抽菸與精液品質之關係:統合分析與系統回顧
彭元宏、黃培林、蔡芳生
楊梅天成醫院泌尿科
The effect of smoking on semen quality in fertile men: a meta-analysis
Yuan-Hung Pong, Pei-Lin Huang, Vincent FS Tsai
Department of Urology, Ten Chen Hospital, Taoyuan, Taiwan
Purpose:
Smoking is common in all countries and affects male fertiliy. This meta-analysis aimed to examine the impact of smoking on the quality of sperm.
Materials and Methods:
The scientific databases of Medline, PubMed, Scopus, Google scholar, Cochrane Library, and Elsevier were searched to identify relevant articles published between 1995 to 2015. In the first step, 56 articles were selected. These studies were cohort, retrospective, cross-sectional, and case control studies that were found through electronic and hand search of references about smoking and male fertility in healthy men. The outcome measurement was the differences between smokers and non-smokers in semen parameters. A total of 10 articles including 2,554 men were ultimately included in a meta-analysis to examine the impact of smoking on sperm parameters. Statistical analysis was performed using Comprehensive Meta-Analysis Ver 3. For the heterogeneity of studies, Cochran's Q test and index I2 were used. Forest plots were calculated by Hedges’s g value. Because of heterogeneity, DerSimonian and Laird random effects model was used.
Results:
The Hedges’s g value in ejaculation volume is -0.634(SE: 0.185, p=0.001). The 95% confidence interval(CI) is -0.996 to -0.271. The Hedges’s g value in concentration is -0.968(SE: 0.258, p=0.000). The 95% confidence interval(CI) is -1.474 to -0.462. The Hedges’s g value in mortility is -0.857(SE: 0.083, p=0.000). The 95% confidence interval(CI) is -1.019 to -0.694. The Hedges’s g value in abnormal form is 0.915(SE: 0.123, p=0.000). The 95% confidence interval(CI) is 0.674 to 1.155.
Conclusion:
The results of this meta-analysis showed that smoking reduces ejaculation volume, sperm concentration, sperm motility and increased abnormal form of sperm.