Maternal and paternal smoking and offspring antral follicle count in women from an infertility clinic.

BACKGROUND: The ovarian reserve is established in utero, and therefore may be influenced by parental characteristics such as tobacco smoking. However, the epidemiologic literature on parental smoking and adult antral follicle count (AFC) remains conflicted. RESEARCH DESIGN AND METHODS: Our study included 631 women enrolled in the Environment and Reproductive Health (EARTH) study, a prospective cohort at an academic fertility center between 2005 and 2019. Exposure was assessed by women self-reporting their mother's and father's overall and pregnancy specific smoking status. Outcome was assessed via AFC measured using transvaginal ultrasonography day 3 of an unstimulated menstrual cycle or progesterone withdrawal bleed. Adjusted multivariable Poisson regression with robust standard errors was used to estimate associations between participant maternal and paternal smoking exposure and AFC. RESULTS: The women in our study were mostly ≥35 years (55 %), never smokers (74 %), college-educated (92 %), White (84 %), and US born (76 %). The median AFC was 13.5 (interquartile range: 8-18). History of maternal smoking was not associated with AFC (ever vs never smoker: 1.3 %, 95 % CI: 8.4 %, 6.4 %) nor was maternal smoking during pregnancy (smoked during pregnancy vs. never smoker: 4.6 %, 95 % CI: 7.6 %, 18.4 %). History of paternal smoking was associated with lower AFC (ever vs never: 9.9 %; 95 % CI: 16.3 %, -2.9 %). Participants who reported that both their parents were ever smokers averaged 10.9 % lower AFC (95 % CI: 18.6 %, -2.5 %) compared to participants whose parents never smoked. CONCLUSION: Paternal smoking, including time periods outside the pregnancy window, may negatively influence the long-term ovarian development and function in female offspring. TRIAL REGISTRATION NUMBER: NCT00011713.