title: Relationship between semen quality and tobacco chewing in men undergoing infertility evaluation.
abstract: OBJECTIVE
  Male fertility is affected by a variety of lifestyle habits that include tobacco use. A large population of Indian men is addicted to tobacco chewing. The objective of our study was to assess the relationship between tobacco chewing in these Indian men--who were part of an infertile couple--and their sperm characteristics.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Private infertility clinic.
  
  
  METHODS
  Six hundred thirty-eight male patients undergoing infertility evaluations were grouped according to the frequency of their tobacco chewing habit: mild (< 3 times/day, n = 177), moderate (3-6 times/day, n = 264), and severe (> 6 times/day, n = 197).
  
  
  METHODS
  None.
  
  
  METHODS
  Sperm characteristics (concentration, motility, morphology, and viability).
  
  
  RESULTS
  Sperm concentration, percentage motility, morphology, and percentage viability were significantly higher in the mild group vs. the moderate group and in the moderate group vs. the severe group. The percentage of men with azoospermia rose with the level of addiction (1%, 3%, and 14%) as did the percentage of men with oligoasthenoteratozoospermia (2%, 8%, and 29%), although the differences were not statistically significant.
  
  
  CONCLUSIONS
  In our study, use of chewing tobacco by a group of Indian men who were undergoing infertility evaluation was strongly associated with a decrease in sperm quality and to a lesser extent with oligoasthenozoospermia or azoospermia. Infertile men should be counseled about the adverse effects of tobacco chewing on sperm quality.
authors.affiliation: Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Tamer M
authors.initials: TM
authors.lastname: Said
authors.forename: Geetha
authors.initials: G
authors.lastname: Ranga
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D006801:Humans; D007248:Infertility, Male / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D012189:Retrospective Studies; D012661:Semen / Q000187:drug effects* / Q000502:physiology; D013076:Sperm Count / Q000706:statistics & numerical data; D013081:Sperm Motility / Q000187:drug effects* / Q000502:physiology; D014029:Tobacco Use Disorder / Q000503:physiopathology*; D014030:Tobacco, Smokeless / Q000009:adverse effects* / Q000494:pharmacology