Does Smoking Affect IVF Success? What Women and Couples Should Know

IVF can be an important step for couples trying to build their families, and many factors can influence the outcome of treatment. One factor that is sometimes overlooked is smoking.

Research has linked cigarette smoking with reduced fertility in both women and men. It may affect reproductive health, egg and sperm quality, ovarian response, pregnancy, and outcomes of assisted reproductive treatments such as IVF. Second-hand smoke exposure may also have reproductive effects.

If you or your partner smoke and are planning IVF, you may wonder: Can smoking reduce the chances of IVF success? Should you stop before treatment? Does second-hand smoke matter?

Here is what you should know.

Can Smoking Affect IVF Success?

Yes, smoking can negatively affect IVF outcomes.

Evidence reviewed by the American Society for Reproductive Medicine (ASRM) shows an association between cigarette smoking and poorer outcomes with assisted reproductive technology (ART), including IVF. Studies have reported lower chances of pregnancy and live birth among smokers, although the exact effect can vary depending on factors such as age, amount and duration of smoking, and other health conditions.

WHO's September 2026 tobacco-and-infertility update also reports that smoking is associated with lower pregnancy and live-birth outcomes following assisted reproduction.

This does not mean that IVF cannot work if someone smokes. It means smoking is a modifiable factor that may reduce the chances of a successful outcome.

How Can Smoking Affect IVF?

Smoking exposes the body to nicotine, carbon monoxide, and numerous other chemicals. These substances can affect reproductive processes in several ways.

1. Smoking May Affect Egg Health

The ovaries and developing eggs can be affected by exposure to tobacco smoke.

Research has associated smoking with:

• Faster depletion of ovarian follicles
• Lower levels of anti-Müllerian hormone (AMH) in some studies
• Changes in ovarian response
• Greater medication requirements during ovarian stimulation
• Fewer eggs retrieved in some IVF studies

ASRM notes that smoking may accelerate reproductive ageing and ovarian follicle depletion, although the strength of individual associations varies across studies.

This becomes particularly relevant as fertility naturally declines with age.

2. Smoking May Affect Sperm Quality

IVF is not only about the woman's health.

Sperm health also matters, particularly when fertilisation or embryo development is part of the treatment process.

Studies have associated smoking in men with changes in:

• Sperm concentration
• Sperm motility
• Sperm morphology
• Sperm function

ASRM describes the evidence as showing poorer semen parameters among smokers, although the relationship between smoking and overall male fertility is more complex.

This is why both partners should consider smoking cessation when preparing for IVF.

3. Smoking May Affect Implantation

After fertilisation and embryo development, the embryo needs to implant successfully in the uterus.

Research has reported lower implantation rates among smokers in some ART studies. Tobacco exposure may affect the reproductive environment and blood flow, potentially making successful implantation more difficult.

However, IVF outcomes are influenced by many factors, so smoking should not be considered the sole explanation for implantation failure.

4. Smoking May Increase the Risk of Miscarriage

Smoking has also been associated with an increased risk of miscarriage in both naturally conceived and assisted pregnancies.

Tobacco exposure can affect early pregnancy through several mechanisms, including effects on blood flow and reproductive tissues.

For someone undergoing IVF, avoiding tobacco is therefore relevant not only before embryo transfer but throughout the pregnancy.

What About Second-Hand Smoke?

You do not necessarily have to be the person smoking to be exposed to tobacco.

Second-hand smoke can expose non-smokers to many of the same harmful substances found in tobacco smoke.

WHO's 2026 review notes that second-hand smoke exposure may also affect fertility, including the chances of conception.

ASRM likewise reports reproductive consequences associated with excessive passive tobacco exposure.

If you are preparing for IVF, creating a smoke-free environment at home and around treatment can therefore be an important part of reducing avoidable exposure.

Does Smoking Affect IVF More Than Natural Conception?

Smoking can affect fertility even before IVF becomes necessary.

It has been associated with delayed conception and reduced fecundity in women. It may also affect reproductive health in men.

IVF cannot completely remove the effects of these factors.

In other words:

IVF can assist the reproductive process, but it cannot completely cancel out the effects of smoking on reproductive health.

This is one reason fertility specialists commonly discuss tobacco use during pre-treatment counselling. ASRM recommends helping patients stop smoking before infertility treatment.

Should You Stop Smoking Before IVF?

Ideally, yes.

Stopping smoking before IVF can remove an avoidable reproductive risk factor and may improve overall health before pregnancy.

There is no single “perfect” number of days before IVF that applies to everyone. The earlier you stop, the better, and your fertility specialist can advise you based on your treatment timeline and smoking history.

Importantly, do not delay speaking to your fertility specialist simply because you are still smoking.

Your doctor can help you understand your individual situation and discuss appropriate smoking-cessation support.

What If You Cannot Quit Immediately?

Quitting can be difficult, particularly if you have been smoking for a long time.

If you are preparing for IVF and have not been able to stop yet:

• Tell your fertility specialist honestly about your smoking.
• Discuss a personalised quitting plan.
• Ask about evidence-based cessation support.
• Try to reduce exposure to second-hand smoke.
• Encourage your partner to quit as well.
• Avoid replacing cigarettes with other nicotine or tobacco products without discussing them with your healthcare professional.

The goal should be complete cessation, rather than simply assuming that switching products makes tobacco exposure safe.

