Vaping, Smoking, and Fertility

Infertility is defined as not being able to become pregnant after one year of unprotected sex or one year of trying to conceive. Infertility may affect millions worldwide and can involve factors related to either partner. Fertility can be affected by genetic conditions, hormonal imbalances, certain health conditions, and lifestyle choices, like smoking or vaping.

Across the United States and Canada, between 11-11.6% of adults smoke, and between 6-6.5% of adults vape. Together, these percentages represent millions of smokers and vapers in each country.

What is in Cigarettes and E-Cigarettes?

E-cigarettes, or vapes, have been used as an alternative to cigarettes and a way to quit smoking. The addition of flavors has also made vaping appealing to people who may not otherwise use nicotine products, including younger users.

Cigarette smoke and vape aerosol can contain some of the same harmful substances, including nicotine, formaldehyde, acetaldehyde, heavy metals, and carcinogens. E-cigarette liquids (vape juice) also contain ingredients like glycerin and flavoring agents, which can produce additional chemicals when heated.

While vapes generally contain lower levels of many harmful chemicals than cigarettes, researchers ask whether their ease of use may encourage frequent use, potentially increasing a person’s overall exposure to harmful substances.

Male Infertility

Inhaling nicotine products can decrease sperm count, movement (motility), and quality. Specifically, high amounts of heavy metals, such as lead and cadmium, are associated with male infertility. Nicotine use in men has also been linked to a higher risk of miscarriage in their partner, as well as an increased risk of birth defects and pregnancy complications.

Smoking has been associated with changes to sperm DNA and abnormal sperm shape (teratozoospermia). Smoking and vaping may also affect seminal fluid and structures involved in sperm maturation, storage, and ejaculation:

• Epididymis: where sperm mature and are stored
• Prostate: creates the fluid that becomes part of semen and helps move semen during ejaculation
• Seminal vesicles: produce fluid that provides nutrients and makes up much of semen

Men may also experience altered reproductive hormones and cells. Those who vape may have decreased testosterone and the hormones that help with testosterone circulation and reproduction, such as:

• Sex hormone-binding globulin (SHBG): binds to estrogen and testosterone and carries them through the bloodstream
• Follicle-stimulating hormone (FSH): helps support sperm production
• Luteinizing hormone (LH): signals the testes to produce testosterone

Those who smoke may have increased testosterone levels at first, but these effects could reverse with long-term use. Additionally, both vaping and smoking have caused testicular cell death in rats. Men who smoke and vape may also experience erectile dysfunction (ED). Hormonal changes may play a role, while damage to blood vessels can make it harder for enough blood to flow into the penis.

Female Infertility

Effects of smoking and vaping in women revolve around the health and function of the ovaries and ovum (eggs). Women who smoke or vape can experience a decrease in their ovarian reserve, which is the number of healthy eggs left in the ovaries. This can affect normal ovulation, cause more painful periods, and lead to earlier menopause. Smoking and vaping may also interfere with how the fallopian tubes move an egg toward the uterus. This can lead to a higher risk for ectopic pregnancies, which happen when a fertilized egg implants outside the uterus. An ectopic pregnancy cannot continue to term and requires medical treatment.

Changes in reproductive hormones, estrogen and progesterone, may affect the eggs and the reproductive environment before fertilization even happens. This can also make the uterine lining thinner, making it harder for a fertilized egg to implant. The decreased hormones may also be linked to an increased risk for miscarriage, although studies have mixed conclusions.

Key Takeaways

• There currently is not enough research to fully understand the effects of vaping and smoking on human fertility.
  • Much of the research on vaping and fertility has been conducted in animals, so its effects on human fertility are still being studied.
  • The differences between how smoking and vaping affect fertility are not yet fully understood.
• Smoking and vaping have been associated with reduced sperm and egg quality, as well as changes to the reproductive systems and hormones.
• Neither vaping nor smoking is considered “risk-free,” and both may affect reproductive health.
  • Vape aerosols generally contain lower levels of many harmful chemicals than cigarette smoke, but vapes are easily accessible, which may increase their use.
  • Flavoring agents add a new element that can be more toxic at high temperatures.
• It is not recommended to smoke or vape for overall health.
• When trying to conceive, try to avoid smoking or vaping. If fertility is still a concern, it may be beneficial to speak with a fertility specialist.

Resources

Budani, M. C., & Tiboni, G. M. (2026). Electronic cigarettes and female reproduction: A systematic review of experimental and clinical evidence. International Journal of Molecular Sciences, 27(14), 6528. MDPI. https://doi.org/10.3390/ijms27146528

Dhage, V. D, Nagtode, N., Kumar, D., & Bhagat, A. K. (2024). A narrative review on the impact of smoking on female fertility. Cureus Journal of Medical Science, 16(4). Springer Nature. https://doi.org/10.7759/cureus.58389

Getreu, N., Wainwright, E., Crawford, L., Nedelcu, S., Dhonnabháin, B. N., Vaz, S. R., Vasavan, T., & O’Neill, H. C. (2026). E-cigarette use (vaping) and cigarette smoking are associated with reduced markers of ovarian reserve: A cross-sectional study of 16,087 women. BMC Women’s Health, 26, 437. Springer Nature. https://doi.org/10.1186/s12905-026-04620-x

Holmboe, S. A., Priskorn, L., Jensen, T. K., Skakkebaek, N. E., Andersson, A.-M., & Jørgensen, N. (2020). Use of e-cigarettes associated with lower sperm counts in a cross-sectional study of young men from the general population. Human Reproduction, 35(7), 1693–1701. Oxford Academic. https://doi.org/10.1093/humrep/deaa089

Montjean, D., Godin Pagé, M.-H., Bélanger, M.-C., Benkhalifa, M., & Miron, P. (2023). An overview of e-cigarette impact on reproductive health. Life, 13(3), 827. MDPI. https://doi.org/10.3390/life13030827