Zitzmann Michael, Rolf Claus, Nordhoff Verena, Schräder Guido, Rickert-Föhring Melanie, Gassner Paul, Behre Hermann M, Greb Robert R, Kiesel Ludwig, Nieschlag Eberhard
Institute of Reproductive Medicine of the University, Münster, Germany.
Fertil Steril. 2003 Jun;79 Suppl 3:1550-4. doi: 10.1016/s0015-0282(03)00339-x.
Smoking by one or both partners can adversely affect IVF outcome. We investigated whether smoking may also play a role in the success rate of intracytoplasmic sperm injection (ICSI), in which initial steps of fertilization are bypassed.
Three hundred one couples (ICSI: 153, IVF: 148) participated in 415 treatment cycles (ICSI: 202, IVF: 213). One hundred thirty-nine men were habitual smokers (ICSI: 71, IVF: 68). Seventy-seven women were smokers (ICSI: 41, IVF: 36). Multiple nominal regression analyses of various steps of assisted reproduction included smoking status, age, semen parameters, and number of embryos transferred.
Reproductive and andrology unit of the university.
PATIENT(S): Three hundred one couples seeking fertility treatment.
INTERVENTION(S): Assisted reproduction by in vitro fertilization (IVF) or ICSI.
MAIN OUTCOME MEASURE(S): Clinical pregnancy.
RESULT(S): Intracytoplasmic sperm injection success (clinical pregnancy) in women with smoking male partners was 22% and was 38% with nonsmoking partners. Similar results were seen for IVF, with 18% vs. 32%. Multinominal logistic regression analysis revealed smoking in men to be a significant predictor of ICSI outcome, along with female age and the number of embryos transferred, whereas clinical pregnancies after IVF were dependent on smoking in men, number of embryos transferred, sperm motility, and female age. Female smoking influenced the number of oocytes retrieved and the fertilization rate of oocytes in IVF but not in ICSI. The odds ratio for failure of ICSI for male smokers in comparison to male nonsmokers was 2.95 (IVF: 2.65).
CONCLUSION(S): Smoking by males decreases the success rates of assisted reproduction procedures, not only in IVF, but also in ICSI. Apart from putative adverse effects during fertilization, altered DNA in spermatozoa might hamper development of the embryo.
夫妻一方或双方吸烟会对体外受精（IVF）结果产生不利影响。我们调查了吸烟是否也会对胞浆内单精子注射（ICSI）的成功率产生影响，ICSI可绕过受精的初始步骤。
301对夫妇（ICSI组：153对，IVF组：148对）参与了415个治疗周期（ICSI组：202个，IVF组：213个）。139名男性为习惯性吸烟者（ICSI组：71名，IVF组：68名）。77名女性为吸烟者（ICSI组：41名，IVF组：36名）。对辅助生殖各步骤进行的多项名义回归分析包括吸烟状况、年龄、精液参数和移植胚胎数量。
大学的生殖与男科学科。
301对寻求生育治疗的夫妇。
通过体外受精（IVF）或ICSI进行辅助生殖。
临床妊娠。
男性吸烟的女性接受ICSI后的成功率（临床妊娠）为22%，男性不吸烟的女性为38%。IVF的结果类似，分别为18%和32%。多项逻辑回归分析显示，男性吸烟是ICSI结果的重要预测因素，同时还有女性年龄和移植胚胎数量，而IVF后的临床妊娠则取决于男性吸烟情况、移植胚胎数量、精子活力和女性年龄。女性吸烟影响IVF中获取的卵母细胞数量和卵母细胞受精率，但不影响ICSI。与男性不吸烟者相比，男性吸烟者ICSI失败的优势比为2.95（IVF为2.65）。
男性吸烟会降低辅助生殖程序的成功率，不仅在IVF中如此，在ICSI中也是如此。除了受精过程中可能产生的不利影响外，精子中DNA的改变可能会阻碍胚胎发育。
