Smoking and Clinical Outcomes of Assisted Reproductive Technologies

Details

• Alternative Title:
  J Womens Health (Larchmt)
• Personal Author:
  Rockhill, Karilynn ; Tong, Van T. ; Boulet, Sheree L. ; Zhang, Yujia ; Jamieson, Denise J. ; Kissin, Dmitry M.
• Description:
  Background:
  
  Smoking near conception has adverse effects on pregnancy outcomes. We estimated the proportion of assisted reproductive technology (ART) cycles with smoking reported and associated clinical outcomes.
  
  Methods:
  
  We used a retrospective cohort study (2009–2013) using national data of ART cycles in the United States. We compared patient characteristics, infertility diagnoses, and treatment procedures by self-reported smoking in the 3 months before treatment. Using multivariable logistic regression accounting for clustering by state, clinic, and patient, we assessed adjusted odds ratios (aOR) and 95% confidence intervals (CI) between smoking and clinical outcomes: cycle cancellations among all cycles (cycle stopped before retrieval of eggs or transfer of embryos), treatment outcomes (implantation, ectopic pregnancy, intrauterine pregnancy, and live birth) among cycles with ≥1 fresh embryo transferred, and pregnancy outcomes (miscarriage, stillbirth, and live birth) among intrauterine pregnancies.
  
  Results:
  
  Smoking was reported in 1.9% of cycles. Higher proportions of cycles among smokers versus non-smokers were younger, non-Hispanic White, multigravida women and had tubal factor and male factor infertility diagnoses; lower proportions had diagnoses of diminished ovarian reserve and unexplained infertility, and used donor eggs. Smoking was associated with higher adjusted odds of cycle cancellation with no embryo transfer (aOR: 1.10; 95% CI: 1.00–1.21) and cancellations before fresh oocyte retrieval or frozen embryo transfer (1.11; 1.02–1.21). Associations between other clinical outcomes were nonsignificant.
  
  Conclusions:
  
  Over 12,000 ART cycles in the United States were exposed to smoking during 2009–2013; smoking increased the odds of cycle cancellation. Providers should encourage women to quit smoking before ART treatments.
  
  
• Keywords:
  Adult Assisted Reproductive Technologies Cigarette Smoking Cohort Studies Cycle Cancellations Female Humans Infertility Odds Ratio Pregnancy Pregnancy Outcome Pregnancy Outcomes Reproductive Techniques, Assisted Retrospective Studies Smoking Treatment Outcome

  More +
• Source:
  J Womens Health (Larchmt). 28(3):314-322
• Pubmed ID:
  30615563
• Pubmed Central ID:
  PMC6420368
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  28
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:21e3a0b35812f9405618b39a3bd5bf04fd2475e1cc5599ab6eccc7905e40fe1616b64fad3996caaae6b38e123d33f4551ee12ef55f7f47b3a4f5b046829f6c35
• Download URL:
  https://stacks.cdc.gov/view/cdc/76949/cdc_76949_DS1.pdf
• File Type:
  [PDF - 472.48 KB ]