الفهرس 
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Abstract
Introduction: Abnormalities in male genom characterized by damaged sperm DNA may be indicative for male subfertility regardless of routine semen parameters and these parameters don not reveal sperm DNA defects. The etiology of sperm DNA damage is multifactorials; it may be due to intrinsic (eg .protamine defficiency ROS and apoptosis) or extrinsic factors which include, cigarette smoking,and varicoceles
Aim of the work (Objective): This prospective, randomized study was designed to investigate the impact of cigarette smoking on semen parameters and DNA fragmentation of human spermatozoa in an attempt to know the pathophysiology of male infertility. Study the degree of DNA fragmentation in the spermatozoa of smokers and nonsmokers of men with normal and abnormal seminogram. was the second outcome.
Patients & Methods: 100 patients were enrolled for the study. The patients attending the clinic were asked to routine seminal analysis, hormonal assay, and Doppler examination of the inguinoscrotal region. Patients who showed abnormal seminograms were selected for the study. This group of abnormal seminograms was then subdivided into three subgroups; 20 subgroups; 20 non smokers and 20 smokers with varicocele. Another group of forty fertile men who matched the group of abnormal seminograms in age were used as controls and were subdivided into 20 smokers and 20 non smokers.
Results The mean values of semen parameters concerning the concentration, motility, morphology and linear velocity were significantly lower in smokers than non smokers in the groups with normal and abnormal seminograms. Moreover, the difference was also significantly lower if the smokers in the two groups with abnormal and normal seminograms were compared. The Comet assay in the groups with normal and abnormal seminograms showed a significantly higher percentage DNA fragmentation in smokers than non smokers.
Conclusion: Smokers have lower semen volume, sperm count, sperm motility and viability compared with non-smokers. The conventional semen parameters such as sperm density, motility, morphology and PH in the semen samples are not sufficient for evaluation of reproductive activity. Sperm DNA integrity must be evaluated in addition to routine sperm parameters. This will indicate the quality of the spermatozoa and could have better diagnostic and prognostic values if compared with routine seminal analysis alone.