World No Tobacco Day 2023: Here's How Smoking Affects Women's Reproductive Health And Pregnancy

Tobacco consumption can lead to life-threatening consequences for smokers as well as those exposed to second-hand smoke. It can negatively affect lungs, heart, throat and neck, causing cancerous tumours, cardiovascular diseases, diabetes, and chronic obstructive pulmonary disease (COPD). Moreover, smoking can also adversely impact one's reproductive function. In women, both active and passive smoking can have detrimental effects on reproductive organs and their function. This can result in various conditions related to ovaries, affecting their fertility, as well as the progress and outcome of pregnancies. This World No Tobacco Day, let's understand the impact of smoking on one's ovaries and pregnancy.

The negative impact of smoking on female reproductive health

Impact on Ovaries

To understand how smoking compromises ovarian function, we need to consider the following factors:

• Hormonal imbalance: In the human body, the release of one hormone is regulated by secretion of another hormone. Chemicals in found in tobacco products such as cigarettes disrupt the function of glands responsible for reproductive hormones; this includes the thyroid, hypothalamus, pituitary, and adrenal glands. This disruption increases the levels of stress hormone called cortisol and the male hormone, testosterone, in females; spike in cortisol and testosterone have been linked to female infertility. Additionally, hormones such as oestrogen, progesterone, Anti-Mullerian Hormone (AMH), and prolactin decrease in quantity, negatively impacting fertility.
• Ovarian and menstrual conditions: Hormonal imbalance caused by smoking is widely known to contribute to ovarian and menstrual cycle disorders. For example, elevated testosterone levels in females are associated with polycystic ovary syndrome (PCOS), characterised by irregular ovulation and menstruation, making natural conception challenging. Low levels of oestrogen and progesterone also lead to irregular menstrual cycles.

Furthermore, decreased Anti-Mullerian Hormone (AMH) indicates a limited number of good quality eggs available for conception, as smoking damages the genetic composition of gametes.

• Menopause: Menopause refers to the complete cessation of the menstrual cycle, typically occurring in late 40s to 50s in females. It signifies the depletion of eggs available for ovulation. Smoking accelerates the rate at which eggs in the ovaries are damaged, diminishing their numbers and causing early menopause. After menopause, natural pregnancy is not possible.

Impact on Pregnancy

Smoking affects both the initial stages of conceiving a baby and the progression of pregnancy.

• Pregnancy complications: Female smokers have a higher risk of ectopic pregnancies (implantation of the embryo outside the uterus), spontaneous abortion, and miscarriage.
• Foetal development: The carbon monoxide produced when smoking is known to pose harm to the central nervous system (CNS). Additionally, it hinders the development of the foetus in the uterus, resulting in restricted growth and a higher likelihood of premature birth. Moreover, smoking during pregnancy can cause damage to the lungs and brain tissues.
• Genetic anomalies and birth defects: The negative impact of smoking on egg quality can result in fertilised eggs with genetic abnormalities such as Down's Syndrome, Turner Syndrome, and Klinefelter Syndrome. Female smokers are also more likely to give birth to children with cleft lip and/or cleft palate.
• Complications after birth: Children born to female smokers often have low birth weights, even when carried to full term. They are also at a higher risk of developing health complications and disabilities as they grow, including obesity, diabetes, asthma, and cardiovascular diseases.

It is crucial for women to limit or quit tobacco use, taking into consideration their own well-being and the potential health of their future children. To assist in the quitting process, temporary replacements such as nicotine gum, patches, or prescribed medications can be utilised. These measures not only enhance female reproductive health but also help preserve undamaged eggs for natural conception. However, in certain cases, achieving a natural pregnancy may prove challenging. Assisted Reproductive Technology (ART) methods, including in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), can be employed to overcome these difficulties. It is important to note that the damage caused by tobacco to a person's overall health can impact the success of such procedures.

(Dr Kshitiz Murdia, is a gynaecologist and CEO & Co-Founder, Indira IVF)

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