The outcomes of 650 patients, 108 of whom were smokers, receiving assisted reproduction treatment were assessed for the effects of smoking habit on ovulation, fertilization, implantation and pregnancy outcome. Smokers produced fewer oocytes, gave a pregnancy rate less than half that of the nonsmokers, and those smokers who became pregnant showed a markedly increased rate of miscarriage.

Previous studies suggest that at around 40 years of age, pregnancy rates achieved by IVF programmes fall and pregnancy loss rates increase. The actual age at which this occurs has not been clearly delineated. This study of 2,692 patients including 94 aged 41 or over shows that satisfactory pregnancy rates can be achieved up to and including age 40. As age 40 is approached the pregnancy loss rate increases to around 40%. In the 41 years and over group the pregnancy rate was poor at 6% (6/94) and the pregnancy loss rate very discouraging at 83% (5/6).

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