Many studies have been performed to examine the effects of cigarette smoking on fertility, with results suggesting that smoking decreases sperm production, motility, and normal morphology as outlined in Table 1 .[1,7] Presumably, the mutagenic components of cigarette smoke have adverse effects on germ cells in the testis, decreasing sperm production. Animal studies support these findings and indicate that cigarette smoke causes testicular atrophy, poor sperm morphology, and impaired spermatogenesis. The main chemical culprit in the toxicity of both smoked and smokeless tobacco appears to be nicotine, which appears to directly impair Leydig cell function. Further studies have shown impairment of the acrosomal reaction and sperm-penetrating ability in smokers. Smoking also leads to elevated estradiol and prolactin levels.[1,3] The literature on cigar and pipe smoking and infertility is insufficient to warrant comment. Both partners should stop tobacco use while trying to conceive.
Semin Reprod Med. 2013;31(4):286-292. © 2013 Thieme Medical Publishers