Obesity and reduced fertility of men

Česká verzia

Authors: M. Škurla; R. Rybář
Authors place of work: Centrum asistované reprodukce Sanus Jihlava, MUDr. V. Šilhan
Published in the journal: Ceska Gynekol 2018; 83(3): 212-217

Summary

Objective:

Description of the relationship between the overweight man and the reduction of his reproductive potential.

Design:

Review article.

Setting:

Center of Assisted Reproduction Sanus, Jihlava.

Methods:

Approximately 15% of couples are trying to get pregnant unsuccessfully. In order to better assess the possible causes of this failure, it is vital to take into consideration the influence of owerweight and/or obesity in both men and women. Reduction of the reproductive potential of obese men occurs due to changes in hormonal levels regulating spermatogenesis, increased temperatures in the testicles, environmental toxins accumulated in adipose tissue, increased levels of oxidative stress as well as a higher incidence of erectile dysfunction. The likelihood of pregnancy is reduced even in the case of assisted reproduction methods.

Conclusion:

Obesity or overweight causes reduced fertility of men and often significantly prolongs the time required to achieve pregnancy. Prior to applying treatment for infertility, we assess all possibilities to increase the reproductive potential of overweight men. Significant weight loss in obese men results in regulated hormonal levels, moreover, in most cases, this leads to improved spermiogram parameters with increasing chances of getting pregnant.

Keywords:

body mass index, male obesity, infertility, spermiogram

Zdroje

1. Agbaje, IM., Rogers, DA., McVicar, DM., et al. Insulin dependant diabetes mellitus: Imlication for male reproductive function. Hum Reprod, 2007, 22, 7, p. 1871–1877.

2. Aggerholm, AS., Thulstrup, AM., Toft, G., et al. Is owerweight a risk factor for reduced semen quality and altered serum hormone profile? Fertil Steril, 2008, 90, 3, p. 619–626.

3. Aquilla, S., Gentile, M., Middea, E., et al. Leptin secretion by ejaculated human spermatozoa. Clin Endocrinol Metab, 2005, 90, 8, p. 4753–4761.

4. Aquilla, S., Gentile, M., Middea, E., et al. Autocrine regulation of insulin secretion in human ejaculated spermatozoa. Endocrinology, 2005, 146, 2, p. 552–557.

5. Bakos, HW., Henshaw, RC., Mitchell, M., et al. Paternal body mass index is associated with decreased blastocyst development and reduced live birth rates following assisted reproductive technology. Fertil Steril, 2011, 95, 5, p. 1700–1704.

6. Bastounis, EA., Karayiannakis, AJ., Syrigos, K., et al. Sex hormone changes in morbidly obese pacient after vertical banded gastroplasty. Eur Surg Res, 1998, 30, 1, p. 43–47.

7. Bornstein, SR., Rutkowski, H., Vrezas, I. Cytokines and steroidogenesis. Mol Cell Endokrinol, 2004, 215, 1–2, p. 135–141.

8. Boyar, RM., Kapen, S., Finkelstein, JW. Hypothalamic-pituitary function in diverse hyperpriolactinemic states. J Clin Invest, 1974, 53, 6, p. 1588–1598.

9. Colaci, DS., Afeiche, M., Gaskins, AJ., et al. Men´s body mass index in relation to embryo quality and clinical outcomes in couples undergoing in vitro fertilization. Fertil Steril, 2012, 98, 5, p. 1193–1199.

10. Considine, RV., Sinha, MK., Heiman ML., et al. Serum immunoreactive leptin concentrations in normal weight and obese humans. N Engl J Med, 1996, 334, 5, p. 292–295.

11. Davi, G., Falco, A. Oxidant stress, Inflamation and atherogenesis. Lupus, 2005, 14, p. 760–764.

12. de Boer, H., Verschoor, L., Rulnemans Koetrs, J., et al. Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadism. Diabetes Obes Metab, 2005, 7, 3, p. 211–215.

13. di Frega, AS., Dale, B., Di Matteo, L., et al. Secondary male factor infertility after Roux-en Y gastris bypass for morbid obesity: case report. Hum Reprod, 2005, 20, 4, p. 997–998.

14. Du Plessis, S., Cabler, S., McAlister, D., et al. The effect of obesity on sperm disorders and male infertility. Nat Rev Urol, 2010, 7, 3, p. 153–161.

15. Fejes, I., Koloszár, S., Závaczki, Z., et al. Effect of body weight on testosterone/estradiol ratio in oligospermic patient. Arch Androl, 2006, 52, 2, p. 97–102.

16. Franczek, T., Sanocka, D., Kamieniczna, M., et al. Proinflammatory cytokines as an intermediate factor enhancing lipid sperm membrane peroxidation in in vitro conditions. J Androl, 2008, 29, 1, p. 85–92.

