a fulfilling life that includes:

1. The right balance of support from home and community
2. Motivation from purpose and a desire to be healthy

If you are trying to conceive you may already be thinking about quitting cigarettes and you may well have that sense of purpose, that desire to be healthy and that support from home and community already on your side. Either way we hope to inspire you and arm you with knowledge on how to prepare for successful smoking cessation. Your future baby will thank you!

Are you ready? Here are the hard facts…

Female smokers: ^1-4

• Take longer to conceive
• Are twice as likely as non-smokers to be infertile (60% increased risk of infertility)
• Have an increased risk of miscarriage and ectopic pregnancy (with the risk increasing with each cigarette smoked: there is a 1% increase in risk per cigarette smoked per day)
• Are more likely to suffer implantation failure in IVF and poorer embryo quality
• During pregnancy are more likely to develop complications such as birth defects, low birth weight, placenta praevia, placental abruption, premature labour and eclampsia (a life-threatening pregnancy condition)
• Will reach menopause ~ 2 years earlier (or for passive smokers: 1 year early); not ideal when you are trying to conceive!
• Increase the DNA (genetic) damage in the egg

Interesting fact: smoking is associated with a thicker zona pellucida (the outer shell of the egg).⁵ This is the outer layer that the sperm must penetrate in order to fertilise the egg and thus the thicker it is the more difficulty the sperm will have, thus making it less likely that conception will occur. It is the same impact for active and passive smoking.

Male smokers are more likely to have;

• Impotence and erectile dysfunction (not helpful when you are trying to conceive!)⁵
• Poorer sperm health (on all semen parameters including numbers, motility and morphology)⁶
• Increased DNA (genetic) damage in the sperm⁷

We also know that even if a woman doesn’t smoke but her male partner or sperm donor does, she is much less likely to conceive naturally or with IVF, and is more likely to miscarry.^8-10 Passive smoking or exposure to second hand smoke (work or home) has also been shown to increase the risk of miscarriage, stillbirth and ectopic pregnancy (i.e. passive smoking is only slightly less harmful than active smoking).^{9, 1}

If you do manage to beat the odds and conceive, if either parent is a smoker at the time of conception, it is likely to substantially affect the health and wellbeing of your baby with increased risk of;

• Small babies (and all the associated health complications)¹¹
• Asthma, decreased lung function¹²
• SIDS¹³
• Birth defects (e.g. cleft lip and/or palate)¹⁴
• Leukaemia and cancer later in life^{15, 1}
• An increased risk of neurological and behavioural issues e.g. attention deficit disorders, impulsivitiy, etc.¹⁶
• Increased risk of smoking as an adult (double the risk)¹⁷
• Increased risk of most psychiatric disorders during adulthood¹⁸
• For female babies; smoking impacts the development of their ovaries ¹

It is good to know that most of the effects of smoking on your fertility will be reversed one year after quitting and you will experience improvement every week that goes by without a cigarette. The effects of passive smoking are not much different to actively smoking yourself so it is a good idea to remove yourself from any smoky environments and encourage your smoking partner to quit. The benefits to fertility start immediately.¹

 Do I have to give up completely or is the occasional cigarette ok?

To achieve the best impact on your fertility you do need to quit completely.¹⁹ Having the occasional one or two cigarettes often leads to an increase in cravings and stronger withdrawal symptoms and makes it more difficult to quit entirely. Also, as mentioned previously, the risk of miscarriage and/or ectopic pregnancy increases with every single cigarette you smoke. If you also consider the harmful chemicals entering your body with each cigarette you smoke (lead, cyanide, nicotine etc.) and the impact this has in reducing the oxygen supply to the eggs and sperm, then the sooner this exposure is ceased the better all round.

I know I have to quit but I’m struggling

Having said all of that, if you are a smoker, giving up is not easy! It is certainly much easier if you know why you are doing it and you have a goal to achieve – a healthy happy bubba.

What will support your intention to give up the smokes for good?

Helpful hints to give up those cigarettes for good

1. WHEN – Identify when you are likely to have a cigarette or feel like a cigarette
2. WHY – Consider why you feel like smoking at those times
3. HOW – Think about how you can avoid those scenarios/situations or put in place alternative options. How can you distract yourself from the moment of smoking and then replace smoking with an alternative positive action: glass of water, a walk, anything but a cigarette.
4. WHAT – what will you replace it with that provides a sense of purpose and fulfilment to motivate you? What will motivate you to be healthy? Could it be a new hobby or passion, hanging out with non-smoker friends, exercise, dancing, the thought of making your child?…

For example, if you only tend to smoke when you drink alcohol, then avoiding the alcohol is a good start. Or if you know that you smoke when you are stressed, focusing on stress management techniques and treatment will help make it easier.  If it is certain people or situations that weaken your will power, it might be good to avoid them for a while until you get the cravings under control and can easily say no.

We had one patient who realised that she only really smoked to escape from work. Having a cigarette break was a way for her to get out of the office and away from a job she hated. After making this realisation she began looking for another job and fortunately was lucky to find one that she enjoyed relatively quickly. She had stopped smoking for good by the end of the first week at her new job.

However, not everyone will find quitting smoking as easy as finding a new job (and looking for a new job isn’t necessarily easy either). If you are struggling to give up then go to the experts. Good and proven options for support in quitting smoking include:

• Quit Line
• Acupuncture
• Naturopathy
• Hypnotherapy
• Nutrition
• Counselling
• Along with a useful website, Quit Line also has a free app (MyQuitBuddy) you can download that helps support you in your journey towards a smoke-free life.²⁰ You can program the app so that it sends you alerts during your “danger times” that remind you of why you need to quit.  It also helps you set realistic goals as well as gain support from others. It can be a useful addition to your quit smoking program.

Charmaine Dennis is a naturopath, fertility and health expert, mentor, writer, mother, and businesswoman. She is the founding director of Fertile Ground Health Group, co- creator of the Be Fertile relaxation CD series and co-author of The Breakfast Project, among other health inspired projects. Her greatest gift and inspiration is making health, wellbeing, and passionate living accessible, inspiring and achievable for everyone.