Mohamad Al-Ali Badereddin, Eredics Klaus
Department of Urology, Hanusch Krankenhaus, Heinrich Collin Straße 30, 1140, Vienna, Austria.
Department of Urology, Kaiser-Franz-Josef Spital, Kundratstraße 3, 1100, Vienna, Austria.
Wien Klin Wochenschr. 2017 Jul;129(13-14):482-486. doi: 10.1007/s00508-017-1199-6. Epub 2017 Apr 24.
To evaluate whether there is a synergistic effect of varicocele and smoking status on semen parameters.
A retrospective evaluation of 715 men attending an infertility clinic between 2001 and 2009 was carried out. The presence of a varicocele was determined by clinical examination and cigarette smoking habits were documented allowing patients to be divided into 4 groups: non-smokers (n = 369), mild smokers (n = 186, 1-10 cigarettes/day), moderate smokers (n = 129, 10-20 cigarettes/day) and heavy smokers (n = 31, over 20 cigarettes/day). Semen samples were harvested according to the World Health Organization (WHO) guidelines. Additionally, serum luteinizing hormone (LH), free testosterone and follicle stimulating hormone (FSH) levels were measured in all patients. Multivariate analysis of variance (MANOVA) was carried out and further corroborated with the non-parametric Kruskal-Wallis and Mann-Whitney U‑tests. A p-value of <0.05 was considered statistically significant.
The median patient age was 30.2 years. Overall there was a statistically significant negative effect of higher varicocele grade on sperm motility and concentration (p < 0.05) and a significant negative effect of smoking status on sperm morphology and motility (very progressive, p < 0.01) as well as a significant synergistic effect of varicocele and smoking status on motility (p = 0.03). In the group of patients smoking less than 10 cigarettes per day no significant synergistic effect on semen parameters could be proven compared to patients with varicocele who did not smoke.
We could show a significant synergistic effect of smoking status (>10 cigarettes) in patients with varicocele on sperm morphology and motility. These findings could play an important role in counselling infertile patients presenting with varicocele and severe smoking to improve their semen quality parameters if they stop smoking. Past smoking history was not investigated.
评估精索静脉曲张与吸烟状况对精液参数是否存在协同作用。
对2001年至2009年间就诊于一家不孕不育诊所的715名男性进行回顾性评估。通过临床检查确定是否存在精索静脉曲张，并记录吸烟习惯，从而将患者分为4组：不吸烟者（n = 369）、轻度吸烟者（n = 186，每天1 - 10支香烟）、中度吸烟者（n = 129，每天10 - 20支香烟）和重度吸烟者（n = 31，每天超过20支香烟）。根据世界卫生组织（WHO）指南采集精液样本。此外，测定所有患者的血清黄体生成素（LH）、游离睾酮和卵泡刺激素（FSH）水平。进行多变量方差分析（MANOVA），并通过非参数Kruskal - Wallis检验和Mann - Whitney U检验进一步证实。p值<0.05被认为具有统计学意义。
患者的中位年龄为30.2岁。总体而言，精索静脉曲张分级越高对精子活力和浓度具有统计学意义的负面影响（p < 0.05），吸烟状况对精子形态和活力（极活跃精子，p < 0.01）具有显著负面影响，且精索静脉曲张与吸烟状况对活力具有显著协同作用（p = 0.03）。与不吸烟的精索静脉曲张患者相比，在每天吸烟少于10支的患者组中，未证实对精液参数有显著协同作用。
我们发现精索静脉曲张患者中吸烟量>10支对精子形态和活力具有显著协同作用。这些发现对于为患有精索静脉曲张且重度吸烟的不育患者提供咨询以改善精液质量参数（如果他们戒烟）可能具有重要作用。未调查既往吸烟史。