17. Gopalkrisnan, K., Padwal, V., Meherji, PK., et al. Poor quality of sperm as it affects reapeated early pregnancy loss. Arch Androl, 2000, 45, 2, p. 111–117.

18. Gruschwitz, MS., Brezinscheck, R., Brezinscheck, HP. Cytokine levels in the seminal plasma of infertile males. J Androl, 1996, 17, 2, p. 158–163.

19. Hammound, AO., Gibson, M., Peterson, CM., et al. Obesity and male reproductive potential. J Androl, 2006, 27, 5, p. 619–626.

20. Heráček J., Sobotka V., Urban, M. Obezita a mužská neplodnost. Čes Gynek, 2012, 77, 5, s. 450–456.

21. Hjollund, NH., Bonde, JP., Jensen, TK., et al. Diurnal scrotal skin temperature and semen quality. The Danish First Pregnancy Planner Study Team. Int J Androl, 2000, 23, 6, p. 309–318.

22. Hofny, ER., Ali, ME., Abdel-Hafez, HZ., et al. Semen parameters and hormonal profile in obese fertile and infertile males. Fertil Steril, 2010, 94, 2, p. 581–584.

23. Jensen, TK., Anderson, A., Jorgensen, N. Body mass index in relation to semen quality and reproductive hormone among 1,558 Danish men. Fertil Steril, 2004, 82, 4, p. 863–870.

24. Jope, T., Lammert, A., Kratzsch, J., et al. Leptin and leptin receptor in human seminal plasma and in human spermatozoa. Int J Androl, 2003, 26, 6, p. 335–341.

25. Kaukua, J., Pekkarinen, T., Sane, T., et al. Sex hormones and sexual function in obese men losing weight. Obes Res, 2003, 11, 6, p. 689–694.

26. Kerr, JB., Millar, M., Maddocks, S., et al. Stage-dependent changes in spermatogenesis and Sertoli cells in relation to the onset of spermatogenic failure following withdrawal of testosterone. Anat Rec, 1993, 235, 4, p. 547–559.

27. Kort, HI., Massey, JB., Elsner, CV., et al. Impact of body mass index values on sperm quantity and quality. J Androl, 2006, 27, 3, p. 450–452.

28. Leisegang, K., Bouic, PJ., Menkveld, R., et al. Obesity is associated with increased seminal insulin and leptin alongside reduced fertility parameters in a controlled male cohort. Reprod Biol Endocrinol, 2014, 12, p. 34.

29. Li, L., Law, C., Lo Conte, R., et al. Intergenerational influences on childhood body mass index, the effect of parental body mass index trajectories. Am J Clin Nutr, 2009, 89, 2, p. 551–557.

30. Loves, S., Rulnemans Koerts, J., de Boer, H., et al. Letrozole once a week normalizes serum testosterone in obesity related male hypogonadism. Eur J Endocrinol, 2008, 158, 5, p. 741–747.

31. Oliva, A., Spira, A., Multigner, L. Contribution of environmental factors to the risk of male infertility. Hum Reprod, 2001, 168, p. 1768–1776.

32. Ramlau-Hansen, C., Thulstrup, A., Nohr, E., et al. Subfecundity in overweight and obese couples. Hum Reprod, 2007, 22, 6, p. 1634–1637.

33. Reis, LO., Zani, EL., Saa, RD., et al. Bariatric surgery does not interfere with sperm quality – preliminary longterm study. Reprod Sci, 2012, 19, 10, p. 1057–1062.

34. Rybář, R., Kopecká, V., Přinosilová, P., et al. Male obesity and age in relationship to semen parameters and sperm chromatin integrity. Andrologia, 2011, 43 ,4, p. 286–291.

35. Rybář R., Rubeš J. Poruchy integrity chromatinu ve spermiích infertilních mužů. Čes Gynek, 2007, 72, 4, s. 287–293.

36. Semple, PA., Graham, A., Malcolm, Y., et al. Hypoxia, depression of testosterone and impotence in Pickwickian syndrome reversed by weight reduction. Br Med J, 1984, 289, 6448, p. 801–802.

37. Sermondale, N., Massin, N., Boitrelle, F., et al. Sperm parameters and male infertility after bariatric surgery: tree case series, Reprod Biomed Online, 2012, 24, 2, p. 206–210.

38. Simpson, ER., Mahendroo, MS., Means, GD., et al. Aromatase cytochrome p450, the enzyme responsible for estrogen biosynthesis. Endocrin Rev, 1994, 15, 3, p. 342–355.

39. Teerds, KJ., De Rooij, DG., Keijer, J. Functional relationship between obesity and male reproduction: from humans to animal models. Hum Reprod Update, 2011, 17, 5, p. 667–683.