{"id":"https://openalex.org/W7212367479","doi":"https://doi.org/10.18502/jfrh.v20i2.22613","title":"Associations of Hookah and Cigarette Smoking With In Vitro Fertilization Outcomes: A Cross-Sectional Study","display_name":"Associations of Hookah and Cigarette Smoking With In Vitro Fertilization Outcomes: A Cross-Sectional Study","publication_year":2026,"publication_date":"2026-09-12","ids":{"openalex":"https://openalex.org/W7212367479","doi":"https://doi.org/10.18502/jfrh.v20i2.22613","pmid":"https://pubmed.ncbi.nlm.nih.gov/42924314","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13690112"},"language":"en","primary_location":{"id":"doi:10.18502/jfrh.v20i2.22613","doi":"https://doi.org/10.18502/jfrh.v20i2.22613","is_oa":true,"landing_page_url":"https://doi.org/10.18502/jfrh.v20i2.22613","pdf_url":null,"source":{"id":"https://openalex.org/S2764720474","display_name":"Journal of Family & Reproductive Health","issn_l":"1735-8949","issn":["1735-8949","1735-9392"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","poland-40"],"host_organization":"https://openalex.org/P4310319141","host_organization_name":"Tehran University of Medical Sciences","host_organization_lineage":["https://openalex.org/P4310319141"],"host_organization_lineage_names":["Tehran University of Medical Sciences"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Family and Reproductive Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.18502/jfrh.v20i2.22613","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5067526273","display_name":"Ashraf Moini","orcid":"https://orcid.org/0000-0002-7114-8331","observed_orcids":["https://orcid.org/0000-0002-7114-8331"]},"institutions":[{"id":"https://openalex.org/I202419968","display_name":"Royan Institute","ror":"https://ror.org/02exhb815","country_code":"IR","type":"nonprofit","lineage":["https://openalex.org/I202419968"]},{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Ashraf Moini","raw_affiliation_strings":["Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran","Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran","institution_ids":["https://openalex.org/I202419968"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I70640408"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086908089","display_name":"Sonia Eskandarion","orcid":"https://orcid.org/0009-0003-3041-4837","observed_orcids":["https://orcid.org/0009-0003-3041-4837"]},"institutions":[{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Sonia Eskandarion","raw_affiliation_strings":["Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I70640408"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5115398536","display_name":"Atiye Heidari Dalfard","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Atiye Heidaridalfard","raw_affiliation_strings":["Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I70640408"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031404034","display_name":"Siamand Mazhar","orcid":"https://orcid.org/0000-0001-5864-6865","observed_orcids":["https://orcid.org/0000-0001-5864-6865"]},"institutions":[{"id":"https://openalex.org/I4210102791","display_name":"Roozbeh Hospital","ror":"https://ror.org/019mzt973","country_code":"IR","type":"healthcare","lineage":["https://openalex.org/I4210102791"]},{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Siamand Mazhar","raw_affiliation_strings":["Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I4210102791","https://openalex.org/I70640408"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5001386175","display_name":"Rana Karimi","orcid":"https://orcid.org/0000-0003-0780-5648","observed_orcids":["https://orcid.org/0000-0003-0780-5648"]},"institutions":[{"id":"https://openalex.org/I70640408","display_name":"Tehran University of Medical Sciences","ror":"https://ror.org/01c4pz451","country_code":"IR","type":"education","lineage":["https://openalex.org/I70640408"]}],"countries":["IR"],"is_corresponding":true,"raw_author_name":"Rana Karimi","raw_affiliation_strings":["Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran","institution_ids":["https://openalex.org/I70640408"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5001386175"],"corresponding_institution_ids":["https://openalex.org/I70640408"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.64898544,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"20","issue":"2","first_page":"120","last_page":"125"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11156","display_name":"Reproductive Health and Technologies","score":0.4884999990463257,"subfield":{"id":"https://openalex.org/subfields/2743","display_name":"Reproductive Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11156","display_name":"Reproductive Health and Technologies","score":0.4884999990463257,"subfield":{"id":"https://openalex.org/subfields/2743","display_name":"Reproductive Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10364","display_name":"Reproductive Biology and