Fertility Challenges Causes & Concerns What You Need to Know About Smoking and Getting Pregnant How Smoking Hurts Fertility By Rachel Gurevich, RN facebook twitter linkedin Rachel Gurevich, RN, is a registered nurse, fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. Learn about our editorial process Rachel Gurevich, RN Medically reviewed by Medically reviewed by Anita Sadaty, MD on January 11, 2018 facebook linkedin Anita Sadaty, MD, is a board-certified obstetrician-gynecologist, resident instructor at Northwell Health, and founder of Redefining Health Medical. Learn about our Review Board Anita Sadaty, MD Updated on January 31, 2020 Print Photodisc/Photodisc/Getty Images Table of Contents View All Overview Dangers Fertility Issues Impact on Your Biological Clock Birth Defect Risks It's no secret that smoking is detrimental to your health, so it should be no surprise that smoking can affect your fertility. However, for many women, it apparently is surprising. One survey of women of childbearing age found that only about 30% knew that smoking could increase their risk of miscarriage. Even fewer (about 10%) knew that smoking could hurt their fertility. Overview Smoking has been linked to an increased risk for many cancers, heart disease, emphysema, and a number of other health problems. The toxins contained in cigarettes take their toll not only on your lungs but on your entire body's health, including your reproductive system. Smoking habits may be responsible for fertility struggles in as many as 13 percent of couples. Dangers Because smoking can harm a child prenatally, it's a good idea to quit smoking before you even consider pregnancy. That being said, if you decide not to quit smoking before you start trying to conceive, you may have trouble getting and staying pregnant in the first place. How much do you need to smoke to have a measurable impact on your fertility? According to a 2017 study on the subject, six or more cigarettes per day will significantly harm your ability to conceive. This doesn't mean smoking fewer cigarettes per day would not lead to lowered fertility. But it is clear that smoking six or more a day increases your risk of developing problems. Other studies have shown that for each cigarette smoked per day, the longer it will take for the couple to get pregnant. For example, a woman who smokes four cigarettes per day will on average take more time to get pregnant than a woman who smokes just two per day. If quitting completely does not seem to be in the cards for you, cutting back is still worth trying for. What Is Fertility? Fertility Issues Smoking is associated with the following fertility problems: Problems with the fallopian tubes, including blockages (preventing egg and sperm from meeting) and an increased risk of ectopic pregnancyDamage to the eggs as they develop in the ovariesIncreased risk of miscarriage, possibly due to damaged eggs, damage to the developing fetus, or unfavorable changes in the uterine lining, which may make healthy implantation of an embryo less likelyCervical changes, specifically an increased risk of developing cervical cancer It's important to point out that not all of these issues are directly caused by smoking. They may be associated with each other. Practicing unsafe sex can also increase the risk of pelvic infection and blocked fallopian tubes, for example. However, in the case of damage to the eggs in the ovaries, this is likely a direct cause of smoking. Impact on Your Biological Clock Some studies have shown that smoking can cause not only problems with fertility while you're smoking, but lead to lowered fertility in the future. Men produce new sperm throughout their lives, but women are born with all the eggs they will ever have. Once those eggs are damaged, there's no going back. Smoking may decrease the total number of eggs a woman has in her ovaries and cause the ovaries to age prematurely. Toxins in cigarettes may also lead to DNA damage to the ovarian follicles, where the eggs normally develop to maturity. This premature aging of the ovaries and decrease in eggs may lead to earlier menopause, as much as four years earlier than normal. Birth Defect Risks Smoking during pregnancy is associated with miscarriage, low birth weight, and premature birth. Another important reason to quit smoking before you conceive is to reduce your risk of birth defects. Because many birth defects occur very early in pregnancy—sometimes before a woman even realizes she has conceived—waiting until you get pregnant is not enough to reduce the risk of harm to your unborn child. A large systematic review on smoking and birth defects—which included 11.7 million controls and just over 170,000 children with congenital defects—found that smoking during pregnancy increased the risk of: Heart and cardiovascular defectsLimb defects (where an arm or leg fails to grow fully or is completely missing)Missing (or extra) fingers or toesClubfootCleft lip or palateSkull malformationsFacial and eye deformationsHerniaGastrointestinal defectsAnal defectsUndescended testes The study also found that babies of smokers were more likely to have two or more congenital defects when compared to the babies of non-smokers. A Word From Verywell Don't feel that there's no turning back after years of cigarette smoking. While smoking can lead to some long-term fertility damage, studies have also shown that fertility rates can improve after one year of quitting. Some women may be tempted to keep smoking until they get pregnant. However, it's best for you and your future baby if you quit before you achieve pregnancy. Quitting smoking before you even start trying to get pregnant may: improve your chances of conceivingbe easier on your bodyhealthier for your babylower the risk of miscarrying the pregnancylower the risk of birth defects for your baby If your partner is also a smoker, consider quitting together. There are many good reasons to do so. His secondhand smoke may lower your fertility and threaten your pregnancy, and some studies have found that smoking lowers male fertility as well. This is not to mention the health problems that can arise in babies and children who are exposed to secondhand smoke. Dropping the habit together will increase your chances of successfully quitting, too. Was this page helpful? Thanks for your feedback! Get diet and wellness tips to help your kids stay healthy and happy. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Polen KN, Sandhu PK, Honein MA, et al. Knowledge and attitudes of adults towards smoking in pregnancy: results from the HealthStyles© 2008 survey. Matern Child Health J. 2015;19(1):144-54. doi:10.1007/s10995-014-1505-0 Practice Committee of the American Society for Reproductive Medicine. Smoking and infertility: a committee opinion. Fertil Steril. 2012;98(6):1400-6. doi:10.1016/j.fertnstert.2012.07.1146 Sarokhani M, Veisani Y, Mohamadi A et al. Association between cigarette smoking behavior and infertility in women: a case-control study. Biomed Res Ther. 2017;4(10):1705-1715. doi:10.15419/bmrat.v4i10.376 Sugawara Y, Tsuji I, Mizoue T, et al. Cigarette smoking and cervical cancer risk: an evaluation based on a systematic review and meta-analysis among Japanese women. Jpn J Clin Oncol. 2019;49(1):77-86. doi:10.1093/jjco/hyy158 Hackshaw A, Rodeck C, Boniface S. Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update. 2011;17(5):589-604. doi:10.1093/humupd/dmr022