Studying Bariatric Surgery Patients to Better Understand Endocrine Disrupting Chemicals Effects on Male Reproduction

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Weight loss promoted by bariatric surgery is generally associated with beneficial health effects. However, the release of lipophilic endocrine-disrupting chemicals (EDCs) accumulated in adipose tissue in a lifetime increases the risk for this population to experience toxic effects. Male patients are exposed to higher levels of EDCs in blood compared to females due to their higher body burden and higher weight loss after surgery. Elevated serum and semen EDCs concentrations have been found to be negatively associated with sperm quality and fertility. The objective of this study is to estimate the serum levels of major EDCs following bariatric surgery and to discuss the potential risk from this exposure to male reproductive health. According to the literature search criteria, nine studies were found that measured the levels of EDCs before and after surgery. Five studies (n=576) were used to calculate the percentage of change in EDCs serum levels per kilogram weight loss. The average weight loss at 6 and 12 months post-surgery for U.S. men are, respectively, 31 and 44 kg, which yielded total serum organochlorines concentrations (p,p’˗ DDE, ∑PCB, ∑HCH, HCB, and ∑PBDE) in 636.2% (Min-Max 187% - 1052.7%) and 913% (Min-Max 278.3% - 1510.4%) at 6 and 12 months post-surgery, respectively. Only seven small cohorts (n = 3 - 46) studies addressed sperm parameters post-surgery and none of them considered EDCs. Reported negative effects included the lack of improvement in sperm characteristics, a worsening of general sperm quality, azoospermia, and an increase in sperm aneuploidy and infertility after surgery. Occupational and non-occupational populations with similar serum EDCs concentrations as post-bariatric patients were also found to have sperm deterioration and infertility. Bariatric patients prove to be a good model to examine how the reproductive system responds to precipitous and progressive increases in circulating EDCs.