Fertility","score":0.21940000355243683,"subfield":{"id":"https://openalex.org/subfields/2743","display_name":"Reproductive Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10060","display_name":"Smoking Behavior and Cessation","score":0.2142000049352646,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/waterpipe-tobacco-smoking","display_name":"waterpipe smoking","score":0.9950000047683716},{"id":"https://openalex.org/keywords/cigarette-smoking","display_name":"cigarette smoking","score":0.9800000190734863},{"id":"https://openalex.org/keywords/ivf-outcomes","display_name":"IVF outcomes","score":0.9570000171661377},{"id":"https://openalex.org/keywords/oocyte-maturation","display_name":"oocyte maturation","score":0.9639999866485596},{"id":"https://openalex.org/keywords/oocyte-maturity","display_name":"oocyte maturity","score":0.7200000286102295},{"id":"https://openalex.org/keywords/embryo-quality","display_name":"embryo quality","score":0.8270000219345093},{"id":"https://openalex.org/keywords/ovarian-response","display_name":"ovarian response","score":0.7039999961853027},{"id":"https://openalex.org/keywords/pregnancy-outcomes","display_name":"pregnancy outcomes","score":0.5870000123977661},{"id":"https://openalex.org/keywords/chemical-pregnancy","display_name":"chemical pregnancy","score":0.7519999742507935}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7688999772071838},{"id":"https://openalex.org/C2779234561","wikidata":"https://www.wikidata.org/wiki/Q11995","display_name":"Pregnancy","level":2,"score":0.6830000281333923},{"id":"https://openalex.org/C512716672","wikidata":"https://www.wikidata.org/wiki/Q200117","display_name":"In vitro fertilisation","level":3,"score":0.6820999979972839},{"id":"https://openalex.org/C2777688143","wikidata":"https://www.wikidata.org/wiki/Q179399","display_name":"Infertility","level":3,"score":0.6000999808311462},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.5234000086784363},{"id":"https://openalex.org/C3019085024","wikidata":"https://www.wikidata.org/wiki/Q7212330","display_name":"Cigarette smoking","level":2,"score":0.5152999758720398},{"id":"https://openalex.org/C29456083","wikidata":"https://www.wikidata.org/wiki/Q1221899","display_name":"Gynecology","level":1,"score":0.4918999969959259},{"id":"https://openalex.org/C131872663","wikidata":"https://www.wikidata.org/wiki/Q5284418","display_name":"Obstetrics","level":1,"score":0.4683000147342682},{"id":"https://openalex.org/C2776537878","wikidata":"https://www.wikidata.org/wiki/Q7239894","display_name":"Pregnancy rate","level":3,"score":0.4081000089645386},{"id":"https://openalex.org/C88972607","wikidata":"https://www.wikidata.org/wiki/Q2666904","display_name":"Human fertilization","level":2,"score":0.4072999954223633},{"id":"https://openalex.org/C2776690073","wikidata":"https://www.wikidata.org/wiki/Q3246226","display_name":"Oocyte","level":3,"score":0.38690000772476196},{"id":"https://openalex.org/C46973012","wikidata":"https://www.wikidata.org/wiki/Q28627","display_name":"Gestation","level":3,"score":0.33000001311302185},{"id":"https://openalex.org/C2779647306","wikidata":"https://www.wikidata.org/wiki/Q648065","display_name":"Female infertility","level":4,"score":0.3285999894142151},{"id":"https://openalex.org/C2776210078","wikidata":"https://www.wikidata.org/wiki/Q351870","display_name":"Reproductive medicine","level":3,"score":0.3179999887943268},{"id":"https://openalex.org/C16685009","wikidata":"https://www.wikidata.org/wiki/Q335057","display_name":"Andrology","level":1,"score":0.3005000054836273},{"id":"https://openalex.org/C196843134","wikidata":"https://www.wikidata.org/wiki/Q33196","display_name":"Embryo","level":2,"score":0.2921999990940094},{"id":"https://openalex.org/C42407357","wikidata":"https://www.wikidata.org/wiki/Q521","display_name":"Physiology","level":1,"score":0.2863999903202057},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2858000099658966},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.27219998836517334},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.2703999876976013},{"id":"https://openalex.org/C160099875","wikidata":"https://www.wikidata.org/wiki/Q237118","display_name":"Embryo transfer","level":3,"score":0.26190000772476196},{"id":"https://openalex.org/C3019190695","wikidata":"https://www.wikidata.org/wiki/Q7212330","display_name":"Tobacco use","level":3,"score":0.25769999623298645},{"id":"https://openalex.org/C2778279030","wikidata":"https://www.wikidata.org/wiki/Q1543380","display_name":"Live birth","level":3,"score":0.25380000472068787},{"id":"https://openalex.org/C2778580812","wikidata":"https://www.wikidata.org/wiki/Q686627","display_name":"Unexplained infertility","level":4,"score":0.25279998779296875}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.18502/jfrh.v20i2.22613","doi":"https://doi.org/10.18502/jfrh.v20i2.22613","is_oa":true,"landing_page_url":"https://doi.org/10.18502/jfrh.v20i2.22613","pdf_url":null,"source":{"id":"https://openalex.org/S2764720474","display_name":"Journal of Family & Reproductive Health","issn_l":"1735-8949","issn":["1735-8949","1735-9392"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","poland-40"],"host_organization":"https://openalex.org/P4310319141","host_organization_name":"Tehran University of Medical Sciences","host_organization_lineage":["https://openalex.org/P4310319141"],"host_organization_lineage_names":["Tehran University of Medical Sciences"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Family and Reproductive Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13690112","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13690112/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13690112/pdf/JFRH-20-120.