To determine the causing association of the cigarettes smoking (measured by cotinine level in the seminal plasma) on the immunologic inflammatory markers (PMN-elastase, pro-inflammatory cytokines, and leukocytospermia) in seminal fluid (SF) of unexplained infertile men.

Materials and Methods

Tow hundred-thirty six unexplained infertile men, one hundred fourteen smoking and ninety six non-smokers were included in the study. They were being found without evident cause for infertility after initial workups. Other ninety fertile healthy non-smokers men were enrolled in the study as a control group. Seminal immunologic inflammatory markers (PMN-elastase, pro-inflammatory cytokines IL-8 and IL-6, and leukocytospermia) were measured in seminal plasma (SP) of all participants. Cotinine level in SP was measured as well, and correlated with inflammatory markers in all three hundred- twenty six specimens.


The differences of seminal plasma inflammatory markers and cotinine level were significant between the three groups of the study, and significantly correlated with inflammatory markers.


The resulted substantial negative impact on sperm motility and morphology, and the correlation of cotinine level with immunologic inflammatory markers in SP, strongly indicate the presence of immunologic reaction in genital tract of the smokers. That may lead to silent genital tract inflammation. Which is, may be, the main cause for their unexplained infertility, and so, it would be sensible to advise infertile men to abstain from smoking cigarettes.


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