Male Subfertility among Patients with Alcohol and Tobacco Use Disorders versus Nonsubstance Users

Abstract Objective: Male subfertility, defined as compromised semen parameters, is a significant global concern, with growing evidence linking alcohol and tobacco use to impaired reproductive health. In this study, we intended to evaluate the impact of substance use on semen quality among patients attending a tertiary care hospital in North India. Methods: A comparative cross-sectional study was done at Kalpana Chawla Government Medical College, Karnal. We recruited 90 male participants aged 18–50 years and divided 30 each into three groups: controls, alcohol users, and tobacco users at the Deaddiction Centre in the Department of Psychiatry. Participants received assessments using a predesigned sociodemographic proforma and semen analysis. Results: Significant differences were observed across semen parameters among the groups. Mean sperm count was highest in the control group (99.5 ± 22.26 million/mL) and significantly reduced in alcohol users (61.4 ± 35.40 million/mL) and tobacco users (64.4 ± 32.67 million/mL) ( p < 0.001). Sperm motility and morphology were significantly impaired in substance users, with alcohol users showing the lowest motility and morphology. The severity of substance use was associated with progressive declines in sperm quality. Conclusion: Alcohol and tobacco consumption are strongly linked to decreased sperm count, motility, and morphology, with more severe use leading to worse outcomes. These findings highlight the urgent need for awareness campaigns to guide public health strategies in North India, emphasizing the reproductive risks of substance use, especially for men of reproductive age.