Tütün Bağımlılığı ve Fertilite

Year 2025, Volume: 19 Issue: 2, 234 - 241, 09.06.2025

Fatma Nur Duman , Zehra Gölbaşı

https://doi.org/10.21763/tjfmpc.1636085

Abstract

Tütün kullanımı, gelişmekte olan ve az gelişmiş ülkelerde yaygın bir bağımlılık sorunudur. Sigara yoluyla alınan nikotin, bağımlılığın en yaygın nedenlerinden biridir ve immün hastalıklar, kanser, kardiyovasküler sorunlar ve solunum hastalıkları, cinsel işlev bozuklukları ve infertilite gibi çok sayıda önemli sağlık sorununa yol açmaktadır. Son yıllarda fertilite oranlarının düştüğü bildirilmektedir ve bu kapsamda üreme sağlığını etkileyen önlenebilir risk faktörlerinin belirlenmesi önem kazanmaktadır. Tütün kullanımı da bu önlenebilir risk faktörlerinden biridir. Tütün bağımlılığı, kadın ve erkek üreme sistemi üzerinde olumsuz etkilere sahiptir. Kadınlarda tütün kullanımı over rezervini azaltarak erken menopoza yol açabilir, steroid hormon dengesini bozarak üreme fonksiyonlarını etkileyebilir ve yardımcı üreme teknikleri başarısını düşürebilmektedir. Erkeklerde ise sperm kalitesini olumsuz etkileyerek doğal yolla veya yardımcı üreme teknikleriyle gebelik şansını azaltabilmektedir. Bu derleme, tütün bağımlılığının kadın ve erkek fertilitesi üzerindeki etkilerini güncel literatür doğrultusunda inceleyerek, bireylere sağlıklı yaşam biçimi kazandırma ve infertiliteyi önlemeye yönelik danışmanlık hizmetlerinin önemini vurgulamayı amaçlamaktadır.

Keywords

Tütün , Sigara , Fertilite , Sağlık

Tobacco Addiction and Fertility

Abstract

Tobacco use is a common addiction problem in developing and underdeveloped countries. Nicotine intake through smoking is one of the most common causes of addiction and leads to many health problems including immune diseases, cancer, cardiovascular and respiratory diseases, sexual dysfunctions and infertility. It has been reported that fertility rates have decreased in recent years, and in this context, determination of preventable risk factors affecting reproductive health has gained importance. Tobacco use is one of these preventable risk factors. Tobacco addiction has negative effects on the male and female reproductive systems. In women, tobacco use may lead to early menopause by decreasing ovarian reserve, may affect reproductive functions by disrupting steroid hormone balance, and may decrease the success of assisted reproductive techniques. In men, it may adversely affect sperm quality and reduce the chance of pregnancy naturally or with assisted reproductive techniques. This review aims to examine the effects of tobacco addiction on female and male fertility in line with the current literature and to emphasise the importance of counselling services for individuals to gain a healthy lifestyle and to prevent infertility.

