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
MA2b
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
CH2b
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.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.