Smoking and Infertility in Women with Polycystic Ovary Syndrome: Validation of Baseline Self Report and Stability Over Time with Serum Cotinine Levels

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 554-573-Ovarian & Uterine Function I
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-561
Richard S Legro*1, Gang Chen2, Allen R Kunselman3, William D Schlaff4, Michael P Diamond5, Christos Coutifaris6, Sandra A Carson7, Michael Paul Steinkampf8, Bruce R Carr9, Peter G McGovern10, Nicholas A Cataldo11, Gabriella G Gosman12, John E Nestler13, Evan R Myers14, Heping Zhang15 and Jonathan Foulds2
1Penn State Univ, College of Med, MS Hershey Medical Center, Hershey, PA, 2Penn State College of Medicine, Hershey, PA, 3Penn State Univ, College of Medicine, Hershey, PA, 4Univ of CO Hlth Sci Ctr, Aurora, CO, 5Wayne State Univ, Grosse Pointe Shores, MI, 6Hosp of Univ of PA, Philadelphia, PA, 7Women & Infants Hosp of Rhode, Providence, RI, 8Alabama Fertility Specialists, Birmingham, AL, 9Univ Texas SW Med Sch, Dallas, TX, 10University of Medicine and Dentistry of New Jersey, Newark, NJ, 11Stanford University School of Medicine, Stanford, CA, 12University of Pittsburgh, Pittsburgh, PA, 13Medical College of VA Hospital, Richmond, VA, 14Duke Univ Med Ctr, Durham, NC, 15Yale University, New Haven, CT


To determine the accuracy of self-report of smoking in infertile women with polycystic ovary syndrome (PCOS) desiring to conceive, and to assess the effects of treatment on smoking status


Nested case-control study.


Multi-center clinical trial at academic medical centers.


A total of 148 women divided into three groups:  current smokers, past smokers and non-smokers


Measure serum cotinine levels during the first treatment cycle and a subsequent treatment cycle (Cycle 5).


Self reported smoking, serum cotinine levels, biometric and hormonal parameters.


Overall self report of smoking agreed well with smoking status as determined by measure of serum cotinine levels, at 90% or better for each of the groups at baseline (98% of never smokers had cotinine levels < 15 ng/mL compared to 90% of  past smokers, and 6% of current smokers). At baseline, total testosterone was higher in the current smokers compared to past smokers (P = 0.03) and never smokers (P = 0.02).  In all 3 self reported groups, SHBG increased over time (P<.0001 for all), as did insulin and HOMA-IR in the current smokers (P=0.01 for both).There were minor changes in smoking status as determined by serum cotinine levels over time,   with the greatest change found in the smoking groups (past or current smokers). 


Self-report of smoking in infertile women with PCOS is accurate, with 10% of past smokers likely to have a current smoking history, and unlikely to change over time with treatment, though there is greater lability in subjects with a smoking history.

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Disclosure: RSL: Research Funding, NICHD. GC: Research Funding, NICHD. ARK: Owner, Merck & Co.. WDS: Research Funding, NICHD. MPD: Research Funding, Abbott Laboratories, Research Funding, Ferring Pharmaceuticals, Research Funding, Boehringer Ingelheim, Research Funding, EMD Serono, Consultant, Genzyme, Consultant, Auxogyn, Consultant, Neomend, Research Funding, NICHD. CC: Research Funding, NICHD. MPS: Research Funding, NICHD. BRC: Speaker, Merck & Co., Committee Member, Seminars in Reproductive Medicine. PGM: Research Funding, NICHD. NAC: Research Funding, NICHD. GGG: , Cassat RRG, Research Funding, NICHD. JEN: Research Funding, NICHD. ERM: Research Funding, GSK Inc., Consultant, Merck & Co.. HZ: Research Funding, NICHD. JF: Consultant, Cypress Bioscience, Consultant, J&J, Consultant, GSK, Consultant, Pfizer, Inc., Research Funding, Pfizer, Inc., Advisory Group Member, Pfizer, Inc.. Nothing to Disclose: SAC

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Sources of Research Support: This work was supported by NIH/NICHD grants U10 HD38998 (WS), U10 HD055925 (HZ), U10 HD39005 (MD),  U10 HD27049 (CC),  H10 HD055944 (PC),  U10 HD055942 (RB), U10 HD055936 (GC), U10 HD38992 (RL), GCRC grant MO1RR10732 and construction grant C06 RR016499 to Pennsylvania State University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or NIH.