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                  <mods:namePart>Hernáez, Álvaro</mods:namePart>
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                  <mods:namePart>Wootton, Robyn E.</mods:namePart>
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                  <mods:namePart>Page, Christian Magnus</mods:namePart>
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                  <mods:namePart>Magnus, Per</mods:namePart>
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                  <mods:namePart>Burgess, Stephen</mods:namePart>
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                  <mods:namePart>Lawlor, Deborah A.</mods:namePart>
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                  <mods:namePart>Magnus, Maria Christine</mods:namePart>
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                  <mods:dateAccessioned encoding="iso8601">2025-05-15T19:20:24Z</mods:dateAccessioned>
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                  <mods:dateIssued encoding="iso8601">2022-07</mods:dateIssued>
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               <mods:identifier type="uri">http://hdl.handle.net/20.500.14342/4578</mods:identifier>
               <mods:identifier type="doi">https://doi.org/10.1016/j.fertnstert.2022.04.001</mods:identifier>
               <mods:abstract>Objective&#xd;
To investigate the association between smoking and infertility.&#xd;
Design&#xd;
Prospective study.&#xd;
Setting&#xd;
Nationwide cohort.&#xd;
Patients&#xd;
28,606 women and 27,096 men with questionnaire and genotype information from the Norwegian Mother, Father, and Child Cohort Study.&#xd;
Intervention&#xd;
Self-reported information on smoking (having ever smoked [both sexes], age at initiation [women only], cessation [women only], and cigarettes/week in current smokers [both sexes]) was gathered. Genetically predetermined levels or likelihood of presenting these traits were estimated for Mendelian randomization.&#xd;
Main outcome measure&#xd;
Infertility (time-to-pregnancy ≥12 months).&#xd;
Results&#xd;
Having ever smoked was unrelated to infertility in women or men. Higher smoking intensity in women was associated with greater infertility odds (+1 standard deviation [SD, 48 cigarettes/week]: odds ratio [OR]crude, 1.19; 95% confidence interval [CI] 1.11–1.28; ORadjusted 1.12; 95% CI, 1.03–1.21), also after adjusting for the partner’s tobacco use. Later smoking initiation (+1 SD [3.2 years]: ORcrude, 0.94; 95% CI, 0.88–0.99; ORadjusted 0.89; 95% CI, 0.84–0.95) and smoking cessation (vs. not quitting: ORcrude, 0.83; 95% CI, 0.75–0.91; ORadjusted, 0.83; 95% CI, 0.75–0.93) were linked to decreased infertility in women. Nevertheless, Mendelian randomization results were not directionally consistent for smoking intensity and cessation and were estimated imprecisely in the 2-sample approach. In men, greater smoking intensity was not robustly associated with infertility in multivariable regression and Mendelian randomization.&#xd;
Conclusions&#xd;
We did not find robust evidence of an effect of smoking on infertility. This may be due to a true lack of effect, weak genetic instruments, or other kinds of confounding.&#xd;
Tabaquismo e infertilidad: regresión multivariable y análisis de aleatorización mendeliana en el estudio de cohorte noruego de madre, padre e hijo.</mods:abstract>
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               <mods:accessCondition type="useAndReproduction">© L'autor/a Attribution 4.0 International</mods:accessCondition>
               <mods:subject>
                  <mods:topic>Hàbit de fumar</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Esterilitat</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Aleatorització Mendeliana</mods:topic>
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               <mods:titleInfo>
                  <mods:title>Smoking and infertility: multivariable regression and Mendelian randomization analyses in the Norwegian Mother, Father and Child Cohort Study</mods:title>
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