WHO notes that evidence for newer products such as e-cigarettes, waterpipes and smokeless tobacco is still developing, while ASRM states that current evidence does not establish electronic nicotine delivery systems as a safe reproductive alternative to cigarettes.

Does Vaping Affect IVF Success?

Vaping is sometimes considered a safer alternative to smoking, but that does not mean it is harmless for reproductive health.

Evidence specifically examining vaping and IVF outcomes is still developing. However, nicotine exposure and other substances in vaping products raise concerns about reproductive health.

If you are trying to conceive or preparing for IVF, it is better to discuss vaping with your fertility specialist rather than assuming it is a safe substitute for cigarettes.

Does Smoking Affect IVF for Men Too?

Yes, smoking is relevant for both partners.

Male smoking has been associated with poorer semen parameters, including changes in sperm concentration, movement and shape. Tobacco exposure may also contribute to reproductive dysfunction.

Because sperm contributes half of the genetic material to an embryo, preparing for IVF should ideally involve both partners, not only the woman undergoing ovarian stimulation.

What Else Can You Do to Prepare for IVF?

Smoking is only one part of pre-IVF health.

Depending on your individual situation, your fertility specialist may discuss:

Maintain a balanced diet

Focus on a varied diet containing vegetables, fruits, whole grains, protein sources, healthy fats and adequate fluids.

Stay physically active

Regular, moderate physical activity can support general health and wellbeing. Your doctor can advise you about exercise appropriate for your circumstances.

Limit alcohol

If you are preparing for pregnancy, discuss alcohol use with your fertility specialist and follow their recommendations.

Take prescribed supplements

If your doctor recommends folic acid or another supplement, take it as directed.

Manage existing health conditions

Conditions such as thyroid disorders, diabetes, high blood pressure and other health problems may need appropriate management before pregnancy.

Prioritise sleep

Good-quality sleep supports overall health and can be particularly important during what can be a physically and emotionally demanding fertility journey.

Can IVF Still Work If You Smoke?

Yes, IVF can still result in pregnancy for someone who smokes.

However, smoking is associated with less favourable reproductive and ART outcomes, so continuing to smoke may reduce the chances of success compared with not smoking.

It is also important not to blame yourself if you have smoked during previous IVF cycles. Fertility outcomes depend on numerous factors, including age, ovarian reserve, sperm factors, embryo quality, uterine factors and underlying medical conditions.

The useful question is not “Did smoking cause my IVF to fail?”

It is:

“What factors can I change before my next treatment cycle?”

Smoking cessation is one of those potentially modifiable factors.

When Should You Talk to a Fertility Specialist?

Consider speaking with a fertility specialist if:

• You are planning IVF and currently smoke.
• Your partner smokes.
• You have had unsuccessful IVF cycles.
• You are concerned about egg or sperm quality.
• You have been trying to conceive without success.
• You want help creating a healthier pre-IVF plan.
• You are finding it difficult to quit smoking.

Your doctor can assess your individual fertility factors rather than attributing IVF outcomes to one lifestyle factor alone.

Frequently Asked Questions

Does smoking reduce IVF success?

Evidence suggests that cigarette smoking is associated with poorer outcomes in assisted reproduction, including lower pregnancy and live-birth rates in some studies. The exact effect varies between individuals.

How long before IVF should I stop smoking?

There is no single timeframe that applies to every patient. Ideally, smoking cessation should begin as early as possible before treatment. Speak with your fertility specialist about your individual treatment plan.

Can smoking affect egg quality?

Smoking has been associated with several changes in ovarian and reproductive function and may contribute to faster loss of ovarian follicles. However, egg quality is influenced by many factors, particularly age.

Can smoking affect sperm quality?

Yes. Smoking has been associated with lower sperm concentration, motility and changes in morphology in research studies.

Does second-hand smoke affect IVF?

Second-hand smoke may also have reproductive effects. WHO and ASRM both identify passive tobacco exposure as a potential fertility concern.

Is vaping safer than smoking during IVF?

The reproductive safety of vaping has not been established. If you are preparing for IVF, discuss vaping and nicotine use with your fertility specialist rather than assuming it is a safe alternative.

Can I still undergo IVF if I smoke?

Whether you can proceed with IVF depends on your individual circumstances and your fertility clinic's policies. However, stopping smoking before treatment is generally encouraged because it removes a modifiable reproductive risk factor.

Conclusion

IVF is a complex process, and its success depends on multiple factors. Smoking is one factor that couples can potentially change.

Research shows that tobacco use can affect fertility and is associated with less favourable outcomes in assisted reproduction. The evidence also highlights potential reproductive effects from second-hand smoke.

If you are preparing for IVF, quitting smoking as early as possible can be an important step towards reducing avoidable risks. And if quitting feels difficult, you do not have to manage it alone. Talk openly with your fertility specialist about your smoking habits so you can receive appropriate, evidence-based support.

Your IVF journey involves more than one treatment cycle. Preparing your body and your overall health matters too.

Medical Disclaimer: This article is intended for general educational purposes only and should not be considered a substitute for personalised medical advice, diagnosis, or treatment. IVF outcomes vary between individuals. If you are planning IVF or have questions about smoking, nicotine use, fertility, or treatment outcomes, consult a qualified fertility specialist or gynaecologist.