5 ways smoking can damage your fertility as a man

• Smoking is associated with poorer sperm quality, including lower sperm count, reduced movement and abnormal sperm shape.

• Chemicals in cigarette smoke can contribute to oxidative stress and sperm DNA damage, potentially affecting male reproductive health and the chances of conception.

• Quitting smoking may improve some sperm quality measures over time, with research suggesting improvements can become noticeable after at least three months.

Smoking is widely known for its harmful effects on the lungs and heart, but its impact on male reproductive health is another reason men should take the habit seriously.

Research has linked cigarette smoking to poorer sperm quality, including lower sperm counts, reduced movement and changes in sperm shape. It has also been associated with damage to sperm DNA, which carries the genetic information needed for reproduction.

Although smoking does not automatically make every man infertile, evidence suggests that it can affect several important aspects of sperm health.

Here are five ways smoking can affect sperm quality.

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Sperm count refers to the number of sperm present in a man's semen. A lower count means fewer sperm are available to reach and fertilise an egg.

Studies have found that men who smoke tend to have lower sperm concentrations and total sperm counts than non-smokers. The American Society for Reproductive Medicine (ASRM) reports that the average reduction in sperm concentration in the studies it reviewed was about 22%, with heavier smoking associated with greater effects.

A Ghanaian study published in 2016 also found significantly lower sperm concentration and total sperm count among smokers compared with non-smokers. The research involved 140 men, including 95 smokers and 45 non-smokers.

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For fertilisation to occur naturally, sperm must be able to move through the female reproductive tract towards the egg.

This ability is known as sperm motility. When sperm movement is reduced, fewer sperm may be able to travel effectively towards the egg.

Research has associated cigarette smoking with lower sperm motility. The Ghanaian study also reported significantly reduced sperm movement among the smokers who participated.

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Healthy sperm typically have an oval-shaped head and a long tail that helps them swim.

Sperm morphology refers to the size and shape of sperm. Abnormalities in the head, middle section or tail can affect how sperm function and move.

Studies have found a higher proportion of abnormally shaped sperm among men who smoke. The Ghanaian study similarly reported poorer sperm morphology among smokers.

However, having some abnormally shaped sperm does not automatically mean a man cannot father a child. Sperm quality is assessed using several parameters together.

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One concern about smoking is its potential effect on the genetic material inside sperm.

Sperm DNA carries information that is passed from a father to his child. DNA fragmentation occurs when this genetic material develops breaks or damage.

A 2023 systematic review and meta-analysis, which examined 190 studies on factors associated with sperm DNA fragmentation, found that smoking was associated with an average increase of 9.19 percentage points in DNA fragmentation compared with non-smoking.

Researchers believe that harmful chemicals in cigarette smoke can contribute to oxidative stress, a process that occurs when harmful molecules overwhelm the body's antioxidant defences. This can damage sperm cells and their genetic material.

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When sperm count, movement and other measures of sperm function are affected, a couple may face greater difficulty conceiving.

The American Society for Reproductive Medicine says there is fair evidence that semen parameters and sperm function test results are lower in men who smoke, with the effects varying according to smoking levels.

However, the organisation also cautions that cigarette smoking has not been conclusively shown to reduce male fertility in every case. Poorer semen measurements do not necessarily mean a man is infertile.

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Quitting smoking can be an important step towards protecting reproductive health, and some research suggests that certain sperm parameters can improve after cessation.

A 2022 study involving 90 men attending an infertility clinic found that sperm concentration, total sperm count and semen volume improved significantly among participants who stopped smoking for at least three months.

However, improvements in sperm movement and morphology were not statistically significant in that particular study. This means quitting does not guarantee that every aspect of sperm quality will return to normal.

Sperm production takes approximately 74 days, so changes in lifestyle may take several months to be reflected in a semen analysis.

Men who are concerned about their fertility can speak to a healthcare professional and undergo a semen analysis to assess sperm count, movement and shape.

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Smoking can affect more than the lungs and heart; it can also interfere with important aspects of male reproductive health.

Although the effects vary from one person to another, quitting smoking, avoiding exposure to tobacco smoke and seeking medical advice when experiencing fertility concerns are sensible steps towards protecting reproductive health.