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Anyone who has experienced fertility issues knows that there’s no shortage of factors that can affect this complex process, including hormones, anatomy, family history, and underlying medical conditions. But what about things you may be exposed to every day, like cigarette smoke? Does smoking affect sperm? And can secondhand smoke affect fertility? Read on to find out.
Does smoking affect male fertility?
Yes, smoking can decrease male fertility. It has a negative effect on sperm quality, affects erectile function, and even passively impacts fertility in partners with ovaries. Let’s take a closer look at how smoking affects each factor individually.
Smoking and sperm quality
Good quality semen and healthy sperm depend on several parameters, including sperm count (total number of sperm), sperm motility (forward movement of sperm towards an egg), and sperm morphology (sperm shape).
A 2016 meta-analysis on the effects of smoking on fertility found that smoking and tobacco exposure can decrease sperm counts and impair both motility and morphology (Sharma, 2016; Beal, 2017). This may make it less likely that sperm will be able to reach an egg and fertilize it.
Smoking also leads to a scenario called oxidative stress. Oxidative stress means that your body has too many harmful molecules called free radicals. This damages sperm’s genetic material (DNA damage) so that they don’t function normally, potentially reducing the likelihood of fertilization (Jenkins, 2017; Harlev, 2015).
Smoking and erections
Smoking is also linked to the inability to achieve or maintain an erection for satisfying sex (erectile dysfunction, or ED). Any amount of tobacco exposure is a risk factor for ED, although heavy smoking has the most severe impact (Kovac, 2015).
Oxidative stress from smoking also exacerbates underlying health conditions like clogged arteries (atherosclerosis) and diabetes, which may worsen or contribute to ED.
Secondhand smoke and fertility
Smoking doesn’t just affect the fertility of the person who smokes. It can also affect your partner and others by exposing them to secondhand smoke. Studies show that exposure to secondhand smoke decreases egg production and impairs fertility (Nizard, 2005).
Male fertility: supplements, foods, tests to take
Can you reverse the effects of smoking on fertility?
Decreased fertility from tobacco exposure doesn’t have to be permanent.
People who stop smoking may see improved erectile function within just six months (Kovac, 2015). And one study found that sperm counts and sperm motility increased just three months after its participants quit smoking (Prentki Santos, 2011).
An even more promising finding comes from another study in which researchers saw similar semen quality among non-smokers and people who quit smoking. This means that after you stop smoking, the quality of your sperm may significantly improve (Tang, 2019).
Does smoking affect treatments like IVF?
Besides increasing the risk of infertility, smoking also affects fertility treatment success rates.
Sperm from people who smoke before conception occurs are more likely to form poor-quality embryos (Hoek, 2020). What this means is that assisted reproductive techniques like IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection) may be less likely to work in people who smoke (Zitzmann, 2003).
Tips for quitting smoking
Your sperm quality may improve when you quit smoking, and your likelihood of conception or successful fertility treatments increases. But it’s not always easy to quit. Luckily, there are a few things you can do that may help make quitting easier.
It can be difficult to stop smoking on your own. But the good news is, you don’t have to—your healthcare provider is a good resource for advice and support. Therapy (behavioral counseling) is often a helpful step in the quitting process.
If you want to talk to people who have been through or are going through the same change, support groups are available in person and online. Or you may decide that your friends, family, and loved ones are the people you can lean on.
Replace the nicotine
Cigarettes contain an addictive substance called nicotine, often making it hard to kick the habit.
But there are ways to replace nicotine, like nicotine replacement patches or nicotine gum, that don’t include the other harmful substances found in cigarette smoke and can help you gradually decrease your nicotine dependence. Studies suggest that these treatments are safe and effective at helping people stop smoking, especially in the first six months of use (Schnoll, 2015).
What is in vitro fertilization (IVF)?
Take medication when needed
Sometimes, therapy and nicotine replacement don’t achieve your desired results. In this case, a healthcare provider may suggest medications. Commonly used medications for smoking cessation include an oral nicotine replacement drug called varenicline and a drug called bupropion (Wellbutrin; see Important Safety Information) that helps lessen nicotine withdrawal symptoms (Barua, 2018).
Other ways to boost male fertility
Besides quitting smoking, there are a number of different strategies that can positively impact fertility, including:
- Staying active: Staying physically active can improve semen quality and may promote higher sperm counts (Gaskins, 2013).
- Eating healthy foods: Eating a nutritious and balanced diet that includes a lot of vegetables and fruits is also linked to better semen parameters (Zampieri, 2008).
- Drinking less alcohol: Having a drink now and then isn’t typically bad for fertility, but excessive drinking can worsen semen quality and decrease fertility (Finelli, 2021).
- Losing weight (when indicated): Reducing excess weight may improve semen quality and fertility, though the data is inconclusive (Håkonsen, 2011).
- Moving your cell phone: Cell phones emit radiation that can damage some sperm functions, so it’s best to keep your phone out of your pocket and away from your groin (Hassanzadeh-Taheri, 2022).
