The effect of Cigarette and Hookah smoking on Anti-Mullerian Hormonelevels: A review study

Background: Tobacco contains many toxic substances that can affect ovarian reserve and lead topoor prognosis in assisted reproductive techniques. A hookah (or waterpipe) is a device throughwhich tobacco smoke is often mixed with fruity aromas, and it is an ancient method that hasbecome widely popular around the world. The main form of tobacco consumption in manycountries is cigarettes, and the connection between smoking and female infertility has been provenfor a long time; However, no comprehensive information is available on the effect of hookah onthe reproductive system, especially its effect on anti-mullerian hormone. Therefore, the presentstudy aimed to systematic review of the effect of both smoking and hookah on the anti-mullerianhormone. Because anti-Müllerian hormone is a suitable indicator for measuring follicle ovarianreserves.Methods: In this systematic review, databases including PubMed, Web of Science, Scopus,EMBASE, ProQuest and EBSCO were searched using the keywords “tobacco”, “cigarette”,“Hookah”, “waterpipe”, “nicotine”, “infertility”, “Ovarian reserve”, “Anti-Müllerian hormone”and "AMH" which were combined with the OR and AND Boolean operators. All observationalstudies from ۲۰۱۰ to the end of October ۲۰۲۲ were included in the study. There were norestrictions on the language of publication of articles.Results: Finally, ۸ articles that were the most appropriate in terms of subject coverage wereevaluated, ۶ articles were about the effect of cigarette and ۲ articles were about the effect ofhookah on AMH hormone and ovarian reserves. The results of this study showed that in most ofthe current studies, chemicals and toxic substances in cigarette were related to poor fertilityoutcomes and reduced fertility; cigarette smoking has an adverse effect on ovarian reserve andleads to atresia of antral follicles and a decrease in AMH serum levels. Also, based on the resultsof these articles, hookah smoke contains toxic and carcinogenic chemicals such as nicotine, carbonmonoxide, tar, and heavy metals, which may release more toxic substances than cigarettes; As aresult, it may have a greater effect on the reproductive system. Hookah has a destructive effect onovarian reserve and the average AMH level was lower in women who used hookah.Conclusion: Considering the harmful effects of smoking on the reproductive function of couplesthrough the reduction of ovarian reserves, the increase in smoking, especially hookah, and exposure to second-hand smoke, more research should be conducted on the causes andconsequences of the reduction of ovarian reserves, especially the anti-Müllerian hormone and aswell as a better understanding of how the nicotine in hookah affects infertility, especially ovarianreserves. On the other hand, couples who are undergoing infertility treatment cycles, should beencouraged to quit smoking

کلیدواژه ها:

Tobacco ، Cigarette ، Hookah ، Anti-Müllerian Hormone ، Infertility