For some couples fertility and getting pregnant are as easy as eating cake. For others, the world of reproductive technology becomes the only hope for conception.

In between, however, are a growing number of couples playing the fertility "waiting game." Some may not yet be ready to turn to technology while others may have failed to discover their problem even in a high-tech arena.

It is for this group that many physicians are now looking to the everyday factors that might make a difference.

"Sometimes everything looks good from a treatment standpoint, but still women don't get pregnant -- so we have begun looking at other factors that might play a role," says Margareta D. Pisarska, MD, co-director of Center for Reproductive Medicine at Cedars Sinai Medical Center in Los Angeles and editor-in-chief of the American Society for Reproductive Medicine News.

Behind the Fertility Smokescreen

Among the most important of these outside factors, say doctors, is smoking. While most folks are aware that cigarettes and pregnancy don't mix, fertility experts say fewer seem to realize the impact that smoking has on fertility.

"It can dramatically reduce both male and female fertility and it really impacts conception rates," says Frederick Licciardi, MD, associate director of reproductive endocrinology at NYU Medical Center and associate professor at the NYU School of Medicine.

In one study published in the journal Fertility and Sterility, sperm counts averaged 17% lower in smokers. More recently, a Polish study showed smoking dramatically lowered sperm count and disrupted the health of sperm. In women, Pisarska says smokers not only have a higher rate of infertility overall, but also those who do get pregnant take a much longer time to conceive.

"We also know that smokers undergoing fertility treatments usually require much higher doses of fertility medication than nonsmokers," says Pisarska.

But it's not just the smoke from your own cigarettes that matters. In a study recently published in Human Reproduction doctors showed that secondhand smoke also reduced the pregnancy rates in women undergoing high-tech infertility procedures.

The good news: Reduce your exposure to cigarette smoke and you may get pregnant faster and easier! In one study published in the journal Fertility and Sterility, doctors found that men who stopped smoking experienced a rise in sperm count of up to 800%!