title: Retrospective assessment of potential negative synergistic effects of varicocele and tobacco use on ultrastructural sperm morphology.
abstract: OBJECTIVE
  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 (> or = 1 but < or = 10 cigarettes/d), moderate (>10 but <20 cigarettes/d), and heavy (> or = 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.
authors: Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Siena, Italy.
authors: G
authors: G
authors: Collodel
authors: S
authors: S
authors: Capitani
authors: F
authors: F
authors: Iacoponi
authors: M G
authors: MG
authors: Federico
authors: N A
authors: NA
authors: Pascarelli
authors: E
authors: E
authors: Moretti
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D013094:Spermatozoa / Q000473:pathology* / Q000648:ultrastructure*; D014646:Varicocele / Q000150:complications*; D055815:Young Adult