Obesity and male infertility

Authors: J. Heráček 1,2;  V. Sobotka 1,2;  M. Urban 1
Authors‘ workplace: Univerzita Karlova v Praze, 3. lékařská fakulta, Urologická klinika, přednosta doc. MUDr. R. Grill, Ph. D. 1;  Fakultní nemocnice Královské Vinohrady, Urologická klinika, Praha, přednosta doc. MUDr. R. Grill, Ph. D. 2
Published in: Ceska Gynekol 2012; 77(5): 450-456


The authors present a review on the effects of obesity on male fertility. Current scientific findings suggest an elevated risk of infertility among couples in which the male partner is obese. In obese men can be found reduced serum levels of androgens and SHBG and increased estrogen levels without compensatory increase in FSH. Among other impacts of male obesity that may contribute to increased risk of infertility are altered retention and metabolism of environmental toxins, lifestyle, sexual dysfunction, genetic factors, excessive secretion of hormones derived from adipose tissue, oxidative stress, sperm specific proteomic changes or elevated levels of cytokines. The increasing prevalence of obesity calls for greater clinical awareness of its impact on male fertility.

Key words:
obesity, male infertility, reproductive hormones, sperm parameters.


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

2. Akingbemi, BT. Estrogen regulation of testicular function. Reprod Biol Endocrinol, 2005, 3, p. 51.

3. Alavanja, MC., Sandler, DP., McMaster, SB., et al. The Agricultural Health Study. Environ Health Perspect, 1996, 104, p. 362–369.

4. Arsov, T., Silva, DG., O’Bryan, MK., et al. Fat aussie – a new alstrom syndrome mouse showing a critical role for ALMSI in obesity, diabetes, and spermatogenesis. Mol Endocrinol, 2006, 20, p. 1610–1622.

5. Avicenna. The disadvantages of excessive weight. In: Avicenna. The canon of medicine, book IV: diseases involving more than one member; the Cosmetic art. Rome: Medical Press, 1593, p. 173–174.

6. Bacon, CG., Mittleman, MA., Kawachi, I., et al. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med, 2003, 139, p. 161–168.

7. Barnett, R. Obesity. Lancet, 2005, 365, p. 1843.

8. Blank, DM., Clark, RV., Heymsfield, SB., et al. Endogenous opioids and hypogonadism in human obesity. Brain Res Bull, 1994, 34, p. 571–574.

9. de Boer, H., Verschoor, L., Ruinemans-Koerts, J., Jansen, M. Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadism. Diabetes Obes Metab, 2005, 7, p. 211–215.

10. Bonde, JP., Ernst, E., Jensen, TK., et al. Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners. Lancet, 1998, 352, p. 1172–1177.

11. Brody, S. Slimness is associated with greater intercourse and lesser masturbation frequency. J Sex Marital Ther, 2004, 30, p. 251–261.

12. Bujan, L., Daudin, M., Charlet, JP., et al. Increase in scrotal temperature in car drivers. Hum Reprod, 2000, 15, p. 1355–1357.

13. Cabler, S., Agarwal, A., Flint, M., du Plessis, SS. Obesity: modern man’s fertility nemesis. Asian J Androl, 2010, 12, p. 480–489.

14. Chung, WS., Sohn, JH., Park, YY. Is obesity an underlying factor in erectile dysfunction? Eur Urol, 1999, 36, p. 68–70.

15. Diaz-Arjonilla, M., Schwarz, M., Swerdloff, RS., Wang, C. Obesity, low testosterone levels and erectile dysfunction. Int J Import Res, 2009, 21, p. 89–98.

16. Esposito, K., Giugliano, F., Di Palo, C., et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA, 2004, 291, p. 2978–2984.

17. Farooqi, IS., Wangensteen, T., Collins, S., et al. Clinical and molecular genetic spectrum of congenital deficiency of the leptin receptor. N Engl J Med, 2007, 356, p. 237–247.

18. Feeley, RJ., Traish, AM. Obesity and erectile dysfunction: is androgen deficiency the common link? Scientific World J, 2009, 9, p. 676–684.