Keywords

Tobacco , Smoking , Fertility , Health

References

• Vardar E. Alkol Madde Bağımlılığı Tanı ve Tedavi El Kitabı. 2012. p. 43-53.
• Jaffe JH, Anthony JC. Substance-related disorders: introduction and overview. In: Sadock HI, Sadock VA, editors. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 1137-67.
• Le Foll B, Piper ME, Fowler CD, Tonstad S, Bierut L, Lu L, et al. Tobacco and nicotine use. Nat Rev Dis Primers. 2022;8(1):19.
• Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021;397(10292):2337-60.
• Uysal MA. Nikotin sizi nasıl esir alıyor? Tütün bağımlılığının nörobiyolojisi. Güncel Göğüs Hastalıkları Serisi. 2016;4(1):37-43.
• Centers for Disease Control and Prevention (CDC). Health Effects | Smoking and Tobacco Use [Internet]. Atlanta: CDC; 2022 Mar [cited 2024 Jan 30]. Available from: https://www.cdc.gov/tobacco/basic_information/health_effects/
• Sadock BJ, Sadock VA, Ruiz P. Psikiyatri Davranış Bilimleri/Klinik Psikiyatri. Bozkurt A, çev. Ankara: Güneş Tıp Kitabevi; 2017. p. 680-5.
• West R. Tobacco smoking: health impact, prevalence, correlates and interventions. Psychol Health. 2017;32(8):1018- 36.
• World Health Organization (WHO). WHO report on the global tobacco epidemic, 2023: protect people from tobacco smoke [Internet]. Geneva: WHO; 2023 [cited 2024 Jan 29]. Available from: https://iris.who.int/bitstream/handle/10665/372043/9789240077164-eng.pdf
• Türkiye İstatistik Kurumu (TÜİK). Bireylerin tütün mamulü kullanma durumunun cinsiyet ve yaş grubuna göre dağılımı [Internet]. 2022 Aug 11 [cited 2024 Jan 29]. Available from: https://data.tuik.gov.tr/Search/Search?text=t%C3%BCt%C3%BCn&dil=1Duman & Gölbaşı. TJFPMC 2025;19(2): 7
• World Bank. Fertility Rates [Internet]. [cited 2024 Jan 30]. Available from: https://data.worldbank.org/indicator/SP.DYN.TFRT.IN
• Sharpe RM. Environment, lifestyle and male infertility. Baillieres Best Pract Res Clin Endocrinol Metab. 2000;14(4):489-503.
• De Angelis C, Nardone A, Garifalos F, Pivonello C, Sansone A, Conforti A, et al. Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol. 2020;18(1):21.
• Practice Committee of the American Society for Reproductive Medicine. Tobacco or marijuana use and infertility: a committee opinion. Fertil Steril. 2024;121(4):589-603.
• Budani MC, Tiboni GM. Ovotoxicity of cigarette smoke: A systematic review of the literature. Reprod Toxicol. 2017;72:164-81.
• Dechanet C, Anahory T, Mathieu-Daude JC, Quantin X, Reyftmann L, Hamamah S, et al. Effects of cigarette smoking on reproduction. Hum Reprod Update. 2011;17:76-95.
• Waylen AL, Metwally M, Jones GL, Wilkinson AJ, Ledger WL. Effects of cigarette smoking upon clinical outcomes of assisted reproduction: A meta-analysis. Hum Reprod Update. 2009;15:31-44.
• De Angelis C, Galdiero M, Pivonello C, Salzano C, Gianfrilli D, Piscitelli P, et al. The environment and male reproduction: The effect of cadmium exposure on reproductive function and its implication in fertility. Reprod Toxicol. 2017;73:105-27.
• Rzymski P, Tomczyk K, Rzymski P, Poniedziałek B, Opala T, Wilczak M. Impact of heavy metals on the female reproductive system. Ann Agric Environ Med. 2015;22:259-64.
• Augood C, Duckitt K, Templeton AA. Smoking and female infertility: A systematic review and meta-analysis. Hum Reprod. 1998;13:1532-9.
• Bolumar F, Olsen J, Boldsen J. Smoking reduces fecundity: A European multicenter study on infertility and subfecundity. Am J Epidemiol. 1996;143:578-87.
• He S, Wan L. Associations between smoking status and infertility: a cross-sectional analysis among USA women aged 18–45 years. Front Endocrinol (Lausanne). 2023;14:1140739.
