Abstract
Obesity has become a well-recognized medical issue. However its exact role in male infertility remains unclear. The objective of the current study was to determine if an increase inBMIis associated with an increase in semen parameter abnormalities and if this relationship was influenced by other patient activities. Charts were reviewed for one hundred and thirty-three male patients who had also undergone a complete initial office face to face interview, as part of an infertility evaluation and a semen analysis. As part of standard patient care, all patients answered a detailed questionnaire regarding demographics, exposures, medical and reproductive history as part of their infertility evaluation. Patients were grouped according toBMIas normal (20 - 24 kg/m2), overweight (25 - 30 kg/m2), or obese (>30 kg/m2). Semen analysis parameters analyzed included: morphology, volume, concentration, percent motility, and agglutination. While some parameters suggested trends, results were similar between the normal, overweight, and obeseBMI, for concentration (P= 0.18), volume (P = 0.845), motility (P = 0.06); % Positive agglutination: 12%, 7%, 7% (P = 0.668) and % normal morphology (P = 0.083). Unlike a number of previous studies, results indicate that there is no statistically significant association betweenBMIand any of the individual semen parameters tested. Raw data suggested a trend for decreasing concentration with increasingBMI. Further, data also suggested equal numbers of oligospermics in each group. However, when the data looked at globally rather than on the effects on individually parameters (total number of normal motile sperm cells—NMS), functional sperm cells decreased with increasing BMI. None of these factors appeared to be affected by other patient factors. Collectively these data suggest that obesity has a multifactorial effect on male fertility; possibly due to relationships with the hormone cascade, body composition and potentially testis temperature regulation. Further study will be needed to confirm such relationships.
Highlights
The Behavioral Risk Factor Surveillance System, in conjunction with the CDC, conducted a national survey in 2000 and found that, the prevalence of obesity (BMI > 30 kg/m2) was 19.8%, a 61% increase when compared to a similar survey in 1991 [1]
The percentage of individuals in each group who had previously fathered at least one pregnancy was calculated as 38%, 33%, 33% (P = 0.67)
The data from the current study demonstrated a decrease in total number of normal motile cells with increasing BMI, suggesting it might be the combined effects of obesity on the sperm cell structure and function which leads to lower fertility and not the effect on one single parameter alone
Summary
The Behavioral Risk Factor Surveillance System, in conjunction with the CDC, conducted a national survey in 2000 and found that, the prevalence of obesity (BMI > 30 kg/m2) was 19.8%, a 61% increase when compared to a similar survey in 1991 [1]. In addition to its well documented devastating effects on overall health, recent studies have described the effects of obesity on fertility in particular. In a study comparing IVF success rates and female obesity, it was shown that a 0.1 unit increase in waist-hip ratio led to a 30% decrease in probability of conception per cycle [3]. As male factor plays a role in up to 40% of couples seeking treatment for infertility [4], it would appear vital to understand any link between male partner obesity and fertility issues in the male partner and how they affect the overall fertility of the couple
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