How long should I quit smoking before IVF?

At least 3 months (sperm cycle + full egg maturation). But many clinics advise 6 months to maximise odds. The sooner you quit, the better.

If I'm already in a stimulation cycle, should I quit mid-way?

Yes, if you can. Even quitting mid-stimulation is beneficial (drop in oxidative stress). Not ideal, but better than nothing.

My clinic said it would refuse me if I keep smoking. Is that allowed?

Yes. Clinics can set medical conditions on treatment, and tobacco is one. The position is backed by learned societies (ESHRE).

Are nicotine substitutes compatible with hormone stimulation?

Yes, they are considered safe during ART protocols. They deliver nicotine alone (no CO, no tars), far less toxic than cigarettes. Use them as a transition to zero nicotine.

What if I haven't conceived after a year even though I quit 3 months ago?

Stay smoke-free. Benefits keep accumulating over time. If pregnancy still doesn't come, it's likely multifactorial — discuss other options with your team (more tests, IVF with ICSI, donor eggs/sperm).

My husband refuses to quit while I do stimulation. Is all my effort wasted?

Partly, yes. Paternal smoking clearly lowers odds. And second-hand smoke affects you too. It's a couple conversation, ideally with a stop-smoking adviser.

And if I relapse mid-journey, is it ruined?

Not at all. A relapse does not erase the accumulated benefits. Restart quitting as soon as possible and keep the journey going. Many people relapse and carry on. A stop-smoking adviser helps through those moments.

Smoking and IVF/ART: why fertility clinics require quitting before any treatment

Smoking halves IVF/ICSI success rates, for both partners. Clinics advise quitting at least 3 months before starting stimulation.

June 11, 2026 Aria

The scientific basis on quitting smoking was reviewed on a voluntary basis by Pr. Bertrand Dautzenberg , a tobacco specialist, in order to rule out gross, potentially dangerous errors. It reflects positions commonly shared by health professionals and health agencies, without always corresponding exactly to his thinking or his practice. He is not the author of this text; he has only carried out a vigilance review of it.

If you're starting on an assisted reproduction (ART) path, you'll hear it from the first consultation: 'quit smoking'. It's not moralism — it's medicine. Smoking slashes the success rate of IVF or ICSI, for both the woman and the man. Here's why, and how to organise yourself.

Why smoking is so harmful in IVF/ART

Woman's side

Man's side

× 2.75 ICSI failure rate if the man smokes. And × 2.5 in IVF. Paternal smoking has an impact as marked as maternal smoking.

Zitmann et al. study, 301 couples

The hard numbers

Parameter	Non-smoker	Smoker	Gap
IVF pregnancy rate	~ 23 %	~ 15 %	− 35 %
ICSI — woman smokes	38 %	22 %	− 42 %
ICSI — man smokes	38 %	22 %	− 42 %
Time to natural conception	Ref.	× 3 to × 4	Much longer
Implantation	Ref.	− 50 %	Severe

The '3 months minimum': why this length

Is quitting 'mandatory' before ART?

Vape, snus, heated tobacco

How to organise yourself

As soon as ART is on the cards

tell the fertility team and your GP/stop-smoking adviser your intention to quit.
3 to 6 months before first stimulation: start quitting, ideally with nicotine substitutes (safe in pre-conception).
To avoid during ART

varenicline, bupropion, cytisine (not recommended during attempts or pregnancy).
Ideally, both partners quit

additive effect on odds, and mutual support.
Dedicated stop-smoking follow-up if possible — many centres have a partner adviser.
Check exhaled CO regularly (simple, free in-consultation test).

The partner counts as much as the woman

Side benefits of quitting before ART

In United Kingdom

Your questions

How long should I quit smoking before IVF?

At least 3 months (sperm cycle + full egg maturation). But many clinics advise 6 months to maximise odds. The sooner you quit, the better.
If I'm already in a stimulation cycle, should I quit mid-way?

Yes, if you can. Even quitting mid-stimulation is beneficial (drop in oxidative stress). Not ideal, but better than nothing.
My clinic said it would refuse me if I keep smoking. Is that allowed?

Yes. Clinics can set medical conditions on treatment, and tobacco is one. The position is backed by learned societies (ESHRE).
Are nicotine substitutes compatible with hormone stimulation?

Yes, they are considered safe during ART protocols. They deliver nicotine alone (no CO, no tars), far less toxic than cigarettes. Use them as a transition to zero nicotine.
What if I haven't conceived after a year even though I quit 3 months ago?

Stay smoke-free. Benefits keep accumulating over time. If pregnancy still doesn't come, it's likely multifactorial — discuss other options with your team (more tests, IVF with ICSI, donor eggs/sperm).
My husband refuses to quit while I do stimulation. Is all my effort wasted?

Partly, yes. Paternal smoking clearly lowers odds. And second-hand smoke affects you too. It's a couple conversation, ideally with a stop-smoking adviser.
And if I relapse mid-journey, is it ruined?

Not at all. A relapse does not erase the accumulated benefits. Restart quitting as soon as possible and keep the journey going. Many people relapse and carry on. A stop-smoking adviser helps through those moments.

sources

NHS, Fertility — how smoking affects your chances.
Zitmann M et al., Smoking and IVF/ICSI outcomes, ESHRE 2003 and later studies.
ESHRE (European Society of Human Reproduction and Embryology), guidelines on lifestyle and ART.
HFEA (Human Fertilisation and Embryology Authority), Improving your chances of IVF success.
ASH UK, Smoking and fertility — fact sheet.
Royal College of Obstetricians and Gynaecologists, Pre-conception lifestyle guidance.