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PMID: 20157305 Published · ppublish English Journal Article Review

The effect of obesity on sperm disorders and male infertility.

Nature reviews. Urology ·Vol. 7 ·No. 3 ·2010-03-00 ·Pages 153-61

Du Plessis SS, Cabler S, McAlister DA, Sabanegh E, Agarwal A

Abstract

The results of several studies point to an increased likelihood of abnormal semen parameters among overweight men, and an elevated risk for subfertility among couples in which the male partner is obese. Obesity is, therefore, associated with a higher incidence of male factor infertility. Several mechanisms might account for the effect of obesity on male infertility, both directly and indirectly, by inducing sleep apnea, alterations in hormonal profiles (reduced inhibin B and androgen levels accompanied by elevated estrogen levels) and increased scrotal temperatures, ultimately manifesting as impaired semen parameters (decreased total sperm count, concentration and motility; increased DNA fragmentation index). Neither the reversibility of obesity-associated male infertility with weight loss nor effective therapeutic interventions have been studied in-depth. The increasing prevalence of obesity calls for greater clinical awareness of its effects on fertility, better understanding of underlying mechanisms, and exploration into avenues of treatment.

MeSH Terms
Humans Infertility, Male/complications,etiology,pathology Male Obesity/complications,etiology,pathology Sperm Count Spermatozoa/pathology
Authors & Affiliations
5 authors, click to expand affiliations / ORCID
Du Plessis Stefan S
Division of Medical Physiology, Faculty of Health Sciences, Stellenbosch University, P. O. Box 19063, Tygerberg 7505, South Africa.
Cabler Stephanie
McAlister Debra A
Sabanegh Edmund
Agarwal Ashok
References (63)
63 references, click to expand
  1. Body mass index, physical activity and erectile dysfunction: an U-shaped relationship from population-based study.
    Int J Obes (Lond). 2007 Oct;31(10):1571-8 PMID: 17452989
  2. The question of declining sperm density revisited: an analysis of 101 studies published 1934-1996.
    Environ Health Perspect. 2000 Oct;108(10):961-6 PMID: 11049816
  3. Beneficial impact of exercise and obesity interventions on erectile function and its risk factors.
    J Sex Med. 2009 Mar;6 Suppl 3:254-61 PMID: 19170860
  4. Obesity.
    Lancet. 2005 Oct 1;366(9492):1197-209 PMID: 16198769
  5. The secretory function of adipocytes in the physiology of white adipose tissue.
    J Cell Physiol. 2008 Jul;216(1):3-13 PMID: 18264975
  6. Inhibin B: a novel marker of spermatogenesis.
    Ann Med. 2003;35(1):12-20 PMID: 12693608
  7. Inhibin B in men with severe obesity and after weight reduction following gastroplasty.
    Endocr Res. 2005;31(1):17-26 PMID: 16238188
  8. Influence of a leptin deficiency on testicular morphology, germ cell apoptosis, and expression levels of apoptosis-related genes in the mouse.
    J Androl. 2006 Mar-Apr;27(2):302-10 PMID: 16304204
  9. Effect of obesity and fertility status on sex steroid levels in men.
    Urology. 1993 Aug;42(2):171-4 PMID: 8367923
  10. Meta-analysis of sperm DNA fragmentation using the sperm chromatin structure assay.
    Reprod Biomed Online. 2006 Apr;12(4):466-72 PMID: 16740220
  11. Sex hormones and sexual function in obese men losing weight.
    Obes Res. 2003 Jun;11(6):689-94 PMID: 12805389
  12. Estrogen regulation of testicular function.
    Reprod Biol Endocrinol. 2005 Sep 27;3:51 PMID: 16188042
  13. Inhibin-B levels in healthy young adult men and prepubertal boys: is obesity the cause for the contemporary decline in sperm count because of fewer Sertoli cells?
