Endocrine Abstracts

Introduction: Smoking habit has always been considered to exert a detrimental effect on male reproductive health. However, several studies do not clearly demonstrate a negative effect of smoke on semen parameters. In addition, the effect of smoke on male genital tract has been poorly studied by ultrasound (US). We evaluated the correlations of smoking with seminal and US characteristics in males of infertile couples. Methods. A consecutive series of 426 men was systematically evaluated. All patients underwent physical, biochemical, seminal evaluation (including seminal interleukin 8, sIL-8) and scrotal/transrectal US before and after ejaculation, Results. Among 426 men, 394 (36.0±8.0 years) without genetic abnormalities were studied. 229 were never-smokers (NS), 56 past-smokers (PS), 109 current-smokers (CS). PS were older compared to NS and CS. CS showed a significantly higher prevalence of alcohol and substance abuse, lower frequency of physical activity compared to NS or PS. CS showed higher testosterone (T) and lower FSH levels compared to NS or PS. CS had significantly lower semen volume, higher normal sperm morphology and higher sIL-8 levels compared to NS. At CDUS, CS and PS showed a lower seminal vesicles (SV) volume before and after ejaculation compared to NS. CS showed a higher prevalence of dilated ejaculatory ducts compared to NS. A further statistical analysis tested the previous significant associations by comparing CS (n=109) and no-smokers (n=285) adjusting for age, alcohol and substance abuse, physical activity, TT, BMI. After adjusting for confounders, CS showed higher risk for higher T levels (AdjOR: 1.06 [1.01–1.15], P=0.01), lower FSH (AdjOR: 0.41 (0.16–1.00), P=0.05), lower semen volume (AdjOR: 0.82 (0.68–0.98), P<0.05) and SV volume before and after ejaculation (AdjOR: 0.35 (0.14–0.89), P<0.05 and AdjOR: 0.31 (0.13–0.73), P<0.01 respectively) and higher risk for dilated ejaculatory ducts (AdjOR: 3.01 (1.26–7.19), P<0.02). Associations with normal sperm morphology and sIL-8 levels were not confirmed.

Conclusions: In males of infertile couples CS is associated with higher T levels, lower semen and SV volume and ejaculatory ducts dilation. CS may lead to lower semen volume by modulating SV volume, despite higher T levels compared to no-smokers, or promoting distal subobstruction.