Associations of Hookah and Cigarette Smoking With In Vitro Fertilization Outcomes: A Cross-Sectional Study.
4 affiliations
- 1Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- 2Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
- 3Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- 4Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
Objective
The global prevalence of smoking among women of reproductive age is significant, and the impact of tobacco on assisted reproductive technologies requires evaluation. This study aimed to determine the association between cigarette or hookah smoking with in vitro fertilization (IVF) outcomes.Materials and methods
In this cross-sectional study, we enrolled 200 women undergoing their first IVF cycle at Arash Infertility Center (Tehran, Iran). Ovarian response, oocyte maturity (Metaphase I (MI) and II (MII), embryo quality, and pregnancy outcomes were compared between cigarette smokers and non-smokers, as well as between hookah users and non-users.Results
Among the 200 participants, cigarette smokers (n=100) had significantly fewer mature (MII) oocytes than non-smokers (6.72±2.90 vs. 8.63±6.20; P = 0.036). Hookah users (n=100) did not show a significant decrease in the number of MII oocytes compared to non-smokers (8.06±5.81 vs. 8.73±6.12; P = 0.512). There were no significant differences in MI oocytes, embryos obtained, embryo quality, or chemical and clinical pregnancy rates between cigarette smokers and non-smokers. Hookah users had more MI oocytes compared to non-users (7.88±5.63 vs. 6.05±4.44; P = 0.010). The chemical pregnancy rate was higher in the hookah-user group than in non-users (P = 0.036). Logistic regression analysis showed no link between cigarette smoking, hookah smoking, age, or BMI and pregnancy rates.Conclusion
Cigarette smoking may impair oocyte maturation, while hookah use showed inconsistent associations with IVF outcomes. These findings should be interpreted cautiously due to the limited sample size and cross-sectional design.
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BibTeX
@article{moini2026associations,
title = {{Associations of Hookah and Cigarette Smoking With In Vitro Fertilization Outcomes: A Cross-Sectional Study.}},
author = {Ashraf Moini and Sonia Eskandarion and Atiye Heidaridalfard and Siamand Mazhar and Rana Karimi},
journal = {Journal of family \& reproductive health},
year = {2026},
month = jun,
doi = {10.18502/jfrh.v20i2.22613},
url = {https://europepmc.org/article/MED/42924314},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Associations of Hookah and Cigarette Smoking With In Vitro Fertilization Outcomes: A Cross-Sectional Study.
AU - Ashraf Moini
AU - Sonia Eskandarion
AU - Atiye Heidaridalfard
AU - Siamand Mazhar
AU - Rana Karimi
PY - 2026
DA - 2026/06/01
JO - Journal of family & reproductive health
DO - 10.18502/jfrh.v20i2.22613
UR - https://europepmc.org/article/MED/42924314
AB - Objective The global prevalence of smoking among women of reproductive age is significant, and the impact of tobacco on assisted reproductive technologies requires evaluation. This study aimed to determine the association between cigarette or hookah smoking with in vitro fertilization (IVF) outcomes.Materials and methods In this cross-sectional study, we enrolled 200 women undergoing their first IVF cycle at Arash Infertility Center (Tehran, Iran). Ovarian response, oocyte maturity (Metaphase I (MI) and II (MII), embryo quality, and pregnancy outcomes were compared between cigarette smokers and non-smokers, as well as between hookah users and non-users.Results Among the 200 participants, cigarette smokers (n=100) had significantly fewer mature (MII) oocytes than non-smokers (6.72±2.90 vs. 8.63±6.20; P = 0.036). Hookah users (n=100) did not show a significant decrease in the number of MII oocytes compared to non-smokers (8.06±5.81 vs. 8.73±6.12; P = 0.512). There were no significant differences in MI oocytes, embryos obtained, embryo quality, or chemical and clinical pregnancy rates between cigarette smokers and non-smokers. Hookah users had more MI oocytes compared to non-users (7.88±5.63 vs. 6.05±4.44; P = 0.010). The chemical pregnancy rate was higher in the hookah-user group than in non-users (P = 0.036). Logistic regression analysis showed no link between cigarette smoking, hookah smoking, age, or BMI and pregnancy rates.Conclusion Cigarette smoking may impair oocyte maturation, while hookah use showed inconsistent associations with IVF outcomes. These findings should be interpreted cautiously due to the limited sample size and cross-sectional design.
SN - 1735-8949
SN - 1735-9392
ER -