    J Androl. 2006 Jul-Aug;27(4):560-4 PMID: 16582411
  14. Effect of body weight on testosterone/estradiol ratio in oligozoospermic patients.
    Arch Androl. 2006 Mar-Apr;52(2):97-102 PMID: 16443585
  15. Sperm chromatin integrity in young men with no experiences of infertility and men from idiopathic infertility couples.
    Andrologia. 2009 Jun;41(3):141-9 PMID: 19400847
  16. Aromatase inhibitors for male infertility.
    J Urol. 2002 Feb;167(2 Pt 1):624-9 PMID: 11792932
  17. Diurnal scrotal skin temperature and semen quality. The Danish First Pregnancy Planner Study Team.
    Int J Androl. 2000 Oct;23(5):309-18 PMID: 11012789
  18. Adipose tissue: the new endocrine organ? A review article.
    Dig Dis Sci. 2009 Sep;54(9):1847-56 PMID: 19052866
  19. Secondary male factor infertility after Roux-en-Y gastric bypass for morbid obesity: case report.
    Hum Reprod. 2005 Apr;20(4):997-8 PMID: 15618249
  20. Treatment of male infertility secondary to morbid obesity.
    Nat Clin Pract Endocrinol Metab. 2008 Jul;4(7):415-9 PMID: 18523426
  21. Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome.
    Diabetes Obes Metab. 2004 May;6(3):208-15 PMID: 15056129
  22. Impact of obesity on female fertility and fertility treatment.
    Womens Health (Lond). 2008 Mar;4(2):183-94 PMID: 19072520
  23. Decreased androgen levels in massively obese men may be associated with impaired function of the gonadostat.
    Int J Obes Relat Metab Disord. 2000 Nov;24(11):1433-7 PMID: 11126339
  24. Is male fertility associated with type 2 diabetes mellitus?
    Int Urol Nephrol. 2009 Dec;41(4):777-84 PMID: 19381857
  25. Sex hormone changes in morbidly obese patients after vertical banded gastroplasty.
    Eur Surg Res. 1998;30(1):43-7 PMID: 9493693
  26. Leptin and androgens in male obesity: evidence for leptin contribution to reduced androgen levels.
    J Clin Endocrinol Metab. 1999 Oct;84(10):3673-80 PMID: 10523013
  27. Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ.
    Proc Nutr Soc. 2001 Aug;60(3):329-39 PMID: 11681807
  28. Semen parameters and hormonal profile in obese fertile and infertile males.
    Fertil Steril. 2010 Jul;94(2):581-4 PMID: 19423100
  29. Male obesity and alteration in sperm parameters.
    Fertil Steril. 2008 Dec;90(6):2222-5 PMID: 18178190
  30. Hypoxia, depression of testosterone, and impotence in pickwickian syndrome reversed by weight reduction.
    Br Med J (Clin Res Ed). 1984 Sep 29;289(6448):801-2 PMID: 6434088
  31. Altered luteinizing hormone and testosterone secretion in middle-aged obese men with obstructive sleep apnea.
    Obes Res. 2005 Apr;13(4):780-6 PMID: 15897488
  32. Leptin levels in infertile male patients are correlated with inhibin B, testosterone and SHBG but not with sperm characteristics.
    Int J Androl. 2007 Oct;30(5):439-44 PMID: 17209884
  33. Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadism.
    Diabetes Obes Metab. 2005 May;7(3):211-5 PMID: 15811136
  34. Insulin-dependent diabetes in men is associated with hypothalamo-pituitary derangement and with impairment in semen quality.
    Hum Reprod. 2002 Oct;17(10):2673-7 PMID: 12351547
  35. Insulin dependant diabetes mellitus: implications for male reproductive function.
    Hum Reprod. 2007 Jul;22(7):1871-7 PMID: 17478459
  36. Diabetes, obesity, and erectile dysfunction.
    Gend Med. 2009;6 Suppl 1:4-16 PMID: 19318216
  37. Association of bioavailable, free, and total testosterone with insulin resistance: influence of sex hormone-binding globulin and body fat.
    Diabetes Care. 2004 Apr;27(4):861-8 PMID: 15047639
