Effects of smoking on varicocelectomy outcomes: a retrospective cohort study

Purpose To evaluate the effects of smoking on semen parameters and spontaneous pregnancy development by comparing smoker and non-smoker varicocelectomy patients.Methods This study included 63 male patients with primary infertility for at least one year, and underwent microscopic subinguinal varicocelectomy at the Erzurum City Hospital urology clinic between 2020 and 2023. Patient files were retrospectively evaluated, and 27 patients were assigned to smoker group, whereas 36 patients were assigned to non-smoker group. Demographic data, semen parameters, spontaneous pregnancy development and timing were compared between two groups.Results No statistically significant differences were observed in age, partner's age, BMI, clinical presentation, varicocele grade, side of varicocele, testicular volume, or testicular vein diameters (p > 0.05). The mean age of the study group was determined to be 30.7 +/- 4.9 years. In the non-smoker group, 27 patients (75%) had only subfertility complaints, while 9 patients (25%) also experienced scrotal pain. Progressive motility was significantly higher in the non-smoker group at the 3rd month (28.11 +/- 5.78 vs. 24.51 +/- 4.24, p < 0.05) and 6th month (29.61 +/- 5.16 vs. 26.22 +/- 4.14, p < 0.05) evaluations. When comparing the rates of pregnancy development, the non-smoker group was determined to have a higher rate (53%), but this comparison was not statistically significant. (p < 0.05) Regarding the timing of pregnancy, the non-smoker group was associated with earlier spontaneous pregnancy. (5.84 +/- 2.26 vs. 9.20 +/- 2.30, p < 0.05).Conclusion Smoking negatively affects the outcomes of varicocelectomy in terms of semen parameters, spontaneous pregnancy development and timing. Prospective, randomized, and larger sample-sized studies are required on this subject.Trial registration This study was approved by the Ataturk University Local Ethics Committee (approval number: B.30.2.ATA.0.01.00/234).