3.4Smoking and male fertility

StudyPopulationOutcomesResultsCommentsStudy typeEL
Vine et al. 19945721 studies of cross-sectional design
Smokers and non-smokers
Qualitative and quantitative assessment of sperm densitySmokers:

Sperm density: 13% to 17% less than non- smokers (CI 8.0 to 21.5%)

In 12 studies with available data (< 10; ≥ 10 cigarettes/day) no strong dose–response relationship between number of cigarettes smoked/day and sperm density
Men from infertility clinic included in 13 studies

Normal men in 8 studies
Merino et al. 199858358 men at infertility clinic: 197 smokers, 161 non-smokers

197 smokers:

Group A: 1–10 cigarettes/day (n = 57)
Group B: 11–20 cigarettes/day (n = 115)
Group C: > 20 cigarettes/day (n = 25)
Semen parameters: volume, sperm count, viability and normal formsSignificant poorer in smokers

Significant differences in grade A forward progressive motility in group C compared with group A
Zhang et al. 200059301 men:

191 smokers and 110 non-smokers at infertility clinic

Amount smoked:

Light: 1–10 cigarettes/day (n = 58)
Medium: 11–20 cigarettes/day (n = 68)
Heavy: > 20 cigarettes/day (n = 65)
Duration of smoking:

Short-term: 1–10 years (n = 148)
Long-term: 11–20 years (n = 43)
Semen parameters: semen volume, sperm density, viability, motility and morphologySignificantly lower in smokers than in non- smokers

No significant differences in semen quality between light, medium and short-term smokers compared with non-smokers

Significantly lower semen parameters in heavy and long-term smokers compared with non-smokers
Also case–control study within this studyCH2b
Trummer et al. 2002601104 men with infertility: 478 smokers; 109 ex-smokers; 517 non-smokersSemen parameters: concentration, morphology, motilityNo difference between non-smokers, smokers and ex-smokersNo analysis on ‘dose’CH2b
Marshburn et al. 198951446 men from infertility clinic: 294 non- smokers; 152 smokersSemen parameters: volume, density, motility, abnormalitySignificance reduction in ejaculate volume in smokers;

No difference in density, motility and abnormality
No analysis on ‘dose’CH2b
Dunphy et al. 199161330 men in infertility clinic: non-smokers

(n = 194); smokers:
1–5/day (n = 32)
6–10/day (n = 26)
11–20/day (n = 53)
> 20/day (n = 25)
Semen parameters: motilityNo significant association between smoking and semen parametersInsufficient dataCH2b

From: Evidence tables

Cover of Fertility
Fertility: Assessment and Treatment for People with Fertility Problems.
NICE Clinical Guidelines, No. 11.
National Collaborating Centre for Women's and Children's Health (UK).
London (UK): RCOG Press; 2004 Feb.
Copyright © 2004, National Collaborating Centre for Women’s and Children’s Health.

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