  38. Influence of genital heat stress on semen quality in humans.
    Andrologia. 2007 Dec;39(6):203-15 PMID: 18076419
  39. Obesity and the role of gut and adipose hormones in female reproduction.
    Hum Reprod Update. 2006 Sep-Oct;12(5):585-601 PMID: 16775192
  40. Leptin is a metabolic signal to the reproductive system.
    Endocrinology. 1996 Jul;137(7):3144-7 PMID: 8770941
  41. Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic.
    Fertil Steril. 2010 May 1;93(7):2222-31 PMID: 19261274
  42. Poor quality of sperm as it affects repeated early pregnancy loss.
    Arch Androl. 2000 Sep-Oct;45(2):111-7 PMID: 11028929
  43. Contribution of environmental factors to the risk of male infertility.
    Hum Reprod. 2001 Aug;16(8):1768-76 PMID: 11473980
  44. Oxidant stress, inflammation and atherogenesis.
    Lupus. 2005;14(9):760-4 PMID: 16218483
  45. Obesity and male reproductive potential.
    J Androl. 2006 Sep-Oct;27(5):619-26 PMID: 16751621
  46. Mild Hypogonadotropic hypogonadism in obese men.
    Metabolism. 1982 Sep;31(9):871-5 PMID: 6811834
  47. Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men.
    Fertil Steril. 2004 Oct;82(4):863-70 PMID: 15482761
  48. Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation.
    Circulation. 2005 Mar 22;111(11):1448-54 PMID: 15781756
  49. Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism.
    Eur J Endocrinol. 2008 May;158(5):741-7 PMID: 18426834
  50. Is semen quality affected by male body fat distribution?
    Andrologia. 2005 Oct;37(5):155-9 PMID: 16266392
  51. Men's body mass index and infertility.
    Hum Reprod. 2007 Sep;22(9):2488-93 PMID: 17636282
  52. Role of oxidative stress in the pathophysiological mechanism of erectile dysfunction.
    J Androl. 2006 May-Jun;27(3):335-47 PMID: 16339449
  53. Impact of body mass index values on sperm quantity and quality.
    J Androl. 2006 May-Jun;27(3):450-2 PMID: 16339454
  54. Effect of Roux-en-Y gastric bypass surgery on the sex steroids and quality of life in obese men.
    J Clin Endocrinol Metab. 2009 Apr;94(4):1329-32 PMID: 19174499
  55. Obesity and androgens: facts and perspectives.
    Fertil Steril. 2006 May;85(5):1319-40 PMID: 16647374
  56. Body mass index vis-à-vis total sperm count in attendees of a single andrology clinic.
    Fertil Steril. 2009 Sep;92(3):1016-1017 PMID: 19243747
  57. Leptin and leptin receptor in human seminal plasma and in human spermatozoa.
    Int J Androl. 2003 Dec;26(6):335-41 PMID: 14636218
  58. The metabolic syndrome and male infertility.
    J Androl. 2008 May-Jun;29(3):251-9 PMID: 18222914
  59. Evidence for decreasing quality of semen during past 50 years.
    BMJ. 1992 Sep 12;305(6854):609-13 PMID: 1393072
  60. Persistent organochlorines, sedentary occupation, obesity and human male subfertility.
    Hum Reprod. 2005 Jan;20(1):208-15 PMID: 15567884
  61. Serum immunoreactive-leptin concentrations in normal-weight and obese humans.
    N Engl J Med. 1996 Feb 1;334(5):292-5 PMID: 8532024
  62. Diminished paternity and gonadal function with increasing obesity in men.
    Fertil Steril. 2008 Aug;90(2):346-51 PMID: 18291378
  63. Is overweight a risk factor for reduced semen quality and altered serum sex hormone profile?
    Fertil Steril. 2008 Sep;90(3):619-26 PMID: 18068160
Article Info
Journal
Nature reviews. Urology
Abbr.
Nat Rev Urol
ISSN
1759-4820
DOI
10.1038/nrurol.2010.6
Published
2010-03-00
Epub
2010-00-16
Pages
153-61
Language
English
Region
England
NLM ID
101500082
Subset
IM
External Links
PubMed source DOI: 10.1038/nrurol.2010.6 View journal details
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