Trying to conceive can be an emotional journey, and the World Health Organization (WHO) has just added a striking piece to the puzzle. In a September 2026 knowledge summary, the agency spotlighted what it calls an “overlooked public health challenge”: the substantial toll that tobacco takes on fertility in both women and men. With roughly 1 in 6 people of reproductive age experiencing infertility globally, the message from WHO’s review is unusually blunt — quitting smoking is one of the most consequential steps prospective parents can take.
What the WHO Summary Found
WHO’s twelfth Tobacco Knowledge Summary pulls together decades of evidence from dozens of studies and hundreds of thousands of participants. Among the standout findings:
- Women who currently smoke face a 40% higher risk of infertility compared with women who have never smoked.
- A review of 44 studies involving more than 60,000 men linked smoking to sperm abnormalities, erectile dysfunction, and ejaculatory problems.
- An analysis of 21 studies on assisted reproduction found that live birth rates after procedures such as IVF “may be roughly halved” among people who smoke.
- Former smokers experienced roughly 25% lower infertility risk than current smokers — evidence that quitting can meaningfully restore reproductive potential.
These figures echo earlier work from the Centers for Disease Control and Prevention and the American Society for Reproductive Medicine, both of which have long identified smoking as a modifiable risk factor for infertility, miscarriage, and pregnancy complications.
How Smoking Damages Female Fertility
Cigarette smoke contains more than 7,000 chemicals, and several of them — including cadmium, nicotine, and polycyclic aromatic hydrocarbons — accumulate in ovarian follicular fluid. Research published in journals such as Human Reproduction Update and Fertility and Sterility suggests that these compounds can:
- Accelerate the loss of ovarian follicles, effectively bringing menopause forward by one to four years on average
- Alter estrogen metabolism, which may disrupt the menstrual cycle and implantation
- Impair the fallopian tubes’ ability to transport an egg, raising the risk of ectopic pregnancy
- Increase rates of early pregnancy loss and stillbirth
Importantly, the harm is not limited to smokers themselves. WHO notes that women exposed to secondhand smoke also face increased infertility risk and reduced monthly conception chances — a reminder that partners’ habits can matter as much as one’s own.
How Smoking Damages Male Fertility
The evidence on male reproductive health is equally strong. A 2020 meta-analysis in the journal Reproductive Biology and Endocrinology found that smokers had significantly lower sperm counts, reduced motility, and more abnormally shaped sperm than non-smokers. The WHO summary highlights that tobacco use is associated with:
- Reduced sperm concentration and total sperm count
- Impaired sperm motility (the ability to swim toward an egg)
- Higher rates of abnormal sperm morphology
- Increased DNA fragmentation in sperm, which may affect embryo development
- Erectile dysfunction, in part through vascular damage
Because sperm production takes approximately 74 days, researchers suggest that men who quit smoking may begin to see improvements in semen parameters within about three months.
Fertility Treatment: Cutting Success in Half
For couples turning to assisted reproductive technology, the stakes of smoking are especially high. WHO cites analyses showing that live birth rates after IVF and related procedures may be reduced by roughly 50% among smokers. Additional data reviewed by the American Society for Reproductive Medicine indicate that smokers typically need almost twice as many IVF cycles to conceive as non-smokers, and are more likely to experience failed implantation and miscarriage.
Fertility clinics across North America and Europe increasingly recommend a smoke-free period of at least three months before beginning treatment, when possible, to give both eggs and sperm a chance to recover.
What About Vaping, Waterpipes, and Smokeless Tobacco?
WHO cautions that evidence on newer nicotine products is still emerging. Early studies suggest that e-cigarettes are not a safe alternative: nicotine itself can constrict blood vessels, disrupt hormones, and alter developing embryos. Waterpipe (hookah) smoking exposes users to many of the same combustion byproducts as cigarettes, while smokeless tobacco delivers high nicotine doses that have been linked in preliminary research to pregnancy complications.
Encouraging News: The Body Can Recover
Perhaps the most hopeful part of the WHO review is how quickly the body begins to heal. Studies indicate that within a year of quitting, ciliary function in the fallopian tubes improves, hormonal cycles stabilize, and semen quality begins to rebound. Former smokers showed roughly a quarter lower infertility risk than current smokers in the pooled data.
Evidence-based strategies that research suggests can help people quit include:
- Nicotine replacement therapy (patches, gum, lozenges) used under medical guidance
- Prescription cessation medications such as varenicline or bupropion
- Behavioral counseling, either in person, by phone (e.g., 1-800-QUIT-NOW in the U.S.), or through apps
- Combining medication and counseling, which typically doubles quit-success rates versus either alone
The Bottom Line
The new WHO summary reframes tobacco use as not only a cancer and cardiovascular issue, but also a reproductive one. For anyone planning a pregnancy — now or years from now — the evidence increasingly points in the same direction: quitting smoking, and reducing exposure to secondhand smoke, is a powerful, modifiable step. Because fertility is influenced by many factors, from age and genetics to underlying medical conditions, personalized guidance from a reproductive endocrinologist or primary care provider can help translate this evidence into an individual plan.
Disclosure: This content is for informational purposes only and is not medical advice. Always consult a qualified healthcare provider before making changes to your health regimen.