Background: Several research endeavours have endeavoured to evaluate the impact of smoking on the physiology of male and female reproduction. Encompassing sperm parameters, male reproductive architecture, and the male hormonal axes. However, the outcomes have been conflicting and ambiguous. Objectives: To investigate the published literature on the effect of smoking on female and male reproductive health. Methods: PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. Rayyan QRCI was employed throughout this comprehensive process. Results & interpretation: We included thirteen studies with a total of 10092 participants; 4419 (43.8%) were males, and 5673 (56.2%) were females. Smoking is a risk factor in and of itself for male reproductive health. This is more likely to explain smokers' elevated SHBG levels and differential activity of the seminal antioxidant system. These negative effects included abnormal semen motility, volume, count, and morphology. Additionally, smoking had no discernible impact on women's fertility or ovarian reserve, according to this study. More research is needed to determine whether stopping smoking can treat male infertility caused by these substances and to better understand how cigarette smoke affects both female and male fertility.
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