Cotinine levels in follicular fluid and serum of IVF patients: effect on granulosa-luteal cell function in vitro.

Cigarette smoking is accepted as a risk factor for pregnancy but its effect on fertility is uncertain. In this study we determined the concentration of cotinine, a nicotine metabolite, in follicular fluid and serum from women participating in an in-vitro fertilization and embryo transfer (IVF-ET) programme. Cotinine was undetectable in serum and follicular fluid of non-smokers but ranged from less than 5 to 371 ng/ml in follicular fluid and from 24 to 245 ng/ml in serum of smokers. Granulosa-luteal cells, obtained from IVF patients and cultured for 4 days, secreted progesterone and, when an aromatizable androgen was added, oestradiol-17 beta. The addition of cotinine or nicotine did not alter progesterone or oestradiol-17 beta secretion. However, the presence of cotinine in follicular fluid of women smokers provides evidence for access of at least one component of cigarette smoke to the developing gamete and the cells of the follicle. Further work is required to determine whether fertility is compromised by the presence, in follicular fluid, of contaminants derived from cigarette smoke.