- Taking care of your health: Underlying medical conditions like high blood pressure and diabetes may decrease fertility, so treating these issues may improve your fertility.
Exercise, weight, and fertility: what’s the connection?
It’s not easy to stop smoking, but doing so may improve your reproductive health. If you have questions about quitting smoking, consult your healthcare provider. They can help you figure out the best steps to take to stop smoking once and for all.
- Barua, R. S., Rigotti, N. A., Benowitz, N. L., et al. (2018). 2018 ACC Expert Consensus Decision Pathway on Tobacco Cessation Treatment: A Report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. Journal of the American College of Cardiology, 72(25), 3332–3365. doi:10.1016/j.jacc.2018.10.027. Retrieved from https://www.sciencedirect.com/science/article/pii/S0735109718388594?via%3Dihub
- Beal, M. A., Yauk, C. L., & Marchetti, F. (2017). From sperm to offspring: Assessing the heritable genetic consequences of paternal smoking and potential public health impacts. Mutation Research. Reviews in Mutation Research, 773, 26–50. doi:10.1016/j.mrrev.2017.04.001. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28927533/
- Finelli, R., Mottola, F., & Agarwal, A. (2021). Impact of alcohol consumption on male fertility potential: A narrative review. International Journal of Environmental Research and Public Health, 19(1), 328. doi:10.3390/ijerph19010328. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751073/
- Gaskins, A., Mendiola, J., Afeiche, M., et al. (2013). Physical activity and television watching in relation to semen quality in young men. British Journal of Sports Medicine, 49(4), 265–270. doi:10.1136/bjsports-2021-091644. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868632/
- Håkonsen, L. B., Thulstrup, A. M., Aggerholm, A. S., et al. (2011). Does weight loss improve semen quality and reproductive hormones? Results from a cohort of severely obese men. Reproductive Health, 8, 24. doi:10.1186/1742-4755-8-24. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177768/
- Harlev A., Agarwal A., Gunes S. O., et al. (2015). Smoking and Male Infertility: An Evidence-Based Review. World Journal of Men’s Health, 33(3), 143-60. doi:10.5534/wjmh.2015.33.3.143. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709430/
- Hassanzadeh-Taheri, M., Khalili, M. A., Hosseininejad Mohebati, A., et al. (2022). The detrimental effect of cell phone radiation on sperm biological characteristics in normozoospermic. Andrologia, 54(1), e14257. doi:10.1111/and.14257. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34628682/
- Hoek, J., Schoenmakers, S., Baart, E. B., et al. (2020). Preconceptional Maternal Vegetable Intake and Paternal Smoking Are Associated with Pre-implantation Embryo Quality. Reproductive Sciences (Thousand Oaks, Calif.), 27(11), 2018–2028. doi:10.1007/s43032-020-00220-8. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522074/
- Jenkins, T. G., James, E. R., Alonso, D. F., et al. (2017). Cigarette smoking significantly alters sperm DNA methylation patterns. Andrology, 5(6), 1089–1099. doi:10.1111/andr.12416. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679018/
- Kovac, J. R., Labbate, C., Ramasamy, R., et al. (2015). Effects of cigarette smoking on erectile dysfunction. Andrologia, 47(10), 1087–1092. doi:10.1111/and.12393. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/
- Nizard, J. (2005). [What are the epidemiological data on maternal and paternal smoking?]. Journal of Gynecology, Obstetrics, and Human Production, 34(Spec No 1): 3S347-3S352. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15980810/
- Prentki Santos, E., López-Costa, S., Chenlo, P., et al. (2011). Impact of spontaneous smoking cessation on sperm quality: case report. Andrologia, 43(6), 431–435. doi:10.1111/j.1439-0272.2010.01089.x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21486415/
- Sharma, R., Harlev, A., Agarwal, A., et al. (2016). Cigarette Smoking and Semen Quality: A New Meta-analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. European Urology, 70(4), 635–645. doi: 10.1016/j.eururo.2016.04.010. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27113031/
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- Tang, Q., Pan, F., Wu, X., et al. (2019). Semen quality and cigarette smoking in a cohort of healthy fertile men. Environmental Epidemiology, 3(4), e055. doi:10.1097/EE9.0000000000000055. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693933/
- Zampieri, N., Zamboni, C., Ottolenghi, A., et al. (2008). The role of lifestyle changing to improve the semen quality in patients with varicocele. Minerva Urologica e Nefrologica = The Italian Journal of Urology and Nephrology, 60(4), 199–204.Retrieved from https://pubmed.ncbi.nlm.nih.gov/18923357/
- Zitzmann, M., Rolf, C., Nordhoff, V., et al. (2003). Male smokers have a decreased success rate for in vitro fertilization and intracytoplasmic sperm injection. Fertility and Sterility, 79(3), 1550–1554. doi:10.1016/s0015-0282(03)00339-x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12801558/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.