Monday 7 November 2011

Cigarette Smoking and Infertility

Despite the mandatory statutory warning of ‘Cigarette smoking is injurious to health’, more and more young women are now picking up smoking, throwing all caution to the winds. The reasons for the increase in this fad are many, including peer pressure, desire to appear ‘cool’ and the like. Most women, since their childhood have known that smoking leads to lung cancer. This is very true but there is more news to follow for women who are planning to start a family, for it is very well known that smoking causes infertility, that is difficulty in conceiving and having children, in a high percentage of women.

After the age of the woman, the second most important factor in determining a woman’s reproductive potential is whether she smokes or not.

Smoking affects fertility in many ways. Cigarette smoke contains more than 2500 chemicals. Most of these components have not been evaluated for their effects on health. Two of the major components that are responsible for adverse effects of cigarette smoke are nicotine and carbon monoxide. In a well-designed study published in Archives of Environmental Health, out of 24,000 women, the frequency of abnormal ovulation and abnormal bleeding was found to be 67% higher in women who were smokers than in non-smokers. A woman ovulates once a month, and normally produces one egg only. If eggs do not form, pregnancy automatically does not happen.

Nicotine also alters tubal motility. Each egg, once produced by the ovary has to be conveyed by the fallopian tubes from the ovary to the uterus. If the tubes do not function properly, the egg gets delayed in its journey towards the uterus, does not meet the sperm at the right time and pregnancy does not happen. If the fallopian tubes are working at suboptimal levels, sometimes fertilization does happen but the embryo does not reach the uterus in time for implantation but gets implanted in the tube itself, what is called an ectopic pregnancy. This situation is a virtual time bomb because as the pregnancy grows, it might rupture the tube leading to excessive bleeding and even death. Women who have been smoking at the time they conceived the child have twice the risk of having an ectopic pregnancy versus non-smoking women.

Even if a woman who smokes does get pregnant, the risk of having a miscarriage is four times higher than in normal women. Smoking is the most important preventable cause of abortion. Not so many women were smoking in the yesteryears, it was mainly very high society women, or very low class laborers who indulged in smoking ‘bidis’. Now the trend of smoking has become very common in young girls. What is worse, most women do not come out in the open about their smoking habits leading to risks in pregnancy like low birth weight of the baby and even sudden death of the baby in the womb of the mother due to a condition called ‘abruptio placentae’. ’

Babies, after birth are at higher risk of ‘Cot Death” or ‘Sudden Infant Death Syndrome’ in which a baby, apparently healthy goes off to sleep one night and does not wake up again. After a lot of research in leading hospitals all over the world, it was determined that babies at risk for cot death were male and whose mothers had smoked during pregnancy.

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