Obesity and Male Infertility

BMI has been found to be associated with altered sperm parameters in numerous reports. In a recent study investigating factors related to semen quality, the prevalence of infertility in obese men was found to be three times greater than in male partners of couples with idiopathic or female-factor infertility [12]. Moreover, sperm density and total count was shown to have a statistically significant negative correlation to increasing BMI [ 12 ] . Another study looked at normozoospermic partners in an infertile population and reported a reduction in sperm concentration among men with BMI greater than 30 kg/m2 when compared to leaner members of the study group [23] . Kort et al. further examined the relationship between sperm parameters and BMI in a generally overweight selection of subjects [24]. After 520 semen samples were subjected to analysis, semen quality and the number of normal sperm per ejaculate exhibited declines with increasing BMI [24]. On the other hand, when obesity was expressed as a measurement of WHR, the similar trend between obesity and impaired sperm parameters was not seen [25] . This further illustrates

Infertility Obesity Mechanism

Fig. 26.2 Obesity can lead to male infertility via various mechanisms. These mechanisms manifest/act directly through or via interplay between reactive oxygen species (ROS) production, the hypothalamus-pituitary-gonadal (HPG) axis, as well as other physical factors (HH hypogonadotro-pic hypogonadism; ED erectile dysfunction; SA sleep apnea)

Fig. 26.2 Obesity can lead to male infertility via various mechanisms. These mechanisms manifest/act directly through or via interplay between reactive oxygen species (ROS) production, the hypothalamus-pituitary-gonadal (HPG) axis, as well as other physical factors (HH hypogonadotro-pic hypogonadism; ED erectile dysfunction; SA sleep apnea)

the inconsistency in obesity measurement techniques. Since an overwhelming evidence indicates that altered spermatogenesis and abnormal sperm parameters— reduced total sperm count and concentration—are correlated to the findings in obese males and that subfertility and infertility of couples are certainly related to such conditions [26], it may be postulated that obesity may induce semen abnormalities via the generation of ROS, dysregulation of the hypothalamic-pituitary-gonadal (HPG) axis, and/or physical manifestations (Fig. 26.2).

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