By Rut Gómez de Segura (Gynaecologist – Reg. No. 28/2908776).
Smoking, beyond being a harmful habit, is a chronic and addictive disease recognized by the World Health Organization (WHO) as a mental and behavioral disorder. This addiction not only affects a person’s overall health but also has devastating effects on the reproductive capacity of both men and women.
The WHO classifies smoking as a disease because of its addictive nature and the serious health consequences it entails. In fact, tobacco consumption is responsible for multiple diseases, including lung cancer, cardiovascular and respiratory disorders. In Spain, it is estimated that smoking causes around 50,000 deaths every year.
“Among the problems caused by smoking, we must keep in mind that it can negatively affect both female and male fertility in different ways,” explains Dr. Rut Gómez de Segura, assisted reproduction specialist at IVF-Life Madrid.
In women, smoking can interfere with the production of estrogens — hormones essential for ovulation and preparing the uterus for pregnancy — and can also reduce the quantity and quality of eggs. This effect occurs whether the exposure to tobacco smoke is active or passive. In this regard, female smokers are up to 60% more likely to develop fertility problems compared to non-smokers.
In men, smoking can lead to a decrease in sperm concentration, motility, and normal morphology, thus affecting their ability to fertilize the egg. Moreover, excessive tobacco use may cause azoospermia, a condition characterized by the absence of sperm in semen.
“The best way to prevent the negative effects of smoking on our fertility is, obviously, to quit smoking. Awareness of its effects and the adoption of preventive measures are essential for protecting reproductive health,” says Dr. Gómez.
However, quitting smoking is not always easy or even possible, and sometimes the damage may already be irreversible. In such cases, assisted reproduction techniques may be necessary to achieve pregnancy. These include the cryopreservation of eggs and sperm to preserve gametes in patients who wish to postpone motherhood or fatherhood, as well as in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI), which enables the selection of the best sperm cells to fertilize the egg and create embryos with higher implantation potential.
In addition, advanced sperm selection techniques are available to identify and use sperm with lower levels of DNA fragmentation before performing ICSI (intracytoplasmic sperm injection). These methods can increase fertilization success rates and improve embryo quality, proving particularly useful in cases where smoking has affected the integrity of sperm genetic material.
Rut Gómez de Segura, reproductive medicine specialist at IVF-Life Madrid
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