Risk of Cigarette Smoking on Male Fertility in Gaza Governorate, Gaza Strip

Abstract

Background: Epidemiological studies have shown an association between smoking and increasing risk of male infertility. Aim: To assess the risk of cigarette smoking on male fertility in Gaza Governorate, Gaza Strip. Place of study: Specialized laboratories in Gaza Governorate, Gaza Strip. Time of study: From October, 2010 to June, 2011 Subjects and Methods: The present case control study included 54 smokers (cases) and 54 non smokers (controls) matched with age. Data were collected by questionnaire interview, semen and hormonal analysis. Data were analyzed using SPSS version 18. Results: The mean ages of controls and cases were 33.5±7.6 and 32.7±6.3 years, respectively. The percentage of cases who had children was lower than controls (37.0% v 81.5%, P=0.000). The percentages of cases who had testes surgery, previous semen and hormone analysis were higher than controls (33.3% v 11.1%; 88.9% v 29.9% and 83.3% v 9.3%, P=0.005, P=0.000 and P=0.000, respectively). Passive smoking was significantly associated with male fertility (P=0.000). The majority of cases were cigarette smokers and around half of them smoked more than 20 cigarettes/day. In addition, more than half of the cases smoked for 5-15 years. The longer duration of smoking, the less number of cases having children (P=0.026). Smoking had negative impact on sexual desire and erection in about quarter of cases. The mean sample volume, total count and active sperm were significantly decreased in cases compared to controls (2.7±1.3, 16.7±16.1 and 22.0±16.3 v 4.1±1.9, 52.6±14.6 and 43.3±11.2, with P=0.004, P=0.000 and P=0.000, respectively), whereas the mean abnormalities and dead sperms were markedly increased (23.0±9.9 and 57.9±16.2 v 10.9±6.0 and 35.8±10.2, respectively, P=0.000). When semen parameters were related to the number of smoked cigarettes/day and duration of smoking, there was a significant decrease in the number of active sperms whereas dead sperms were significantly increased with increasing the number of smoked cigarettes/day and smoking duration. In addition, total sperm count was significantly decreased only with increasing smoking duration. The mean levels of testosterone, luteinizing hormone (LH), follicular stimulating hormone (FSH) and prolactin in cases showed no significant decrease compared to controls. Also, the number of smoked cigarettes/day and duration of smoking had no significant effect on hormonal profile. Conclusions: Cigarette smoking affects fertility by its main negative impact on semen parameters rather than hormonal profile at least in our patients.