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Cigarette smoking and sperm density: a meta-analysis*

  • Eli Y. Adashi
    Affiliations
    The American Fertility Society Annual Meeting
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  • Author Footnotes
    † Department of Epidemiology.
    ,
    Author Footnotes
    ‡ Reprint requests: Marilyn F. Vine, Ph.D., Department of Epidemiology, CB 7400 School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599–7400.
    Marilyn F. Vine
    Footnotes
    † Department of Epidemiology.
    ‡ Reprint requests: Marilyn F. Vine, Ph.D., Department of Epidemiology, CB 7400 School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599–7400.
    Affiliations
    University of North Carolina, Chapel Hill, North Carolina
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  • Author Footnotes
    § Department of Biostatistics.
    Barry H. Margolin
    Footnotes
    § Department of Biostatistics.
    Affiliations
    University of North Carolina, Chapel Hill, North Carolina
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  • Author Footnotes
    † Department of Epidemiology.
    ,
    Author Footnotes
    ‖ Present address: Bureau of Chronic Disease Epidemiology, Laboratory Center for Disease Control, Health and Welfare, Canada, Ottawa, Ontario, Canada KIA 0L2.
    Howard I. Morrison
    Footnotes
    † Department of Epidemiology.
    ‖ Present address: Bureau of Chronic Disease Epidemiology, Laboratory Center for Disease Control, Health and Welfare, Canada, Ottawa, Ontario, Canada KIA 0L2.
    Affiliations
    University of North Carolina, Chapel Hill, North Carolina
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  • Author Footnotes
    † Department of Epidemiology.
    Barbara S. Hulka
    Footnotes
    † Department of Epidemiology.
    Affiliations
    University of North Carolina, Chapel Hill, North Carolina
    Search for articles by this author
  • Author Footnotes
    † Department of Epidemiology.
    ‡ Reprint requests: Marilyn F. Vine, Ph.D., Department of Epidemiology, CB 7400 School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599–7400.
    § Department of Biostatistics.
    ‖ Present address: Bureau of Chronic Disease Epidemiology, Laboratory Center for Disease Control, Health and Welfare, Canada, Ottawa, Ontario, Canada KIA 0L2.
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      Objective

      To quantify, through meta-analysis techniques, the association between cigarette smoking and sperm density.

      Methods

      The logarithm of the ratio of mean sperm density for smokers to that for nonsmokers for the studies included in this meta-analysis was regressed against a constant, an indicator of study population source (infertility clinic patients or normal men), minimum number of cigarettes smoked per day among smokers (<10, ≥10), exclusion of azoospermic men (yes/no), number of semen specimens analyzed (one versus two), and blinding of laboratory personnel to the smoking status of the study participants (yes/no). Regression analyses were performed both unweighted and weighted inversely by study size. A qualitative and quantitative assessment of the relationship between the numbers of cigarettes smoked per day and sperm density was performed.

      Results

      Results of the meta-analysis indicate that smokers’ sperm density is on average 13% to 17% (95% confidence interval=8.0, 21.5) lower than that of nonsmokers. No other factors besides cigarette smoking were found to be independent predictors of sperm density. No clear dose-response relationships between the numbers of cigarettes smoked per day and sperm density emerged. Research conducted by the authors supports the findings of the meta-analysis.

      Conclusion

      Cigarette smoking is associated with lowered sperm density. The inconsistency in the literature with regard to this conclusion appears to be the result of small sample sizes in most studies.

      Key Words

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