Does Nicotine Affect Fertility?

Thinking about starting a family? If so, it may be time to reconsider your nicotine use. Research suggests that nicotine can reduce sperm quality, disrupt hormones, and impair ovarian function—factors that could impact fertility. Whether it’s cigarettes, chewing tobacco, or vaping, nicotine may have lasting effects on reproductive health for both men and women. Here’s what you need to know.

Nicotine use has been linked to several factors that can negatively impact sperm:

• Oxidative Stress: Nicotine triggers oxidative stress which happens when harmful molecules build up in the body faster than it can clear them. Oxidative stress leads to sperm DNA damage and lower sperm health.

• Hormonal Disruption: It can interfere with hormone production by altering the hypothalamic-pituitary-gonadal axis, essential for healthy sperm production.

• Blood Flow Issues: Nicotine constricts blood vessels, potentially reducing blood flow to the testes and impairing sperm development.

While cigarettes are often the main focus, other nicotine sources also affect fertility. A 2022 study of over 600 Swedish men found that those using chewing tobacco had 24% lower sperm counts than non-users, yet their testosterone levels were, on average, 14% higher. Similarly, a 2020 study found that both e-cigarette and cigarette users had lower total sperm counts than non-users.

Emerging evidence also suggests that vaping negatively affects sperm quality. A video from an Australian IVF clinic demonstrated that a semen sample from a man who vaped showed fewer and less motile sperm compared to a non-vaper's sample.

Nicotine doesn’t just impact sperm—it can also have serious consequences for fertility in women. While smoking may be linked to higher testosterone levels in men, it doesn’t appear to have the same effect in women. But women aren’t in the clear—nicotine can disrupt their reproductive health in several key ways:

• Hormonal Imbalances: Nicotine use may interfere with estrogen regulation, which could impact menstrual cycles and ovulation.

• Reduced Ovarian Function: Long-term nicotine use can lower ovarian reserve and compromise egg quality, making conception harder.

• Higher Risk of Miscarriage: Smoking during pregnancy is linked to increased miscarriage rates and other pregnancy complications.

Long-term nicotine use can make starting a family more challenging for both men and women. Reducing or eliminating nicotine use may support your fertility goals, and choosing tobacco-free products could also minimize exposure to certain smoke-related toxins. 

If you’re planning to conceive, lowering your nicotine intake with nicotine pouches—or quitting altogether—could be one of the best steps you take for your fertility and future family.