WHO report links smoking to infertility, says quitting smoking can make a big difference

According to the latest report from the World Health Organization (WHO), tobacco use is associated with infertility in women, as well as poor sperm quality and sexual function in men. Women who quit smoking may have a 25% lower risk of infertility than those who continue to smoke, a report says.

The report provides evidence that tobacco use is associated with potentially lower odds of success for some fertility treatments. It said evidence on new products including e-cigarettes, hookahs and smokeless tobacco was still emerging, saying that while the evidence is strongest for cigarette smoking, other tobacco and nicotine products may also pose a risk to fertility and require further research.

Globally, one in six people of reproductive age will experience infertility at some point in their lives. Infertility is defined as the inability to become pregnant after 12 months or more of regular unprotected sex.

40% increased risk

The publication provides decades of evidence that smoking can harm women’s reproductive health. A systematic review of studies conducted between 2000 and 2026 found that women who currently smoke tobacco have a 40% higher risk of infertility compared to those who do not smoke.

The publication also notes that women who have smoked tobacco in the past but do not currently smoke may have a 25% lower risk of infertility compared with women who continue to smoke, suggesting that quitting tobacco may make a significant difference.

The WHO emphasized that infertility is not only a problem of women’s health. “A recent review of 44 studies involving more than 60,000 men found that smoking is associated with reproductive dysfunction, including sperm abnormalities and sexual dysfunction. Data indicates that men who smoke are more likely to suffer from erectile dysfunction, ejaculation problems and related problems such as lack of sperm in semen, poor sperm motility and abnormal sperm shape,” the report said.

Effect on treatment

For people undergoing fertility treatment, smoking tobacco may reduce the chances of success. The publication cited earlier findings from 21 studies showing that cigarette smoking is associated with fewer live births and fewer pregnancies after assisted reproductive technologies such as in vitro fertilization, with findings suggesting that cigarette smoking can reduce the chances of successful outcomes by about half.

WHO recommended that health professionals inform individuals and couples planning pregnancy about the reproductive risks associated with tobacco use and offer evidence-based support to help them quit smoking. It also recommended that brief smoking cessation advice be consistently provided to all tobacco users in all health care settings.