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Less is known about the impact of paternal smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We estimated differences in semen parameters and testicle size according to paternal smoking in 772 adult sons of women enrolled in the Danish National Birth Cohort when pregnant. Parents\u2019 smoking was reported around gestational week 16, and analyses were adjusted for parents\u2019 ages at conception, maternal pre\u2010pregnancy body mass index, maternal alcohol and caffeine intake, family occupational status, ejaculatory abstinence time, clinic of semen analysis, and season.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sons of smoking fathers and non\u2010smoking mothers had a 10% (95% confidence interval: \u221224%, 7%) lower semen concentration and 11% (95% confidence interval: \u221227%, 8%) lower sperm count than sons of non\u2010smoking parents. Having two smoking parents was associated with 19% reduction in sperm count (95% confidence interval: \u221237%, 3%). Paternal smoking was not associated with volume, motility, or morphology. Adjusting for maternal smoking, paternal smoking was associated with a 26% increased risk of small testicular volume (95% confidence interval: 0.89, 1.78).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Exclusion of sons with a history of testicular cancer, chemotherapy, orchiectomy, and with only one or no testicles may have caused us to underestimate associations if these men's reproductive health including semen quality are in fact more sensitive to paternal smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study provides limited support for slightly lower sperm concentration and total sperm concentration in sons of smoking fathers, but findings are also compatible with no association.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.12782","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T13:40:14Z","timestamp":1583761214000},"page":"1117-1125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Fetal exposure to paternal smoking and semen quality in the adult son"],"prefix":"10.1111","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-7948","authenticated-orcid":false,"given":"Katia Keglberg","family":"H\u00e6rvig","sequence":"first","affiliation":[{"name":"Department of Occupational and Environmental Medicine Bispebjerg &amp; Frederiksberg Hospital Copenhagen Denmark"},{"name":"Department of Public Health The Faculty of Health Sciences University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit Bjerre","family":"H\u00f8yer","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Medicine Bispebjerg &amp; Frederiksberg Hospital Copenhagen Denmark"},{"name":"Department of Public Health Research Unit for Epidemiology Aarhus University Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5816-0785","authenticated-orcid":false,"given":"Aleksander","family":"Giwercman","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine Molecular Reproductive Medicine Lund University Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin S\u00f8rig","family":"Hougaard","sequence":"additional","affiliation":[{"name":"Department of Public Health The Faculty of Health Sciences University of Copenhagen Copenhagen Denmark"},{"name":"National Research Centre for the Working Environment Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia H\u00f8st","family":"Ramlau\u2010Hansen","sequence":"additional","affiliation":[{"name":"Department of Public Health Research Unit for Epidemiology Aarhus University Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ina Olmer","family":"Specht","sequence":"additional","affiliation":[{"name":"Research Unit for Dietary Studies The Parker Institute Bispebjerg Frederiksberg Hospital Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7542-6853","authenticated-orcid":false,"given":"Gunnar","family":"Toft","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8181-3673","authenticated-orcid":false,"given":"Jens Peter","family":"Bonde","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Medicine Bispebjerg &amp; Frederiksberg Hospital Copenhagen Denmark"},{"name":"Department of Public Health The Faculty of Health Sciences University of Copenhagen Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-4360","authenticated-orcid":false,"given":"Sandra","family":"S\u00f8gaard T\u00f8ttenborg","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Medicine Bispebjerg &amp; Frederiksberg Hospital Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,24]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"NielsenHS SchmidtL AndersenAN et al.Forebyggelse af nedsat frugtbarhed [Prevention of infertility in Danish].2016;1\u2010152."},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","unstructured":"Practice Committee of the American Society for Reproductive Medicine.Diagnostic evaluation of the infertile male: A committee opinion. 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