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Family Reprod Health","raw_type":"Text"},{"id":"pmid:42924314","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42924314","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of family & reproductive health","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.18502/jfrh.v20i2.22613","doi":"https://doi.org/10.18502/jfrh.v20i2.22613","is_oa":true,"landing_page_url":"https://doi.org/10.18502/jfrh.v20i2.22613","pdf_url":null,"source":{"id":"https://openalex.org/S2764720474","display_name":"Journal of Family & Reproductive Health","issn_l":"1735-8949","issn":["1735-8949","1735-9392"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","poland-40"],"host_organization":"https://openalex.org/P4310319141","host_organization_name":"Tehran University of Medical Sciences","host_organization_lineage":["https://openalex.org/P4310319141"],"host_organization_lineage_names":["Tehran University of Medical Sciences"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Family and Reproductive Health","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7212367479.pdf","grobid_xml":"https://content.openalex.org/works/W7212367479.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W1969364034","https://openalex.org/W4380730911","https://openalex.org/W2411445778","https://openalex.org/W2265581199","https://openalex.org/W2136559105","https://openalex.org/W2158826841","https://openalex.org/W4395684710","https://openalex.org/W4323536466","https://openalex.org/W1963834565","https://openalex.org/W63248494"],"abstract_inverted_index":{"Objective:":[0],"The":[1,178],"global":[2],"prevalence":[3],"of":[4,8,16,128],"smoking":[5,35,213],"among":[6],"women":[7,52],"reproductive":[9,20],"age":[10],"is":[11],"significant,":[12],"and":[13,43,71,76,84,92,154,161,208,239],"the":[14,29,96,126,185,235],"impact":[15],"tobacco":[17],"on":[18],"assisted":[19],"technologies":[21],"requires":[22],"evaluation.":[23],"This":[24],"study":[25],"aimed":[26],"to":[27,132,170,234],"determine":[28],"association":[30],"between":[31,81,89,158,200],"cigarette":[32,82,99,159,201],"or":[33,152,206],"hookah":[34,90,203,219],"with":[36,224],"in":[37,125,145,184,189],"vitro":[38],"fertilization":[39],"(IVF)":[40],"outcomes.":[41,226],"Materials":[42],"methods:":[44],"In":[45],"this":[46],"cross-sectional":[47,240],"study,":[48],"we":[49],"enrolled":[50],"200":[51,97],"undergoing":[53],"their":[54],"first":[55],"IVF":[56,225],"cycle":[57],"at":[58],"Arash":[59],"Infertility":[60],"Center":[61],"(Tehran,":[62],"Iran).":[63],"Ovarian":[64],"response,":[65],"oocyte":[66,216],"maturity":[67],"(Metaphase":[68],"I":[69],"(MI)":[70],"II":[72],"(MII),":[73],"embryo":[74,150],"quality,":[75,151],"pregnancy":[77,156,180,209],"outcomes":[78],"were":[79,141],"compared":[80,131,169],"smokers":[83,100,160],"non-smokers,":[85],"as":[86,88],"well":[87],"users":[91,117,164],"non-users.":[93],"Results:":[94],"Among":[95],"participants,":[98],"(n=100)":[101,118],"had":[102,165],"significantly":[103],"fewer":[104],"mature":[105],"(MII)":[106],"oocytes":[107,130,168],"than":[108,188],"non-smokers":[109,133],"(6.72\u00b12.90":[110],"vs.":[111,135,173],"8.63\u00b16.20;":[112],"P":[113,137,175],"=":[114,138,176,192],"0.036).":[115,193],"Hookah":[116,163],"did":[119],"not":[120],"show":[121],"a":[122],"significant":[123,143],"decrease":[124],"number":[127],"MII":[129],"(8.06\u00b15.81":[134],"8.73\u00b16.12;":[136],"0.512).":[139],"There":[140],"no":[142,198],"differences":[144],"MI":[146,167],"oocytes,":[147],"embryos":[148],"obtained,":[149],"chemical":[153,179],"clinical":[155],"rates":[157],"non-smokers.":[162],"more":[166],"non-users":[171,190],"(7.88\u00b15.63":[172],"6.05\u00b14.44;":[174],"0.010).":[177],"rate":[181],"was":[182],"higher":[183],"hookah-user":[186],"group":[187],"(P":[191],"Logistic":[194],"regression":[195],"analysis":[196],"showed":[197,221],"link":[199],"smoking,":[202,204],"age,":[205],"BMI":[207],"rates.":[210],"Conclusion:":[211],"Cigarette":[212],"may":[214],"impair":[215],"maturation,":[217],"while":[218],"use":[220],"inconsistent":[222],"associations":[223],"These":[227],"findings":[228],"should":[229],"be":[230],"interpreted":[231],"cautiously":[232],"due":[233],"limited":[236],"sample":[237],"size":[238],"design.":[241]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-09-13T00:00:00"}