الفهرس 
The effect of chronic use of nicotine, cannabis and tramadol on semen quality among subfertile males
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Abstract
Nowadays, nicotine, cannabis and tramadol misusehas become prevalent in our society mainly among menduring reproductive years. Exposure of men to these misused substances may result in adverse effects on male fertility. However the effect of these substances on male fertility is still controversial. The aim of this study is to evaluate the effect of nicotine, cannabis and tramadol on semen quality among subfertile males. 85 subfertile male patients were divided into four groups. For every patient in each group, full history was taken, local examinationof genital organs was done, semenanalysis was done by conventional method and the motility was assessed by both conventional and computer assisted semen analysis and urine samples were collected for qualitative and quantitative assessment ofnicotine,cannabis and tramadol. In ourstudy we found that there was significantdecrease of sperm motility in the nicotine group while cannabis group showed hyper activated motility .The tramadol group showed no significant difference in motility but there was increase in the mean of amplitude of lateral head displacement which suggests hyperactive motility. Nicotine, cannabis and tramadol have negative effect on semen quality but by different mechanisms. Nicotine decreases both progressive and total motility of sperms while cannabis and tramadol produce hyperactivated motility