• Peng L, Luo X, Cao B, Wang X. Unraveling the link: environmental tobacco smoke exposure and its impact on infertility among American women (18–50 years). Front Public Health. 2024;12:1358290.
• Montjean D, Godin Pagé MH, Bélanger MC, Benkhalifa M, Miron P. An overview of e-cigarette impact on reproductive health. Life (Basel). 2023;13(3):827.
• Dhage VD, Nagtode N, Kumar D, Bhagat AK. A narrative review on the impact of smoking on female fertility. Cureus. 2024;16(4):e58389.
• Sun L, Tan L, Yang F, Luo Y, Li X, Deng HW, et al. Meta-analysis suggests that smoking is associated with an increased risk of early natural menopause. Menopause. 2012;19:126-32.
• Schoenaker DA, Jackson CA, Rowlands JV, Mishra GD. Socioeconomic position, lifestyle factors and age at natural menopause: A systematic review and meta-analyses of studies across six continents. Int J Epidemiol. 2014;43:1542- 62.
• Dolleman M, Verschuren WM, Eijkemans MJ, Dolle ME, Jansen EH, Broekmans FJ, et al. Reproductive and lifestyle determinants of anti-Mullerian hormone in a large population-based study. J Clin Endocrinol Metab. 2013;98:2106- 15.
• Oladipupo I, Ali T, Hein DW, Pagidas K, Bohler H, Doll MA, et al. Association between cigarette smoking and ovarian reserve among women seeking fertility care. PLoS One. 2022;17(12):e0278998.
• Cooper GS, Baird DD, Hulka BS, Weinberg CR, Savitz DA, Hughes CL Jr. Follicle-stimulating hormone concentrations in relation to active and passive smoking. Obstet Gynecol. 1995;85:407-11.
• Plante BJ, Cooper GS, Baird DD, Steiner AZ. The impact of smoking on antimullerian hormone levels in women aged 38 to 50 years. Menopause. 2010;17:571-6.
• Budani MC, Carletti E, Tiboni GM. Cigarette smoke is associated with altered expression of antioxidant enzymes in granulosa cells from women undergoing in vitro fertilization. Zygote. 2017;25:296-303.
• Fowler PA, Childs AJ, Courant F, MacKenzie A, Rhind SM, Antignac JP, et al. In utero exposure to cigarette smoke dysregulates human fetal ovarian developmental signalling. Hum Reprod. 2014;29:1471-89.
• Soldin OP, Makambi KH, Soldin SJ, O'Mara DM. Steroid hormone levels associated with passive and active smoking. Steroids. 2011;76:653-9.
• Zhao J, Leung JY, Lin SL, Schooling CM. Cigarette smoking and testosterone in men and women: A systematic review and meta-analysis of observational studies. Prev Med. 2016;85:1-10.
• Daniel M, Martin AD, Drinkwater DT. Cigarette smoking, steroid hormones, and bone mineral density in young women. Calcif Tissue Int. 1992;50:300-5.
• Whitcomb BW, Bodach SD, Mumford SL, Perkins NJ, Trevisan M, Wactawski-Wende J, et al. Ovarian function and cigarette smoking. Paediatr Perinat Epidemiol. 2010;24:433-40.
• Hartz AJ, Kelber S, Borkowf H, Wild R, Gillis BL, Rimm AA. The association of smoking with clinical indicators of altered sex steroids--a study of 50,145 women. Public Health Rep. 1987;102:254-9.
• Mishra GD, Dobson AJ, Schofield MJ. Cigarette smoking, menstrual symptoms and miscarriage among young women. Aust N Z J Public Health. 2000;24:413-20.
• Li S, Winuthayanon W. Oviduct: Roles in fertilization and early embryo development. J Endocrinol. 2017;232:R1- R26.Duman & Gölbaşı. TJFPMC 2025;19(2): 8
• Hyland A, Piazza KM, Hovey KM, Ockene JK, Andrews CA, Rivard C, et al. Associations of lifetime active and passive smoking with spontaneous abortion, stillbirth and tubal ectopic pregnancy: A cross-sectional analysis of historical data from the Women's Health Initiative. Tob Control. 2015;24:328-35.
• Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, et al. Risk factors for ectopic pregnancy: A comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003;157:185-94.
