title: Effect of cigarette smoking on levels of seminal oxidative stress in infertile men: a prospective study.
abstract: OBJECTIVE
  To investigate levels of seminal oxidative stress (OS) and sperm quality in a group of infertile men with a history of cigarette smoking.
  
  
  METHODS
  A prospective clinical study.
  
  
  METHODS
  Male infertility clinic, Urological Institute, the Cleveland Clinic Foundation, Cleveland, Ohio.
  
  
  METHODS
  Infertile men who smoked cigarettes (n = 20), infertile men who were nonsmokers (n = 32), and healthy nonsmoking donors (n = 13).
  
  
  METHODS
  Genital examination, standard semen analysis, sperm DNA damage.
  
  
  METHODS
  Levels of seminal reactive oxygen species (ROS) and total antioxidant capacity (TAC) measured by a chemiluminescence assay and seminal OS assessed by calculating a ROS-TAC score. Sperm DNA damage was measured by sperm chromatin structure assay.
  
  
  RESULTS
  Smoking was associated with a 48% increase in seminal leukocyte concentrations (P<.0001), a 107% increase in ROS levels (P=.001), and a 10-point decrease in ROS-TAC scores (P=.003). Differences in standard sperm variables and DNA damage indices between the infertile smokers and infertile nonsmokers were not statistically significant.
  
  
  CONCLUSIONS
  Infertile men who smoke cigarettes have higher levels of seminal OS than infertile nonsmokers. Given the potential adverse effects of seminal OS on fertility, physicians should advise infertile men who smoke cigarettes to quit.
authors.affiliation: Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Urological Institute, The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: Ramadan A
authors.initials: RA
authors.lastname: Saleh
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Sharma
authors.forename: David R
authors.initials: DR
authors.lastname: Nelson
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Thomas
mesh_terms: D000704:Analysis of Variance; D002843:Chromatin / Q000235:genetics / Q000473:pathology; D004249:DNA Damage; D006801:Humans; D007248:Infertility, Male / Q000503:physiopathology*; D008163:Luminescent Measurements; D008297:Male; D018384:Oxidative Stress / Q000502:physiology*; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism; D012016:Reference Values; D012661:Semen / Q000502:physiology; D012907:Smoking / Q000503:physiopathology*; D013081:Sperm Motility / Q000502:physiology*; D013094:Spermatozoa / Q000166:cytology / Q000473:pathology; D014646:Varicocele / Q000503:physiopathology
chemical_list: D002843:Chromatin; D017382:Reactive Oxygen Species