19. Fejes, I., Koloszar, S., Szollosi, J., et al. Is semen quality affected by male body fat distribution? Andrologia, 2005, 37, p. 155–159.

20. Feldman, HA., Johannes, CB., Derby, CA., et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts Male Aging Study. Prev Med, 2000, 30, p. 328–338.

21. Giagulli, VA., Kaufman, JM., Vermeulen, A. Pathogenesis of the decreased androgen levels in obese men. J Clin Endocrinol Metab, 1994, 79, p. 997–1000.

22. Globerman, H., Shen-Orr, Z., Karnieli, E., et al. Inhibin B in men with severe obesity and after weight reduction following gastroplasty. Endocr Res, 2005, 31, p. 17–26.

23. Goyal, HO., Robateau, A., Braden, TD., et al. Neonatal estrogen exposure of male rats alters reproductive functions at adulthood. Biol Reprod, 2003, 68, p. 2081–2091.

24. Guzick, DS., Overstreet, JW., Factor-Litvak, P., et al. Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med, 2001, 345, 1388–1393.

25. Hammoud, AO., Gibson, M., Peterson, CM., Carrell, DT. Effect of sperm preparation techniques by density gradient on intra-individual variation of sperm motility. Arch Androl, 2007, 53, p. 349–351.

26. Hammoud, AO., Gibson, M., Peterson, CM., et al. Impact of male obesity on infertility: a critical review of the current literature. Fertil Steril, 2008, 90, p. 897–904.

27. Hammoud, AO., Wilde, N., Gibson, M., et al. Male obesity and alteration in sperm parameters. Fertil Steril, 2008, 90, p. 2222–2225.

28. Hammoud, AO., Carrel, DT., Meikle, AW., et al. An aromatase polymorphism modulates the relationship between weight and estradiol levels in obese men. Fertil Steril, 2010, 94, p. 1734–1738.

29. Hanafy, S., Halawa, FA., Mostafa, T., et al. Serum leptin correlates in infertile oligozoospermic males. Andrologia, 2007, 39, p. 177–180.

30. Ivell, R. Lifestyle impact and the biology of the human scrotum. Reprod Biol Endocrinol, 2007, 5, p. 15.

31. Jensen, TK., Andersson, AM., Jorgensen, N., et al. Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. Fertil Steril, 2004, 82, p. 863–870.

32. Jung, A., Schill, WB. Male infertility. Current life style could be responsible for infertility. MMW Fortschr Med, 2000, 142, p. 31–33.

33. Kahn, H., Cheng, Y. Longitudinal changes in BMI and in an index estimating excess lipids among white and black adults in the United States. Int J Obes, 2008, 32, p. 136–143.

34. Kasturi, SS., Tannir, J., Brannigan, RE. The metabolic syndrome and male infertility. J Androl, 2008, 29, p. 251–259.

35. Kaukua, J., Pekkarinen, T., Sane, T., Mustajoki, P. Sex hormones and sexual function in obese men losing weight. Obes Res, 2003, 11, p. 689–694.

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

37. Luboshitzky, R., Lavie, L., Shen-Orr, Z., Herer, P. Altered luteinizing hormone and testosterone secretion in middle-aged obese men with obstructive sleep apnea. Obes Res, 2005, 13, p. 780–786.

38. Magnusdottir, EV., Thorsteinsson, T., Thorsteinsdottir, S., et al. Persistent organochlorines, sedentary occupation, obesity and human male subfertility. Hum Reprod, 2005, 20, p. 208–215.

39. Mieusset, R., Bujan, LE., Massat, G., et al. Inconstant ascending testis as a potential risk factor for spermatogenesis in infertile men with no history of cryptorchism. Hum Reprod, 1997, 12, p. 974–979.

40. Momen, MN., Fahmy, I., Amer, M., et al. Semen parameters in men with spinal cord injury: changes and aetiology. Asian J Androl, 2007, 9, p. 684–689.

