Effect of exposure to second-hand smoke from husbands on biochemical hyperandrogenism, metabolic syndrome and conception rates in women with polycystic ovary syndrome undergoing ovulation induction

Jian Li, Q. Wu, Xiao Ke Wu, Zhong Ming Zhou, Ping Fu, Xiu Hua Chen, Ying Yan, Xin Wang, Zheng Wang Yang, Wei Li Li, Elisabet Stener-Victorin, Richard S. Legro, Ernest Hung Yu Ng, Heping Zhang, Ben Willem J. Mol, Chi Chiu Wang

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6 Citations (Scopus)


STUDY DESIGN, SIZE, DURATION: This study was a secondary analysis of the Polycystic Ovary Syndrome Acupuncture and Clomiphene Trial (PCOSAct), a large randomized controlled trial conducted at 27 hospitals from 2012 to 2015 in mainland China. PARTICIPANTS/MATERIALS, SETTING, METHODS: Out of 1000 women with PCOS, SHS exposure status were available in 500 women, of whom 271 women were non-exposed and 229 exposed to cigarette smoke (170 women ?10 cigarettes per day as low-SHS exposed and 59 women >10 cigarettes per day as high-SHS exposed). We compared circulating sex steroids, glucose and lipid metabolism, metabolic syndrome and phenotypes, fertility and obstetric outcomes between non-exposed and exposed women. MAIN RESULTS AND THE ROLE OF CHANCE: Women exposed to SHS, compared to non-exposed women, had a higher serum total testosterone (1.7 vs 1.5 nmol/L, P = 0.01), free androgen index (5.7 vs 4.0, P = 0.001) and lower sex hormone binding globulin (30.1 vs 35.6 nmol/L, P = 0.03). Metabolic syndrome, but not other phenotypes, was more frequent in exposed women as compared to nonexposed women (21.8 vs 13.3%, adjusted odds ratio (OR)=1.66; 95% CI, 1.022.71, P = 0.04). Ovulation rates between exposed and nonexposed groups were not significantly different (76.9 vs 82.9%, adjusted OR=0.72; 95% CI, 0.451.15, P = 0.17). Conception rates were significant lower in the exposed group (26.6 vs 36.9%; adjusted OR=0.61; 95% CI, 0.410.91; P = 0.01), while clinical pregnancy and live birth rates showed a similar trend that was not statistically significant. Gestational age, birth weight and other obstetric outcomes were not affected by SHS exposure. LIMITATIONS, REASONS FOR CAUTION: Data on SHS exposure were missing in 50% of the women. We did not assay serum nicotine or cotinine levels to quantify the SHS exposure status. WIDER IMPLICATIONS OF THE FINDINGS: These data suggest that smoking partners of infertile women with PCOS who seek treatment should be advised to quit smoking.

Original languageEnglish
Pages (from-to)617-625
Number of pages9
JournalHuman Reproduction
Issue number4
Publication statusPublished or Issued - 1 Apr 2018


  • metabolic syndrome
  • polycystic ovary syndrome
  • pregnancy and obstetric outcomes
  • second-hand smoke
  • sex hormones

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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