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Retrospective Assessment of Potential Negative Synergistic Effects of Varicocele and Tobacco Use on Ultrastructural Sperm Morphology

  • G. Collodel
    Affiliations
    Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Siena, Italy
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  • S. Capitani
    Affiliations
    Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Siena, Italy

    Department of Physiopathology, Experimental Medicine, and Public Health, University of Siena, Siena, Italy
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  • F. Iacoponi
    Affiliations
    Department of Biomedical Sciences, Section of Applied Biology, University of Siena, Siena, Italy
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  • M.G. Federico
    Affiliations
    Department of Biomedical Sciences, Section of Applied Biology, University of Siena, Siena, Italy
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  • N.A. Pascarelli
    Affiliations
    Department of Biomedical Sciences, Section of Applied Biology, University of Siena, Siena, Italy
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  • E. Moretti
    Correspondence
    Reprint requests: Elena Moretti, Ph.D., Department of Biomedical Sciences, Section of Applied Biology, University of Siena Policlinico Le Scotte, Viale Bracci 14, Siena 53100 Italy
    Affiliations
    Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Siena, Italy

    Department of Biomedical Sciences, Section of Applied Biology, University of Siena, Siena, Italy
    Search for articles by this author

      Objectives

      To investigate, in a retrospective study, whether smoking cigarettes increases the effect of varicocele on sperm morphology.

      Methods

      The semen quality of 2 groups of patients with varicocele were compared, those who smoked (n = 121) and those who did not (n = 158). The semen parameters were evaluated, and sperm morphology was assessed using transmission electron microscopy and quantitatively elaborated (fertility index, immaturity, necrosis, and apoptosis percentages).

      Results

      In the smoker and nonsmoker varicocele-associated cases, sperm motility and the results from transmission electron microscopy analysis were significantly impaired compared with controls. However, a nonsignificant difference was detected when the semen parameters were compared. Subsequently, we divided the patients into 4 groups: mild (≥1 but ≤10 cigarettes/d), moderate (>10 but <20 cigarettes/d), and heavy (≥20 cigarettes/d) smokers and a group of randomly chosen nonsmoker patients with varicocele. The sperm motility, sperm concentration, and fertility index decreased and the percentage of sperm pathologic features increased as the number of cigarettes smoked daily increased.

      Conclusions

      A detrimental effect of cigarette smoking (>10 cigarettes/d) associated with varicocele on sperm motility and morphology was observed. Because much of reduced fecundity associated with smoking may be reversed within 1 year of cessation, as reported in published studies, effective interventions targeted at helping patients quit smoking should be addressed for the benefit of general health and fertility.
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      Linked Article

      • Editorial Comment
        UrologyVol. 74Issue 4
        • Preview
          This report highlights the challenges clinical researchers face in designing studies whose primary objective is to answer even simple, straight-forward questions. In this case, whether smoking cigarettes further reduces the fertility potential in men with varicoceles.
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      • Reply
        UrologyVol. 74Issue 4
        • Preview
          The reviewer has raised interesting points, in addition to those discussed in our article about the possible effects that smoking might have on semen quality.
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