AUTHOR=Rehman Rehana , Zahid Nida , Amjad Sofia , Baig Mukhtiar , Gazzaz Zohair Jamil 

TITLE=Relationship Between Smoking Habit and Sperm Parameters Among Patients Attending an Infertility Clinic

JOURNAL=Frontiers in Physiology

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.01356

DOI=10.3389/fphys.2019.01356

ISSN=1664-042X

ABSTRACT=Background: This study aimed to estimate stress markers, oxidative stress, reproductive hormones and sperm parameters in male smokers and non-smokers and observe the impact of oxidative stress markers and smoking on sperm count, motility and morphology in a selected population of Karachi, Pakistan. 
Methods: The cross-sectional study was carried out from July 2017 to July 2018 at Aga Khan University Karachi, Pakistan. The subjects were recruited from the Sindh Institute of Reproductive Medicine (SIRM), Karachi based on defined inclusion criteria. The subjects were categorized into fertile and infertile based on cut off values of sperm parameters (WHO criteria). Two hundred eleven fertile and 165 infertile male subjects were included in the study. Serum cortisol, adrenaline, superoxide dismutase (SOD), glutathione peroxidase (GPX) was analyzed by ELISA kit. Data was analyzed on SPSS-22. 
Results: Age, Body Mass Index (BMI), and body fat were similar among smokers and non-smokers, age was significantly lower while mean BMI and body fat were significantly higher among infertile smokers vs. fertile smokers (p-value <0.05).  The testosterone levels were significantly reduced among smokers as compared to non- smokers (p-value <0.05).  The median cortisol levels were increased as well as glutathione peroxidase and steroid hormone-binding globulin (SHBG) were significantly reduced among smokers as compared to non-smokers. In addition to this, the same findings with a significant difference have also been seen among infertile smokers as compared to fertile smokers (p-value <0.05). This study has shown that the semen parameters (total count, motility, and morphology) are decreased in infertile smokers as compared to infertile non-smokers. Furthermore, the multivariate analysis showed that smoking causes a significant decrease in sperm count and morphology; however, it did not have any significant effect on motility.  
Conclusion: Smoking has a significant effect on fertility specifically sperm count and normal morphology of sperm. This might be due to oxidative stress produced by smoking, which has devastating effects on semen parameters, thus reducing male fertility. Infertility specialist should counsel their patients about the ill effects of smoking on their fertility status and should advise maintaining a healthy lifestyle.