title: Cocaine Use in the Infertile Male Population: A Marker for Conditions Resulting in Subfertility.
abstract: BACKGROUND
  We sought to evaluate the incidence and effect of cocaine use in the infertile male population.
  
  
  METHODS
  Men presenting for fertility evaluation reporting cocaine usage were identified via prospectively collected database. Data were analyzed for usage patterns, reproductive history, associated drug use and medical conditions, hormonal and semen parameters.
  
  
  RESULTS
  Thirty-eight out of 4,400 (0.9%) men reported cocaine use. Most used cocaine every 3 months or less. Compared with non-cocaine using men, cocaine users reported more recreational drug use (89 vs. 9.2%), marijuana use (78.9 vs. 11.4%), chlamydia (10.5 vs. 3%), herpes (7.9 vs. 2.5%), and tobacco use (55.3 vs. 19.5%). After excluding men with causes for azoospermia, the mean semen parameters for cocaine users were: volume 2.47 ± 1.02 ml; concentration 53.55 ± 84.04 × 10(6)/ml; motility 15.72 ± 12.26%; total motile sperm count 76.67 ± 180.30 × 10(6).
  
  
  CONCLUSIONS
  Few (< 1%) men in our infertile population reported the use of cocaine, and the frequency of use was low. Given the low use rates and limitations of reporting bias, it is difficult to determine the direct effect of cocaine use on male fertility. However, while infrequent cocaine use seems to have limited impact on semen parameters, men reporting cocaine use represent a different cohort of men than the overall infertile population, with higher rates of concurrent substance abuse, tobacco use and infections, all of which may negatively impact their fertility. Reported cocaine users should be screened for concurrent drug use and infections.
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Samplaski
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
authors.forename: Bassel G
authors.initials: BG
authors.lastname: Bachir
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada ; Faculty of Medicine, Institute of Medical Science, University of Toronto, Ontario, Canada.
authors.forename: Kirk C
authors.initials: KC
authors.lastname: Lo
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
authors.forename: Ethan D
authors.initials: ED
authors.lastname: Grober
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Lau
authors.affiliation: Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Ontario, Canada ; Faculty of Medicine, Institute of Medical Science, University of Toronto, Ontario, Canada ; Lunenfeld Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Jarvi
keywords: Cocaine; Infection; Male fertility; Semen; Substance abuse