So much has been said about the dangers of smoking but it seems we are yet to hit the half mark. Researchers and physicians can confirm that smokers are at risk of failing to make babies. Women who smoke are in danger of failing to conceive, and when they do, the dreaded miscarriage stalks their wombs. Sadly, the malady affects does not spare men as the chemical elements in cigarettes can cause the can reduce fertility.A woman in Kigali, who preferred to remain anonymous for fear of stigmatisation, said she started smoking for fun around 2000 but later became addicted."My situation worsened in 2010 when I got married and we tried to conceive but all in vain. The only time I was able to conceive, I got a miscarriage and my doctor told me those (failing to conceive and miscarriage) were the effects of smoking,” the woman said.Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital in Musanze District, said smoking affects fertility both in men and women because of the hormonal damage it causes. She said nicotine and tar from cigarettes affect ovulation in women, increase risk of miscarriage and  increased risk of sudden infant death."In men, specifically, it leads to erectile dysfunction, reduced sperm count and reduced sperm motility. I have come across many cases of male impotence of which some where definitely smoking. I have also seen two women from rural background who smoked and then had difficulty conceiving,” Dr Pande said."Individuals desiring to conceive should quit smoking because even smoking one cigarette per day can cause damage as cigarette smoke [a single puff] carries about 1,000 chemicals which harm body in multiple ways.”How it happensResearchers from the Monell Centre in Philadelphia, US, suggest that smoking reduces the amount of estrogen that a woman’s body produces. Smoking may cause a decrease of blood flow to the genital organs, which can cause dryness of the vagina and other sexual issues.The same studies suggest that women who have never smoked have had as much as twice the degree of success when trying to conceive than those who have smoked. The rate of successful conception drops further the longer the woman has smoked."If you are trying to conceive, many healthcare providers will recommend that you cease smoking at least two months before conception. Because of the health risks involved to you and your baby, you should absolutely cease smoking once you discover that you are pregnant,” said Dr Samuel Kagali, of Hospital LA Croix DU SUD in Kigali.Dr Kagali said smoking makes it harder to conceive, irrespective of which partner smokes. Both female and male smokers have lower fertility levels. "I have encountered a number of miscarriages due to smoking, smoke affects the pregnancy irrespective of which partner is smoking,” he said.The doctor said smoking may contribute to the destruction of eggs while they are in the ovaries, before they reach maturity."This results in a lower egg count and Smoking can negatively impact the fallopian tubes, and can even lead to disease of the fallopian tubes,” Dr Kagali said.A recent publication in the American Journal of Epidemiology showed that underweight and obese smokers were more likely to take longer than nine and a half months of unprotected intercourse to conceive than underweight and obese non-smokers. It is thought to take around three months for improvement to be maximised in relation to fertility after stopping smoking. It’s thought nicotine reduces a woman’s fertility by affecting the production of hormones that are necessary for pregnancy. Smoking also impedes the transportation of the egg through the Fallopian tubes to the womb. Male smokers tend to have a sperm count that is 15 per cent lower than that of non-smokers. Smoking can also: reduce the amount of semen, harm the motility of sperm, that’s to say, their ability to move around, affect their shape and also affect the blood vessels that supply the penis, causing erectile problem. Local doctors suggest that if one is planning to try intrauterine insemination, or in vitro fertilisation (IVF), u need to make an effort to stop smoking today. Smoking may affect your success rates when undergoing these fertility treatments.Studies show that smokers are less likely to get pregnant with Assisted Reproductive Technology (ART) procedures like IVF. While ART does work for some women that smoke, smokers are more likely to miscarry after ART than their nonsmoking peers.However, fewer studies have been done on the effects of male smoking and fertility, but some of the research does suggest that there may be a connection between smoking and a low sperm count. Other studies suggest that smoking may affect the sperm’s motility, and may even lead to genetically abnormal sperm.

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How smoking makes it harder to conceiveWomen smokers who try for a baby may take up to two months longer to conceive than non-smokers, doctors say.Researchers have, for the first time, measured the effect of the habit on a woman’s chances of becoming pregnant. A study looked at the success rates of 569 women aged around 29 who were trying to have a baby, including smokers, ex-smokers and nonsmokers.Its findings show that those who continued to smoke took, on average, almost two months longer to conceive than women who gave up smoking during that period.However, quitting helps immediately. Within a year of giving up, ex-smokers took no longer to become pregnant than women who had never smoked.Chief researcher Dr Marcus Munafo, from the Imperial Cancer Research Fund’s General Practice Research Group, said women were encouraged not to smoke during pregnancy because of the harm it causes the unborn baby.He said: "There is a lot of evidence about the risks of smoking during pregnancy such as higher infant mortality, the increased risk of the baby developing serious respiratory infection, and lower birth weights. But many women may not be aware that quitting also greatly improves their chances of getting pregnant in the first place.”"The study clearly shows a link between smoking and fertility problems,” Dr Munafo added.Published in the Journal of Biosocial Science, last year, the study suggests heavy smokers are affected to a greater degree. But Dr Munafo said smoking made conception harder for all women.It is not clear how smoking damages women’s fertility but it may affect the release of an egg before fertilisation or the quality of the eggs.Dr Munafo said: "When trying to conceive, many women often change their lifestyle by cutting down their alcohol intake, taking vitamins and minerals and eating a healthier diet.”This study shows that stopping smoking should be a part of the pre- conception routine and women should quit as soon as they are thinking about having a baby. The message from this research is that if you want to get pregnant, you will not only improve your chances by quitting, you will also be doing something to protect the health of your child in the long term.Other research has found that if a non-smoking woman is exposed to passive smoking, her chances of conceiving within a year are reduced by 14 per cent.