Male obesity and infertility
Obesity is considered a global health problem affecting more than a third of the population. Obesity is known to disrupt male fertility and the reproduction potential, particularly through alteration in the hypothalamic‐pituitary‐gonadal axis.
Affects of obesity
- Altered hormone profile: Testosterone and gonadotropins levels were low and estrogen levels were found to be high in obese men.
- Sperm concentration, motility and morphology: obesity has a negative impact on semen parameters (count, motility and morphology).
- Serum leptin level: Increased levels of leptin might suppress the testosterone secretion by inhibiting the Leydig cell function.
- Sleep apnea: Characterized by disturbed sleep
- Erectile dysfunction: High blood pressure caused by obesity can affect the way blood flows to the penis, sometimes making it difficult to achieve or maintain an erection.
- Obesity inhibits chromatin condensation, DNA fragmentation, increases apoptosis and epigenetic changes that can be transferred to the offspring.
- Raised temperature: Increased testicular heat is associated with lower sperm count and quality. The insulation of excess body fat may raise the temperature in the scrotum, causing damage to the sperm.
- Appetite suppressors
- Aromatase inhibitors
- Clomiphene citrate
Diet and exercise
- Lifestyle modifications that include caloric restriction
- Increased physical activity
- Bariatric Surgery: Azoospermic men undergoing gastric bypass demonstrate increased serum testosterone and sperm count after bariatric surgery.
- Scrotal lipectomy