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What ' s known on the subject? and What does the study add?The relationship between high levels of BMI and changes in altered standard semen analysis parameters are described in the literature. However, the functional characteristics of the sperm are essential to complete the evaluation of male infertility. Thus, this study provides important information about the functionality of the sperm of men with different levels of BMI.Study Type -Prognosis (cohort) Level of Evidence 3a OBJECTIVE• To assess the effect of obesity on semen analysis, sperm mitochondrial activity and DNA fragmentation. MATERIALS AND METHODS• A transversal study of 305 male patients, presenting for clinical evaluation, was carried out. The patients were divided into three groups according to body mass index (BMI) as follows: eutrophic (BMI < 25 kg/ m 2 , n = 82), overweight (BMI ≥ 25 kg/m 2 and < 30, n = 187) and obese (BMI ≥ 30 kg/ m 2 , n = 36).• The variables analysed were semen analysis, rate of sperm DNA fragmentation and sperm mitochondrial activity.• Groups were compared using one-way analysis of variance followed by a least signifi cant difference post-hoc test. A P -value of < 0.05 was considered to indicate statistical signifi cance. RESULTS• No differences were observed in age, ejaculatory abstinence, ejaculate volume, sperm vitality, morphology or round cell and neutrophil count among the groups.• The eutrophic group had a higher percentage of sperm with progressive motility ( P = 0.001). Mitochondrial activity was lower in the obese group ( P = 0.037) when compared to the eutrophic, and the percentage of sperm with DNA damage was higher in the obese group ( P = 0.004) than the other two groups. CONCLUSION• Increased BMI values are associated with decreased mitochondrial activity and progressive motility and increased DNA fragmentation.

Funding for the study was provided by Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp) (2007/59423-7) and by the Division of Urology, Human Reproduction Section at the São Paulo Federal University.

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Purpose To assess the effect of leukocytospermia and semen processing on sperm DNA and mitochondria. Methods Twenty-two patients with and 41 without leukocytospermia were included. Sperm DNA fragmentation was assessed by the Comet assay, and mitochondrial activity by a colorimetric method for active mitochondria. Semen was processed using Percoll, and motility, DNA fragmentation, and mitochondrial activity were analyzed pre-and post-processing. Results No differences were observed in age, abstinence, volume, sperm morphology, progressive motility, concentration, and vitality (p>0.10). Variables were grouped according to time (pre-vs post-processing) and group (leukocytospermia vs non-leukocytospermia) because no interactions could be observed. Leukocytospermia was associated to increased DNA fragmentation, while semen processing led to a decrease in DNA fragmentation and to increased mitochondrial activity. Conclusion While semen processing selects sperm with higher rates of DNA integrity independent of the presence or absence of leukocytes in semen, samples without leukocytospermia present more sperm without DNA fragmentation. Semen processing also selects sperm with higher mitochondrial activity.