Relationships between Smoking, Age, Body Mass Index, and Abstinence with DNA Fragmentation Index in Male Infertile Patients


  • Atifa Nadira Ediningtyas Faculty of Medicine, Universitas Sebelas Maret
  • Abdurahman Laqif Faculty of Medicine, Universitas Sebelas Maret/ Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta
  • Eriana Melinawati Faculty of Medicine, Universitas Sebelas Maret/ Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta
  • Supriyadi Hari Respati Faculty of Medicine, Universitas Sebelas Maret/ Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta


Background: Infertility increases annually, by 0.370% in women and 0.291% in men. One of the causes of male infertility is idiopathic in the form of cigarettes, alcohol, drugs, obesity, psychological stress, old age, dietary factors, and exposure to toxins in the environment or work. These factors can cause oxidative stress that can lead to sperm DNA damage or sperm DNA fragmentation as measured through the DNA Fragmentation Index (DFI). So this study to analyzed about the relationship between smoking, age, Body Mass Index, and abstinence period with DNA Fragmentation Index in infertile patient.

Subjects and Method: This type of research is observational analytics with a cross-sectional approach. The study was conducted at the Sekar Clinic of Dr. Moewardi Hospital Surakarta. A total of 35 subjects of male infertility patients performed DNA examinations of sperm fragmentation. Inde


Agarwal A, Baskaran S, Parekh N, Cho CL, Henkel R, Vij S, Arafa M, et al. (2021). Male infertility. Lancet. 397(10271): 319

Agarwal A, Cho CL, Majzoub A, Esteves SC (2017). Risk factors associated with sperm DNA fragmentation. Trans. Androl. Urol. 6(4): S519

Agarwal A, Gupta S, Du Plessis S, Sharma R, Esteves SC, Cirenza C, Eliwa J, et al. (2016). Abstinence Time and Its Impact on Basic and Advanced Semen Parameters. Urology. 94: 102

Agarwal A, Selvam MKP, Baskaran S, Cho CL (2019). Sperm DNA damage and its impact on male reproductive health: A critical review for clinicians, reproductive professionals and researchers. Expert Rev. Mol. Diagn. 19(6): 443

Al Omrani B, Al Eisa N, Javed M, Al Ghedan M, Al Matrafi H, Al Sufyan H (2018). Associations of sperm DNA fragmentation with lifestyle factors and semen parameters of Saudi men and its impact on ICSI outcome. Reprod. Biol. Endocrinol. 16(1): 1

Albani E, Castellano S, Gurrieri B, Arruzzolo L, Negri L, Borroni EM, Levi-Setti PE (2019). Male age: Negative impact on sperm DNA fragmentation. Aging. 11(9): 2749

Anifandis G, Bounartzi T, Messini CI, Dafopoulos K, Sotiriou S, Messinis IE (2014). The impact of cigarette smoking and alcohol consumption on sperm parameters and sperm DNA fragmentation (SDF) measured by Halosperm

Bandel I, Bungum M, Richtoff J, Malm J, Axelsson J, Pedersen HS, Giwercman A (2015). No association between body mass index and sperm DNA integrity. Human Reproduction. 30(7): 1704

Barati E, Nikzad H, Karimian M. (2020). Oxidative stress and male infertility: current knowledge of pathophysiology and role of antioxidant therapy in disease management. Cel. Mol. Life Sci. 77(1): 93

Bisht S, Faiq M, Tolahunase M, Dada R (2017). Oxidative stress and male infertility. Nat. Rev. Urol. 14(8): 470

Brandt JS, Cruz Ithier MA, Rosen T, Ashkinadze E (2019). Advanced paternal age, infertility, and reproductive risks: A review of the literature. Prenat. Diagn. 39(2): 81

Cho CL, Agarwal A (2018). Role of sperm DNA fragmentation in male factor infertility: A systematic review. Arab J. Urol. 16(1): 21

Dupesh S, Pandiyan N, Pandiyan R, Kartheeswaran J, Prakash B (2020). Ejaculatory abstinence in semen analysis: does it make any sense? Ther Adv Reprod Health. 14. doi: 10.1177/2633494120906882

Durairajanayagam D (2018). Lifestyle causes of male infertility. Arab J. Urol. 16(1) 10

Hanson BM, Aston KI, Jenkins TG, Carrell DT, Hotaling JM, Hanson BM (2018). The impact of ejaculatory abstinence on semen analysis parameters: a systematic review. J Assist Reprod Genet. 25(2): 213

Harlev A, Agarwal A, Gunes SO, Shetty A, du Plessis SS (2015). Smoking and Male Infertility: An Evidence-Based Review. WJMH. 33(3): 143. doi: 10.5534/wjmh.2015.33.3.143.


Kahn BE, Brannigan RE (2017). Obesity and male infertility. Curr Opin Urol. 27(5): 441

Khatun A, Rahman MS, Pang MG (2018). Clinical assessment of the male fertility. Obstet Gynecol Sci. 61(2): 179

Kim GY (2018). What should be done for men with sperm DNA fragmentation? Clin Exp Reprod Med. 45(3): 101

Le MT, Nguyen DN, Le DD, Tran NQT (2020). Impact of body mass index and metabolic syndrome on sperm DNA fragmentation in males from infertile couples: A cross-sectional study from Vietnam. Metabolism Open. 7: 100054. doi: 10.1016/j.metop.2020.100054.

Leisegang K, Sengupta P, Agarwal A, Henkel R (2021). Obesity and male infertility: Mechanisms and management. Andrologia. 53(1): 1

Leone A, Landini L, Leone A (2010). What is Tobacco Smoke? Sociocultural Dimensions of the Association with Cardiovascular Risk. Curr. Pharm. Des. 16(23): 2510

Lestari SW, Sari T (2015). Fragmentasi DNA spermatozoa: penyebab, deteksi, dan implikasinya pada infertilitas laki-laki (Spermatozoa DNA fragmentation: causes, detection and implications for male infertility). Journal Kedokteran Indonesia Indonesian Medical Journal). 3(2). doi: 10.23886/ejki.3.5050.

McPherson NO, Lane M (2015). Male obesity and subfertility, is it really about increased adiposity? Asian J. Androl. 17(3): 450

Nuttall FQ (2015). Body mass index: Obesity, BMI, and health: A critical review. Nutr. Today. 50(3): 117

Pons I, Cercas R, Villas C, Bra

Rooney KL, Domar AD (2018). The relationship between stress and infertility. Dialogues Clin Neurosci. 20(1): 41

Sigman M (2020). Significance of sperm DNA fragmentation and paternal age. Fertil. Steril. 114(2): 262. doi: 10.1016/j.fertnstert.2020.05.011.

Softness KA, Trussler JT, Carrasquillo RJ (2020). Advanced sperm testing. Curr Opin Urol. 30(3): 290

Zeqiraj A, Beadini S, Beadini N, Aliu H, Gashi Z, Elezaj S, Bexheti S, et al. (2018). Male infertility and sperm DNA fragmentation. Open Access Maced. J. Med. Sci. 6(8): 1342




How to Cite

Ediningtyas, A. N., Laqif, A., Melinawati, E., & Respati, S. H. (2022). Relationships between Smoking, Age, Body Mass Index, and Abstinence with DNA Fragmentation Index in Male Infertile Patients. Journal of Maternal and Child Health, 7(4), 398–407. Retrieved from