Revisiting the association between smoking and female fertility using the oocyte donation model.

Research Question: Is active smoking among donors, recipients and male partners associated with oocyte donation cycle outcomes, in donors and recipients?

Design: Retrospective cohort over a 4-year period including 4747 oocyte recipients and partners, and 3101 oocyte donors. All oocyte donation cycles were carried out between 2010 and 2014, and for whom donor, recipient and male partner smoking status at the time of treatment were known.

Results: Ovarian response was significantly reduced in oocyte donors who smoked compared with those who did not: 13.9 (SD 6.7) mature oocytes in heavy smokers versus 14.8 (SD 7.6) in non-smokers (P = 0.020). Nevertheless, biochemical, clinical and ongoing pregnancy rates and live birth rates were not affected by the degree of smoking among donors, recipients or recipients' partners.

Conclusions: This study suggests that smoking is not associated with compromised oocyte quality or altered uterine receptivity in oocyte donation cycles.