患者告知书：吸烟与不孕

患者告知书：吸烟与不孕（美国 2003）
 

资料来源：http://www.asrm.com顺德第一人民医院妇科古伟文岳阳市第一人民医院妇产科李诚

patient’s fact sheet 患者告知书

smoking and infertility

吸烟与不孕

the health risks of tobacco smoking are well known with regard to diseases of the heart, lungs, and blood vessels. substantial harmful effects of cigarette smoke on fertility have become apparent, but are not generally appreciated. cigarette smoking has a negative impact on the ability to become pregnant and carry a pregnancy to term.

众所周知吸烟危害健康导致心血管病和肺病。吸烟显然对生育力有很多有害影响，但未引起重视。吸烟对受孕和妊娠分娩有消极影响。

 

impact of cigarette smoking on reproduction in women:

吸烟对女性生殖的影响：

virtually all scientific studies support the conclusion that smoking has an adverse impact on fertility. the prevalence of infertility is higher, and the time it takes to conceive is longer, in smokers compared to nonsmokers. active smoking by either partner has adverse effects, and the impact of passive cigarette smoke exposure is only slightly smaller than for active smoking. research indicates that cigarette smoking is harmful to a woman’s ovaries, and the degree of harm is dependent upon the amount and the period of time a woman smokes. smoking appears to accelerate the loss of eggs and reproductive function and may advance the time of menopause by several years.

实际上所有的科学研究都支持吸烟对生殖力有不良影响。吸烟与不吸烟比较，不孕症发病率更高，需更长时间才能受孕。任何伴侣主动吸烟都有不良影响，被动吸二手烟的影响只比主动吸烟轻微减少，研究表明吸烟对女性的卵巢有害。危害程度依女性吸烟的数量和烟龄而定。吸烟似乎加速卵子减少和生殖功能减退，结果绝经时间可能提前好几年。

 

components in cigarette smoke have been shown to interfere with the ability of cells in the ovary to make estrogen and to cause a woman’s eggs (oocytes) to be more prone to genetic abnormalities. smoking is strongly associated with an increased risk of spontaneous miscarriage and possibly ectopic pregnancy as well. pregnant smokers are more likely to have low birth weight babies and premature birth. the incidence of sudden infant death syndrome (sids) also increases in households where someone smokes.

烟草的成分显示妨碍卵巢细胞产生雌激素的能力和有导致卵子基因异常的倾向。吸烟与增加自然流产和宫外孕的风险密切相关。孕妇吸烟更可能出生低体重儿和早产。家里有人吸烟，婴儿猝死综合症发病率也增加。

 

impact of cigarette smoking on assisted reproductive therapy outcomes: 吸烟对辅助生育结局的影响：

nearly twice as many in vitro fertilization (ivf) attempts are required to conceive in smokers than in nonsmokers. studies of ivf have reported that female smokers require higher doses of gonadotropins to stimulate their ovaries, have lower peak estradiol levels, fewer oocytes obtained, more canceled cycles, lower implantation rates, and undergo more cycles with failed fertilization than nonsmokers. miscarriage rates are also increased. the adverse effect of cigarette smoking is more noticeable in older women. overall, the reduction in natural fertility associated with smoking may not be overcome by assisted reproductive technologies.

想做体外受精怀孕的妇女中，吸烟者是非吸烟者的两倍。体外受精的研究报告女性吸烟者比非吸烟者要用更大剂量的促性腺激素促排卵。雌激素峰值更低，采卵更少，取消周期更多，种植率更低，而受精失败周期更多。流产率也增加。吸烟对大龄妇女的不良影响更显著。总之，辅助生殖技术可能遏止不了与吸烟有关的自然受孕减少。

 

impact of cigarette smoking on reproduction in men:

吸烟对男性生殖的影响：

men who smoke cigarettes have a lower sperm count and motility and increased abnormalities in sperm shape and function. the effect of smoking on male fertility, however, is more difficult to discern because it is difficult to create studies to address that question. although the effects of cigarette smoking on male fertility remain inconclusive, the harmful effect of passive smoke on the fertility of female partners and the evidence that smoking adversely affects sperm quality suggest that smoking in men should be regarded as an infertility risk factor.

男性吸烟者精子的数量和活动力更小，精子的形态和功能更反常，男性吸烟对生育力的影响因为难以设计解决问题的研究而更模糊。尽管男性吸烟对生育力的影响依然不确定，但被动吸烟对女性伴侣生育力的有害影响和吸烟影响精子质量的证据提示男性吸烟应该被认为是不育的危险因素。

 

smoking cessation as a treatment issue in couples undergoing fertility therapy: 戒烟作为不孕夫妇的一种治疗方法

one important investigation showed that cessation of smoking for at least two months before attempting ivf significantly improved chances for conception. although long-term cigarette smoking can have an irreversible effect on ovarian function, the harmful effect on treatment outcome may, in part, be reversed if smoking is discontinued prior to entering into fertility therapy.

一个重要的调查显示在尝试体外受精前戒咽2个月以上受孕机会明显增加。长期吸烟会对卵巢功能有不可逆的影响，但若在不育治疗前戒咽，对治疗结局的不良影响也可以部分逆转。

 

summary: the best available scientific data indicate that cigarette smoking strongly contributes to infertility. smoking should be discouraged for both male and female partners in couples with a history of infertility or recurrent miscarriage. smoking cessation may improve natural fertility and success rates with infertility treatment.

简言之：可利用的最好的科研资料表明吸烟与不孕不育密切相关。要劝阻有不孕不育和流产病史的夫妇吸烟。戒咽可改进自然生育力和不孕症治疗的成功率。

 

the american society for reproductive medicine grants permission to photocopy this fact sheet and distribute it to patients. revised 11/2003

美国生殖医学会批准这份告知书复印件派发患者  2003年11月修订