Impact of Environmental Tobacco Smoke Exposure in Women on Oxidative Stress in the Antral Follicle and Assisted Reproduction Outcomes



Kazemi A¹ ; Ramezanzadeh F² ; Nasr Esfahani MH³ ; Sabooryaraghi AA⁴ ; Nejat S⁵ ; Rahimiforoshani A⁵ Show Affiliations
Source: Journal of Research in Medical Sciences Published:2013

Abstract

Background: Cigarette smoke contains many oxidants and may alter the human reproduction by inducing oxidative stress (OS) in both active and passive smokers. This study was designed to evaluate the effect of environmental tobacco smoke (ETS) exposure on oxidative stress in the follicular fuid and the assisted reproduction outcomes. Materials and Methods: An observational prospective study was carried out on 236 infertile women, who underwent assisted reproduction cycles. Te ETS exposure was assessed using self-reported ETS exposure and the cotinine level in follicular fuid. To evaluate the OS in follicular fuid (FF) malon-di-aldehyde (MDA) and total antioxidant capacity (TAC) were measured. The number of retrieved oocytes, rate of metaphase II stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were considered as the assisted reproduction outcomes. Te results were adjusted for age, body mass index, duration, and etiology of infertility; P-values less than 0.05 were considered signifcant. Results: Te MDA and TAC levels in FF were not related to the self-report number of the weekly ETS exposure and cotinine levels in FF. Also, the number of retrieved oocytes, MII stage oocytes, fertilization rate, good cleavage rate, and no-fragmented embryo rate were not related to the cotinine level and weekly ETS exposure. However, in women whose cotinine levels in FF were lower and equal/above 3.5 ng/ml, the number of retrieved oocytes was higher (12.63 ±.71 vs. 9.28 ± 1.11, P = 0.01). Te relationship between the MDA level and cleavage rate (Beta = -18.5, confdence interval-34.9 and-2.1, P < 0.05) was negatively signifcant and the relationship between the MII stage rate with TAC (Beta = 0.02, confdence interval 0.01 and 0.04, P < 0.05) was positively signifcant. Conclusion: Te ETS exposure may alter the assisted reproduction success by influencing the number of available oocytes. Although, the OS in a follicular environment affect the ability of oocytes to reach the specific cleavage stages at appropriate time intervals, it does not mediate poor-assisted reproduction outcomes due to ETS exposure.