Tobacco smoking is now increasing rapidly throughout the Arab countries and is one of the biggest threats to current and future world health. The negative effect of cigarette smoking on the quality of semen has been examined in numerous research. In Saudi Arabia, the overall number of couples consulting infertility clinics is on the rise. This systematic research aims to investigate the impact of smoking on the hormonal profile and semen parameters of Saudi Arabian male patients visiting infertility clinics. Online databases were searched for pertinent English publications that met the inclusion and exclusion criteria of this research (Cochrane library, PubMed, EMBASE, and Google Scholar respectively). Semen parameters (volume, count, motility concentration, pH, morphological and hormonal parameters), morphological abnormalities, and reproductive hormones were all evaluated as clinical endpoints. Finally, we looked at 6 studies that met the inclusion and exclusion standards of this study and were incorporated into the systematic review. The studies enrolled participants from 2004, including 1236 infertile male subjects, 41.54% smokers, and 58.45% non-smokers. Two included studies observed a significant reduction in semen volume, three studies observed a significant reduction in sperm motility, four included studies found a significant reduction in sperm count, and one study each reported a significant reduction in sperm abnormal forms and semen pH respectively in comparison to smoker and non-smoker infertile patients. Overall findings demonstrated a considerable negative impact of smoking on semen parameters. In conclusion, concerning the clinical endpoints that were studied in this analysis, tobacco smoking is found to be associated with a lower testosterone level, semen volume, sperm motility, sperm count and concentration, and an increase in the number of morphological defects or abnormal sperm forms in Saudi Arabian infertile men
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