title: Impact of active female smoking on controlled ovarian stimulation in intracytoplasmic sperm insemination cycles.
abstract: OBJECTIVE
  To examine the impact of smoking among females on controlled ovarian stimulation (COS), at intra-cytoplasmatic sperm injection (ICSI) outcome.
  
  
  METHODS
  A prospective analysis of outcomes of 876 women (fresh, non donor cycles) of which 559 (63.8%) were non-smokers, 317 (36.2%) were smokers, underwent standard COS/ICSI treatment.
  
  
  RESULTS
  Among smokers, the average time of COS, expressed in days, was significantly longer compared with non-smokers (10.5±2.10 vs. 10±1.90 p less than 0, 05). There were no registered significant differences in the number of retrieved oocytes, (10.4±6.8 vs10.3±6.9), mature oocytes (8.6±5.8 vs. 8.4±5.9), in the group of non-smokers versus smokers. However, smoking and age have a significant impact of the number of high-quality embryos, i.e. older smokers had a lower number of high-quality transferred embryos (non-smokers ≥ 35 years : smokers ≥ 35 years; 1.9±1.1 vs. 1.6±1). On multiple logistic regression analysis, factor that had a significantly negative impact of clinical pregnancy was maternal age.
  
  
  CONCLUSIONS
  Smoking among patients entering the COS and ICSI fertilization process had insignificant negative impact on the final outcome of the process resulting in reduced pregnancy rate. The chance for the pregnancy declines with age, but smoking did not significantly influence the outcome.
authors.affiliation: In Vitro Fertilisation Centre, First Private General Hospital ReMedika, Skopje, Republic of Macedonia. zpetanovski@yahoo.com
authors.forename: Zorancho
authors.initials: Z
authors.lastname: Petanovski
authors.forename: Gligor
authors.initials: G
authors.lastname: Dimitrov
authors.forename: Byrol
authors.initials: B
authors.lastname: Aydin
authors.forename: Makjuli
authors.initials: M
authors.lastname: Hadzi-Lega
authors.forename: Valentina
authors.initials: V
authors.lastname: Sotirovska
authors.forename: Damjan
authors.initials: D
authors.lastname: Susleski
authors.forename: Stefan
authors.initials: S
authors.lastname: Saltirovski
authors.forename: Vladimir
authors.initials: V
authors.lastname: Matevski
authors.forename: Snezana
authors.initials: S
authors.lastname: Stojkovska
authors.forename: Emilija
authors.initials: E
authors.lastname: Petanovska
authors.forename: Mladen
authors.initials: M
authors.lastname: Savic
authors.forename: Trajan
authors.initials: T
authors.lastname: Balkanov
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D054315:Oocyte Retrieval; D010062:Ovulation Induction; D011247:Pregnancy; D012907:Smoking / Q000009:adverse effects*; D020554:Sperm Injections, Intracytoplasmic