Premature ovarian insufficiency: A review on the role of tobacco smoke, its clinical harm, and treatment
Bibliographic record
Abstract
Background: Premature ovarian insufficiency (POI) is the cessation of normal ovarian function before the age of 40 and is associated with infertility, hypoestrogenism, and increased risk of chronic disease. In environmental and lifestyle factors, cigarette smoking is a modifiable risk factor accelerate ovarian aging. Objective: This systematic review evaluate the association between tobacco smoke exposure and POI in women of reproductive age by reviewing findings from original studies assessing ovarian reserve markers, reproductive hormone profiles, and fertility outcomes. Methods: A literature search was conducted in (PubMed, Scopus, and Web of Science) for studies published between 2010 and 2025. Eligible studies included human participants aged 18 to 45, with exposure to active or passive cigarette smoking through self-report or biochemical markers. Included outcomes were anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), in vitro fertilization (IVF) parameters, and natural fecundability. Studies were selected through a two phase screening process and analyzed qualitatively due to methodological heterogeneity. Results: Six original studies were included. Smoking was associated with lower AMH levels, higher FSH levels, and diminished ovarian reserve. Active smoking was linked to fewer oocytes retrieved, poorer embryo quality, and reduced pregnancy rates during IVF. Long-term or high-dose smokers show reduced fecundability in natural cycles. One study found no significant difference in IVF outcomes in smokers with normal ovarian reserve. Conclusion: Cigarette smoking negatively affects ovarian reserve and fertility. Smoking cessation should be advised to preserve reproductive health and prevent POI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".