Abstract

Abstract Introduction Extensive research efforts have always focused on the deleterious effects of smoking on male reproduction by comparing fertility in smokers versus nonsmokers. Nevertheless, studies on the effect of smoking cessation on male fertility remain scarce. Objective Our primary aim was to investigate the reversibility of the negative impact of smoking on male fertility. Secondarily, we studied the effect of both time after smoking cessation as well as the smoking index on semen quality improvement. Methods Our study included 60 participants who applied to a smoking cessation program. The volunteers started by completing a fertility background questionnaire. Two semen specimens, provided 2 weeks apart, were analyzed according to the WHO guidelines for each candidate on three different occasions. The first was right before smoking cessation followed by the 2nd and 3rd at 3 and 6 months after stopping smoking, respectively. Semen quality was compared between the 3 occasions. The degree of change was correlated with the level of smoking. The nicotine level in urine was used for smoking cessation compliance monitoring during the study. Results Comparing semen quality on the 3 different occasions respectively, we detected a significant improvement in semen volume (3.33 ml ± 1.07 vs. 3.88 ml ± 0.80 vs. 4.34 ml ± 0.67, P < 0.001), sperm concentration (14.77 million /ml ± 6.49 vs. 17.71 million/ml ± 6.41 vs. 19.27 million/ml ± 6.46, P < 0.001), total sperm count (49.33 million ± 25.31 vs. 70.16 million ± 30.85 vs. 84.01 million ± 31.00, P < 0.001), progressive motility (20.7% vs. 35.3% vs. 42.28%, P < 0.001), total motility (41.48% vs. 60.33% vs. 67.67%, P < 0.001) and abnormal morphology (69.32% Vs. 50.88% vs. 40.82%, P < 0.001). Improvement in all parameters was positively correlated to time after cessation. Higher smoking indices were related to higher levels of improvement in semen volume, sperm concentration, and total count (areas under the curve of 0.867, 0.852, and 0.863 respectively, P < 0.001 for each). Conclusions The negative effect of smoking on semen quality is reversible. Smoking cessation has a time-dependent positive effect on main semen parameters, hence, positive potential for fecundity improvement in men. Disclosure No.

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