• Kim SM, Kim JS. A Review of Mechanisms of Implantation. Dev Reprod. 2017;21:351-9.
• Jukic AM, Weinberg CR, Baird DD, Wilcox AJ. The association of maternal factors with delayed implantation and the initial rise of urinary human chorionic gonadotrophin. Hum Reprod. 2011;26:920-6.
• Sahin Ersoy G, Zhou Y, Inan H, Taner CE, Cosar E, Taylor HS. Cigarette Smoking Affects Uterine Receptivity Markers. Reprod Sci. 2017;24:989-95.
• Khorram O, Han G, Magee T. Cigarette smoke inhibits endometrial epithelial cell proliferation through a nitric oxidemediated pathway. Fertil Steril. 2010;93(1):257–63.
• Sansone A, Di Dato C, de Angelis C, Menafra D, Pozza C, Pivonello R, et al. Smoke, alcohol and drug addiction and male fertility. Reprod Biol Endocrinol. 2018;16(1):1–11.
• Sengupta P, Dutta S, Krajewska-Kulak E. The disappearing sperms: analysis of reports published between 1980 and 2015. Am J Mens Health. 2017;11(4):1279–304.
• Barazani Y, Katz BF, Nagler HM, Stember DS. Lifestyle, environment, and male reproductive health. Urol Clin North Am. 2014;41(1):55–66.
• Wang X, Zhang J, Xu W, Huang Q, Liu L, Tian M, et al. Low-level environmental arsenic exposure correlates with unexplained male infertility risk. Sci Total Environ. 2016;571:307–13.
• Dai JB, Wang ZX, Qiao ZD. The hazardous effects of tobacco smoking on male fertility. Asian J Androl. 2015;17(6):954–60.
• Ramlau-Hansen CH, Thulstrup AM, Aggerholm AS, Jensen MS, Toft G, Bonde JP. Is smoking a risk factor for decreased semen quality? A cross-sectional analysis. Hum Reprod. 2007;22(1):188–96.
• Kunzle R, Mueller MD, Hanggi W, Birkhauser MH, Drescher H, Bersinger NA. Semen quality of male smokers and nonsmokers in infertile couples. Fertil Steril. 2003;79(2):287–91.
• Yeung CH, Tuttelmann F, Bergmann M, Nordhoff V, Vorona E, Cooper TG. Coiled sperm from infertile patients: characteristics, associated factors and biological implication. Hum Reprod. 2009;24(6):1288–95.
• Taha EA, Ezz-Aldin AM, Sayed SK, Ghandour NM, Mostafa T. Smoking influence on sperm vitality, DNA fragmentation, reactive oxygen species and zinc in oligoasthenoteratozoospermic men with varicocele. Andrologia. 2014;46(6):687–91.
• Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol. 2013;11:66.
• Practice Committee of the American Society for Reproductive Medicine. Smoking and infertility: a committee opinion. Fertil Steril. 2012;98(6):1400–6.
• Kanetkar SR, Mohite S, Kadam RS, Gupta N, Vadhel CR. Effect of tobacco use on semen in infertile male. J Pharm Bioallied Sci. 2024;16(Suppl 1):S412–S414.
• Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette smoking and semen quality: a new meta-analysis examining the effect of the 2010 World Health Organization Laboratory methods for the examination of human semen. Eur Urol. 2016;70(4):635–45.
• Ramon R, Warli SM, Rasyid N, Atmoko W. Effect of tobacco smoking and alcohol consumption on semen quality and hormone reproductive levels in infertile males: a systematic review and meta-analysis. Pharmacia. 2024;71:1–14.
• Holmboe SA, Priskorn L, Jensen TK, Skakkebaek NE, Andersson AM, Jørgensen N. Use of e-cigarettes associated with lower sperm counts in a cross-sectional study of young men from the general population. Hum Reprod. 2020;35(7):1693–1701.
• Kaya Y, Şahin N. Kadınlarda madde kullanımı ve hemşirenin rolü. Hemşirelikte Eğitim ve Araştırma Dergisi. 2013;10(1):3-7.
• Gökdemir F, Eryılmaz G. Prekonsepsiyonel sağlık hizmetleri. Turkiye Klinikleri J Obstet Womens Health Dis NursSpecial Topics. 2017;3(3):204-12.