Does weight loss improve semen quality and reproductive hormones? results from a cohort of severely obese men

Abstract

BackgroundA high body mass index (BMI) has been associated with reduced semen quality and male subfecundity, but no studies following obese men losing weight have yet been published. We examined semen quality and reproductive hormones among morbidly obese men and studied if weight loss improved the reproductive indicators.MethodsIn this pilot cohort study, 43 men with BMI > 33 kg/m2 were followed through a 14 week residential weight loss program. The participants provided semen samples and had blood samples drawn, filled in questionnaires, and had clinical examinations before and after the intervention. Conventional semen characteristics as well as sperm DNA integrity, analysed by the sperm chromatin structure assay (SCSA) were obtained. Serum levels of testosterone, estradiol, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH) and inhibin B (Inh-B) were measured.ResultsParticipants were from 20 to 59 years of age (median = 32) with BMI ranging from 33 to 61 kg/m2. At baseline, after adjustment for potential confounders, BMI was inversely associated with sperm concentration (p = 0.02), total sperm count (p = 0.02), sperm morphology (p = 0.04), and motile sperm (p = 0.005) as well as testosterone (p = 0.04) and Inh-B (p = 0.04) and positively associated to estradiol (p < 0.005). The median (range) percentage weight loss after the intervention was 15% (3.5 - 25.4). Weight loss was associated with an increase in total sperm count (p = 0.02), semen volume (p = 0.04), testosterone (p = 0.02), SHBG (p = 0.03) and AMH (p = 0.02). The group with the largest weight loss had a statistically significant increase in total sperm count [193 millions (95% CI: 45; 341)] and normal sperm morphology [4% (95% CI: 1; 7)].ConclusionThis study found obesity to be associated with poor semen quality and altered reproductive hormonal profile. Weight loss may potentially lead to improvement in semen quality. Whether the improvement is a result of the reduction in body weight per se or improved lifestyles remains unknown.

The impact of obesity on semen parameters and hormone levels in infertile men

“…We found no significant differences between the groups in terms of semen parameters in term of normal sperm morphology, progressive motility, and total sperm count. In a review of 23 studies investigating paternal obesity and their effect on basic sperm parameters; sperm concentration was found to be decreased in 15 studies, motility decreased in 7, and 7 studies showed that sperm morphology was impaired by obesity [16].…”

“…This cycle starts at puberty in men and continues until death. It has been hypothesized that obesity disturbs spermatogenesis through the hypothalamicpituitary axis [16]. Obesity alters sex hormone levels as in women, and consequently hormonal changes affect male fertility [13,17].…”

Changing of the ejaculate parameters and sperm structure in men with overweight

“…Так, у пациентов с варикоцеле и инфекционными заболеваниями урогенитального тракта часто выявляют астенозооспермию (снижение подвижности сперматозоидов), возникающую в ре-зультате множественных структурных нарушений в цитоскелете жгутика. По данным некоторых авторов [1,2,10,11,18], астенозооспермия является частой патологией и у мужчин с ожирением. Возможными причинами могут быть гипертермия и оксидативный стресс, возникающие в результате увеличения про-слойки жировой ткани в мошонке.…”

“…L. Hakonsen и соавт. [11] провели анализ параметров эякулята (концентрация, общее количество, подвижность гамет, число спер-матозоидов с нормальной морфологией) у мужчин с ожирением (ИМТ=33,0-61,0 кг/м 2 ) исходно и через 14 нед проведения программы по снижению массы тела. Выявлена отрицательная связь между ИМТ и вышеперечисленными параметрами.…”

Influence of Male Obesity on Fertility

“…Although reduction in body weight is mostly associated with a consistent increase in SHBG, testosterone, LH and FSH levels and a reduction in estradiol, not much is known about the impact of diet/ exercise interventions on the semen parameters in obese men 47 . In the fi rst cohort study of 44 severely obese men having participated in a 14-week weight loss program, weight loss was associated with an increase in total sperm count and semen volume in addition to improvement in testosterone, SHBG and anti-müllerian hormone levels 48 . Pharmacological methods employed in obesity-related male subfertility include the use of several drugs, such as aromatase inhibitors, estrogen receptor modulators, gonadotropins, phosphodiesterase inhibitors, and insulin-sensitizing agents 49 .…”