title: Ovarian reserve and in vitro fertilization cycles outcome according to women smoking status and stimulation regimen.
abstract: OBJECTIVE
  Smoking is known to be deleterious on female fertility and in vitro fertilization (IVF) outcome, probably partly through ovarian reserve alteration. Recently, anti-Müllerian hormone (AMH) and antral follicle count (AFC) have been shown to be the most accurate ovarian reserve markers. Here, we compared ovarian reserve markers in women undergoing IVF according to smoking status and stimulation regimen.
  
  
  METHODS
  AFC, AMH, basal FSH, LH and estradiol, and IVF outcome were compared in 277 women undergoing IVF. Smoking status and ovarian stimulation protocol (i.e. agonists or antagonists) were recorded.
  
  
  RESULTS
  Active smoking women had lower AMH and modified follicles' size repartition in AFC compared to non-smokers. They also experienced poorer IVF outcome with decreased ovarian response and lower pregnancy rate. This remained true in both antagonist and agonist stimulation protocol groups.
  
  
  CONCLUSIONS
  Active smoking in infertile women is associated with ovarian reserve alteration, as reflected by AFC modification and decreased serum AMH, and leads to poor prognosis in ART cycles, whatever the stimulation protocol used. Infertile women should be strongly discouraged from smoking before they start IVF cycles.
authors.affiliation: Reproductive Medicine Unit, University Hospital of Nantes, Nantes, France. thomas.freour@chu-nantes.fr
authors.forename: Thomas
authors.initials: T
authors.lastname: Freour
authors.forename: Damien
authors.initials: D
authors.lastname: Masson
authors.forename: Lionel
authors.initials: L
authors.lastname: Dessolle
authors.forename: Dalila
authors.initials: D
authors.lastname: Allaoua
authors.forename: Thomas
authors.initials: T
authors.lastname: Dejoie
authors.forename: Sophie
authors.initials: S
authors.lastname: Mirallie
authors.forename: Miguel
authors.initials: M
authors.lastname: Jean
authors.forename: Paul
authors.initials: P
authors.lastname: Barriere
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D006080:Ovarian Follicle / Q000503:physiopathology*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*
chemical_list: D054304:Anti-Mullerian Hormone