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Moreover, it is demonstrated that male infertility is more affected by tobacco use than female infertility.10 Chewing tobacco consists of coarsely crushed tobacco leaf, which is mixed slacked lime paste, areca nuts (pan, gutka and mishri) and consumed, the dissolved tobacco content is then taken up by the gums and soft tissues of mouth.Some of the potent carcinogens present includes N-nitrosamine, N- nitrosonornicotine, 4- (methylnitrosamino)-1-(3-pyridyl)-1-butanone and 3- methylnitrosaminopropionaldehyde which have shown many detrimental effects.11 Several studies have shown the negative effects of tobacco chewing on semen quality while some studies have shown no association.12-18 Since last decade authors have witness increase in population of male infertility patients as well as tobacco chewers

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At the 9 month mark, it should have increased by around 10%