Men’s Health Mythbuster is a section on UrologyTimes.com that explores common statements and beliefs about men’s health and evaluates whether these statements are false.
In this article, we strive to discuss the impact smoking and drinking can have on fertility. We provide a summary of recent data on these social behaviors and how they may influence reproductive potential.
Cigarettes. While the proportion of smokers has declined, 17.8% of adults in the United States continue to report smoking cigarettes. When looking at gender differences, 20.5% and 15.3% of men and women report smoking, respectively (MMWR Morb Mortal Wkly Rep 2014; 63:1108-12). Cigarette smoking can lead to numerous adverse maternal-fetal health consequences. These can range from preterm delivery, intrauterine growth restriction, to even perinatal mortality (Fertil Steril 2018; 110:611-8). A survey of female employees at a Connecticut hospital found over 95% of respondents knew about the cardiac and respiratory consequences of smoking, but only 27% and 22% were aware of the risks of ectopic pregnancy and infertility, respectively. Public health campaigns have done well at increasing awareness of the more common adverse health consequences of smoking, but further awareness is required for its effect on fertility (Am J Obstet Gynecol 2001; 194:934-9). Smoking can also lead to significant abnormalities with respect to sperm production and semen parameters. These include a reduction in sperm concentration and motility as well as DNA damage. The exact mechanism that leads to sperm impairment is yet to be fully elucidated, but a potential causative agent may be nicotine, which was found to have a dose-dependent deleterious effect on sperm characteristics in male rats (Postgrad Med 2015; 127:338-41; Reprod Biol Endocrinol 2018; 16:3).
Paternal smoking has also been shown to significantly impact the success of assisted reproductive technology (ART) such as in vitro fertilization and even intracytoplasmic sperm injection. Abnormal DNA may be the cause of the failure in the development of the embryo (Fertil Steril 2003; 79:1550-4). Not only is there evidence to support the strong association between smoking and abnormal semen parameters, sperm DNA, and failure of ART, but reports suggest abnormal sperm parameters in males who had exposure to cigarette smoke in utero (Postgrad Med 2015; 127:338-41). Therefore, it is critical from a public health perspective to increase the awareness of not only the more commonly known consequences of smoking but also the adverse effects to reproduction. E-cigarettes contain nicotine to various concentrations, with a study finding nicotine levels even in products that were labeled nicotine-free, suggesting insufficient manufacturing quality control. Given the use of e-cigarettes is quite prevalent among young adults, it is important to counsel patients on the potential impact it may have on reproduction (MMWR Morb Mortal Wkly Rep 2018; 629–33; JAMA 2018; 2039-41).
Next: Marijuana, alcohol