Fatemeh Zaremobini - Nursing and Midwifery Care Research Center, Department of Midwifery, Faculty of Nursing andMidwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Fatemeh Razeghi Haghighi - Master's student, consultation in midwifery, Faculty of Nursing and Midwifery, Shahid SadougiUniversity of Medical Sciences, Yazd, Iran.
Zahra Ghasemi - Master's student, consultation in midwifery, Faculty of Nursing and Midwifery, Shahid SadougiUniversity of Medical Sciences, Yazd, Iran.

Background: Infertility is experienced as a stressful situation by couples worldwide.Approximately ۶% of Iranian women suffer from primary infertility and ۳% suffer from secondaryinfertility. Inappropriate lifestyle, including tobacco use, is one of the factors affecting women'sfertility. more than ۱۰.۵% of Iranian women smoke cigarettes. Considering the importance offertility and the youth of the population in Iranian society, as well as the psychologicalconsequences of infertility, this study was conducted with the aim of reviewing the effect oftobacco on female infertility.Methods: The keywords 'tobacco', 'infertility', 'smoking', 'reproductive health' and 'nicotine' weresearched through Google Scholar, PubMed, SID and Scopus databases and the most relevantarticles published from ۲۰۱۵ were investigated. The search result included ۲۸ studies, which weused ۱۶ related studies.Results: The results of few studies showed that cigarette smoking did not have a significant effecton infertility, low quality of oocytes or number of follicles. But other studies indicated thenegative effects of tobacco on fertility and reproductive health. In which tobacco users are almosttwice as likely to report infertility versus non-users. Results were stronger among women whosmoked ≥۱۰ cigarettes/day for ≥۱۰ years. Smoking in the female is associated with impairedfecundity and increased risks of spontaneous abortion and ectopic pregnancy. Also, in a study, itwas shown that the AMH value scored higher in non-smokers than in smokers. Nonsmokers withexcessive exposure to tobacco smoke may have reproductive consequences as great as thoseobserved in smokers. Existing data suggests the association between chronic smokeless tobaccouse and impairment of ovarian morphology and function, oocyte quality, hormonal perturbations,fetal development and long‐term health effects on the fetus. In addition, smoking is negativelyassociated with ART outcomes such that smokers require nearly twice the number of IVF attemptsto conceive as nonsmokers.Conclusion: using tobacco has harmful consequences on women's fertility and reproductivehealth. In line with the goals of childbearing and population youth policies in Iran, specialattention should be paid to the screening of these women and providing counseling and supportservices to adopt a healthy lifestyle.

Tobacco, Infertility, Smoking, Reproductive Health, Nicotine