title: [In vitro fertilization and smoking: use of urinary cotinine and expired air carbon monoxide measurements].
abstract: OBJECTIVE
  To study the correlation between expired air carbon (EACO) and urinary cotinine, and to determine the impact of tobacco smoking on in vitro fertilization (IVF) results.
  
  
  METHODS
  We studied prospectively 221 patients in our ART center from October 2002 to October 2004: 51 active smokers, 85 passive smokers, and 85 non-smokers. Patients were classified into active, passive smokers, or non-smokers, based on a questionnaire. We measured urinary cotinine and EACO on the embryo transfer day and we recorded the IVF parameters.
  
  
  RESULTS
  Two hundred and twenty-one patients were included. We observed a 17.2% reduction of estradiolemy (P=0.05), a 1.5% reduction of pregnancies (NS), a 7.8% reduction of infants born alive (NS), a 28.5% reduction of twin pregnancies (P=0.06), as well as a 10% increase of miscarriages (NS) in the active smokers in comparison with non-smokers (the same trends were observed between active and passive smokers). EACO and urinary cotinine were well correlated. There was a negative correlation between estradiolemy and urinary cotinine (R=-0.15, P=0.02).
  
  
  CONCLUSIONS
  Tobacco smoking intensity may be dilatory on IVF results. There is a high correlation between EACO and urinary cotinine. Other larger studies would probably obtain results more statistically significant.
authors.affiliation: Service de gynécologie-obstétrique, département de médecine de la reproduction, CHU Carémeau, place Robert-Debré, 30900 Nîmes cedex, France. gtriopon@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Triopon
authors.forename: M-L
authors.initials: ML
authors.lastname: Tailland
authors.forename: J-L
authors.initials: JL
authors.lastname: Faillie
authors.forename: E
authors.initials: E
authors.lastname: Bolzinger
authors.forename: G
authors.initials: G
authors.lastname: Mercier
authors.forename: S
authors.initials: S
authors.lastname: Ripart
authors.forename: J-C
authors.initials: JC
authors.lastname: Boyer
authors.forename: P
authors.initials: P
authors.lastname: Fabbro-Peray
authors.forename: S
authors.initials: S
authors.lastname: Poirey
authors.forename: A
authors.initials: A
authors.lastname: Archambault
authors.forename: P
authors.initials: P
authors.lastname: Marès
mesh_terms: D000293:Adolescent; D000328:Adult; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis*; D003367:Cotinine / Q000652:urine*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution; D002248:Carbon Monoxide; D003367:Cotinine