Reduced Fertility Among Overweight and Obese Men

Sallmén, Markku; Sandler, Dale P.; Hoppin, Jane A.; Blair, Aaron; Baird, Donna D.

doi:10.1097/01.ede.0000229953.76862.e5

Cited by 316 publications

(220 citation statements)

References 22 publications

(17 reference statements)

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“…48 A recent study even showed lower fertility in obese men with a dose relationship to BMI. 49 According to the data of our present study it seems that the association between increased fat mass and lower testosterone levels is already present during pubertal development.…”

Section: Laboratory Markers Of Pubertal Developmentsupporting

confidence: 62%

Pubertal development in obese children and adolescents

et al. 2007

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Objective: To investigate clinical and laboratory markers of pubertal development in a large sample of obese children and adolescents. Methods: Analysis of parameters of sexual maturation in 1232 obese individuals (582 boys) aged 6-18 years (mean 13.072.42 years). Clinical evaluation of pubertal stage and determination of bone age in a subset (227 patients).Results: Mean Height -standard deviation scores (height-SDS) was positive during childhood and reached zero approximately at age 14 years followed by a turn to negative mean height-SDS in both genders. Accordingly, bone age was accelerated until age 14. No significant differences in average time points of occurrence of pubic hair stages PH 2 to PH 4 in boys and PH 2 to PH 5 in girls were observed as compared to references of the First Zurich Longitudinal Study. In girls, breast stage B 3 was reached earlier (11.6 vs 12.2 years, P ¼ 0.03). In boys, mean volume of testis revealed no significant deviation from reference. Mean dehydroepiandrosterone sulfate (DHEAS) levels were elevated in boys (within age ranges 8-10 years and 12-16 years, Po0.02) and in girls (within age ranges 6-8 years and 12-18 years, Po0.005) and mean testosterone levels in boys 412 years were lower as compared to reference ranges (all P-values o0.0001). Conclusion: The study data suggest normal development of pubarche and gonadarche in obese German boys and normal timing of pubarche in girls. Breast development in obese girls seems to be slightly advanced. In obese boys, an obvious dissociation of clinical and laboratory parameters of pubertal development was observed. Despite significantly increased height-SDS and increased DHEAS levels, gonadal development was normal and testosterone levels were decreased. Elevated DHEAS levels in both genders may contribute to the acceleration of bone maturation, a lower final body height and could increase cardiovascular risk.

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Section: Laboratory Markers Of Pubertal Developmentsupporting

confidence: 62%

Pubertal development in obese children and adolescents

et al. 2007

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“…The effect is attributed to a reduction of E 2 's negative feedback on hypothalamic gonadotrophin-releasing hormone secretion. As recent reports indicate that fertility is reduced in overweight and obese men, the FSH response to aromatase inhibition may serve to improve fertility (15,37). The aromatase inhibitors have been successfully used in (eugonadal) subfertile, oligospermic men and were shown to improve sperm quantity and quality (16).…”

Section: Discussionmentioning

confidence: 99%

“…However, aromatase inhibition may also have new advantageous effects because of its stimulatory effects on follicle-stimulating hormone (FSH) secretion. This could be of benefit in the case of reduced fertility, which is common in severely obese men (15,16).…”

Section: Introductionmentioning

confidence: 99%

Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism

Loves¹,

Ruinemans-Koerts²,

Boer³

2008

European Journal of Endocrinology

123

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Objective: Isolated hypogonadotropic hypogonadism (IHH) is frequently observed in severely obese men, probably as a result of increased estradiol (E 2 ) production and E 2 -mediated negative feedback on pituitary LH secretion. Aromatase inhibitors can reverse this process. This study evaluates whether letrozole once a week can normalize serum testosterone in severely obese men and maintain its long term effect. Design: Open, uncontrolled 6-month pilot study in 12 severely obese men (body mass indexO 35.0 kg/m 2 ) with obesity-related IHH and free testosterone levels !225 pmol/l, treated with 2.5 mg letrozole once a week for 6 months. Results: Six weeks of treatment reduced total E 2 from 123G11 to 58G7 pmol/l (P!0.001, meanG S.E.M.), and increased serum LH from 4.4G0.6 to 11.1G1.5 U/l (P!0.001). Total testosterone rose from 5.9G0.5 to 19.6G1.4 nmol/l (P!0.001), and free testosterone from 163G13 to 604G 50 pmol/l (P!0.001). Total testosterone rose to within the normal range in all subjects, whereas free testosterone rose to supraphysiological levels in 7 out of 12 men. The testosterone and E 2 levels were stable throughout the week and during the 6-month treatment period. Conclusion: Letrozole 2.5 mg once a week produced a sustained normalization of serum total testosterone in obese men with IHH. However, free testosterone frequently rose to supraphysiological levels. Therefore, a starting dose !2.5 mg once a week is recommended.European Journal of Endocrinology 158 741-747

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“…The increasing number of patients being diagnosed prior to and/or during their reproductive years coincides with the reports linking various elements of the syndrome with decreased fecundity. In the male, studies by Ramlau-Hansen et al (2007) and Nguyen et al (2007) concluded obesity to be associated with a 20% greater likelihood of subfertility or infertility, respectively, whereas a large epidemiological study by Sallmen et al (2006) concluded that a 10 kg increase in weight was sufficient to decrease male fertility by as much as 10%.…”

Section: Introductionmentioning

confidence: 99%

Spermatogenic and sperm quality differences in an experimental model of metabolic syndrome and hypogonadal hypogonadism

Mallidis¹,

Czerwiec²,

Filippi³

et al. 2011

Reproduction

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The synergistic effect of the co-morbidities that comprise metabolic syndrome (MetS) is increasingly being recognised as an important contributor in the pathology of a broad spectrum of seemingly disparate conditions. However, in terms of male reproductive function, beyond erectile dysfunction, little is known about the influence of this cohort (collectively or separately) on spermatogenesis and sperm quality. The aims of this study were to assess the reproductive tract of a MetS animal model for detrimental changes, to determine whether a group of compounds (advanced glycation end products and their receptor) known to cause cell dysfunction and DNA damage was present and assess whether hypogonadotropic hypogonadism was the main contributing factor for the changes seen. Animals fed a high-fat diet were found to have significantly increased cholesterol, triglycerides, blood glucose, mean arterial pressure and visceral fat levels. Although serum testosterone was decreased, no changes were seen in either testicular or epididymal histology. Immunolocalisation of N 3 -carboxymethyl-lysine and the receptor for advanced glycation end products was found in the testes, epididymides and sperm of the two treated groups of animals; however, ELISA did not show any difference in protein levels. Similarly, assessment of sperm nuclear DNA (nDNA) fragmentation by acridine orange test did not find significant differences in nDNA integrity. We conclude that the minimal effect on spermatogenesis and sperm quality seen in our model is probably due to the moderate increase of blood glucose rather than the hypogonadism.

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Reduced Fertility Among Overweight and Obese Men

Abstract: This report of lower fertility in overweight and obese men needs replication. If the findings are robust, programs to prevent obesity may improve men's reproductive health and save medical costs for infertility treatment.

Cited by 316 publications

References 22 publications

Pubertal development in obese children and adolescents

Pubertal development in obese children and adolescents

Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism

Spermatogenic and sperm quality differences in an experimental model of metabolic syndrome and hypogonadal hypogonadism

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