41. Nguyen, R., Wilcox, A., Skjaerven, R., Baird, DD. Men’s body mass index and infertility. Hum Reprod, 2007, 17, p. 2488–2493.

42. Niskanen, L., Laaksonen, DE., Punnonen, K., et al. Changes in sex hormone–binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome. Diabetes Obes Metab, 2004, 6, p. 208–215.

43. O’Brien, JH., Lazarou, S., Deane, L., et al. Erectile dysfunction and andropause symptoms in infertile men. J Urol, 2005, 174, p. 1932–1934.

44. Okada, Y., Tateishi, K., Zhang, Y. Histone dementhylase JHMD2A is involved in male infertility and obesity. J Androl, 2010, 31, p. 75–78.

45. Pavlovich, CP., King, P., Goldstein, M., Schlegel, PN. Evidence of a treatable endocrinopathy in infertile men. J Urol, 2001, 165, p. 837–841.

46. Ramlau-Hansen, CH., Thulstrup, AM., Nohr, EA., et al. Subfecundity in overweight and obese couples. Hum Reprod, 2007, 22, p. 1634–1637.

47. Reddy, UM., Wapner, RJ., Rebar, RW., Tasca, RJ. Infertility, assisted reproductive technology, and adverse pregnancy outcomes: executive summary of a National Institute of Child Health and Human Development workshop. Obstet Gynecol, 2007, 109, p. 967–977.

48. Sallmen, M., Sandler, DP., Hoppin, JA., et al. Reduced fertility among overweight and obese men. Epidemiology, 2006, 17, p. 520–523.

49. Schneider, G., Kirschner, MA., Berkowitz, R., Ertel, NH. Increased estrogen production in obese men. J Clin Endocrinol Metab, 1979, 48, p. 633–638.

50. Semple, PA., Graham, A., Malcolm, Y., et al. Hypoxia, depression of testosterone, and impotence in pickwickian syndrome reversed by weight reduction. Br Med J (Clin Res Ed), 1984, 289, p. 801–802.

51. Shafik, A., Olfat, S. Lipectomy in the treatment of scrotal lipomatosis. Br J Urol, 1981, 53, p. 55–61.

52. Sharpe, RM. Lifestyle and environmental contribution to male infertility. Br Med Bull, 2000, 56, p. 630–642.

53. Slama, R., Eustache, F., Ducot, B., et al. Time to pregnancy and semen parameters: a cross-sectional study among fertile couples from four European cities. Hum Reprod, 2002, 17, p. 503–515.

54. Stellato, RK., Feldman, HA., Hamdy, O., et al. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care, 2000, 23, p. 490–494.

55. Traish, AM., Feeley, RJ., Guay, A. Mechanisms of obesity and related pathologies: androgen deficiency and endothelial dysfunction may be the link between obesity and erectile dysfunction, FEBS J, 2009, 276, p. 5755–5767.

56. Tsai, EC., Matsumoto, AM., Fujimoto, WY., Boyko, EJ. Association of bioavailable, free, and total testosterone with insulin resistance: influence of sex hormone-binding globulin and body fat. Diabetes Care, 2004, 27, p. 861–868.

57. Vermeulen, A., Kaufman, JM., Deslypere, JP., Thomas, G. Attenuated luteinizing hormone (LH) pulse amplitude but normal LH pulse frequency, and its relation to plasma androgens in hypogonadism of obese men. J Clin Endocrinol Metab, 1993, 76, p. 1140–1146.

58. Vgontzas, AN., Papanicolaou DA., Bixler, EO., et al. Sleep apnea and daytime sleepness and fatigue: relation to visceral obesity, insulion resistance, and hypercytokinemia. J Clin Endocrinol Metab, 2000, 85, p. 1151–1158.

59. Zorn, B., Osredkar, J., Meden-Vrtovec, H., Majdic, G. Leptin levels in infertile male patients are correlated with inhibin B, testosterone and SHBG but not with sperm characteristics. Int J Androl, 2006, 30, p. 439–444.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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