How does smoking affect our fertility? Many of us think it doesn't, or at least it shouldn't…. What about the pictures of our mother's friends in maternity clothes, with a martini in one hand and a cigarette in the other? Worse yet are the images of pregnant women who live on the streets, rarely eat anything but junk food, drink, smoke, and use every imaginable recreational drug. Both illustrations are great justifications for smokers who are trying to conceive that nicotine can't really affect our fertility. If it did, cigarettes would make great contraceptives. Conflicting medical reports abound regarding the effects of caffeine, alcohol, and stress on our fertility, rendering yet further justification to continue smoking.

If you are trying to conceive and you smoke, there is a built-in defensive mechanism that allows your habit to go on. You justify your smoking with images of women who have gotten pregnant while they were smokers. I know. I used to smoke, and I have treated many women who smoke. They all say the same thing. "I'll quit when I get pregnant."

I know how hard it is to give up yet one more vice for the hope of a child that just isn't happening. We don't believe it will make a difference. The focus of this article is to show that yes, it may even make the difference.

There isn't much controversy over the negative effects of nicotine on an unborn child — damage to the nervous system, low birth weight… but what about the effects of nicotine on a yet unconceived child?

Smoking paralyzes cilia — the tiny, hair-like projections found in our trachea and bronchi. Guess where else we have cilia? In our fallopian tubes. The cilia are responsible for advancing the egg down the fallopian tube toward the uterus. If your powers of denial are taking over now, you should be telling yourself, "Yes, but… smoke is inhaled directly into the respiratory tract, not into the reproductive tract." The American Journal of Epidemiology reports that nicotine is ten times more concentrated in the uterine fluid than it is in plasma. Not only can it affect the transit of the embryo down the fallopian tube, but can affect implantation as well.

If you need more denial busters, let's look at how smoking affects the quality of the egg itself. Not only does nicotine make the outer shell tougher to penetrate, even moderate tobacco use has been estimated to advance the onset of menopause by up to three years and increase the rate of follicular atresia (causing more eggs go into the resting phase rather than being released) by seven percent.

Are you convinced yet? If not, your denial may be stronger than my powers of persuasion. For those of us with impaired fertility, our reproductive system may be viewed as our body's weakest link. We just can't afford to add potential insults to an already compromised system.

Okay, I'm done lecturing. If you are to give up this powerful addiction, the initiative must come from within. So let the data sink in, and may you come to your own conclusion. If you do decide to join the ever-growing population of ex-smokers, there are many forms of help available — patches (only as an initial boost, not as a continuing crutch), hypnotherapy, and acupuncture to name a few. And you can begin at any time, one day at a time.

The Tao Te Ching says,

Prevent trouble before it arises.

Put things in order before they exist.

The giant pine tree

grows from a tiny sprout.

The journey of a thousand miles

starts from beneath your feet.