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Authors:
Augood C. Duckitt K. Templeton AA.
Institution:
C. Augood, Clinical Guidelines, Royal Coll. Obstetricians Gynaecol., 27
Sussex Place, London NW1 4RG; United Kingdom.
Title:
Smoking and female infertility: A systematic review and meta-analysis (1998-2163).
Source:
Human Reproduction. Vol 13(6) (pp532-1539), 1998.
Abstract:
The high prevalence ofsmoking among women in their reproductive years continues to be a matter of concern. The negative effects ofsmoking on general health are well known, butsmoking may also affect fertility. The objective of the present study was to perform a systematic review of the literature to determine whether there is an association betweensmoking and risk ofinfertility in women of reproductive age, and to assess the size of this effect. In the 12 studies used for this meta-analysis, the overall value of the odds ratio (OR) for risk ofinfertility in women smokers versus non-smokers was 1.60 [95% confidence interval (CI) 1.34-1.91]. Studies of subfertile women undergoing in-vitro fertilization (IVF) treatment also show a reduction in fecundity among women smokers. A meta-analysis of nine studies found an OR of 0.66 (95% CI 0.49-0.88) for pregnancies per number of IVF-treated cycles in smokers versus non-smokers. Despite the potential limitations of meta-analyses of observational studies, the evidence presented in this review is compelling because of the consistency of effect across different study designs, sample size and types of outcome. However, continued reassurance is needed that the calculated overall effect is not in fact due to confounding variables.

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