Effect of bariatric surgery on semen parameters and sex hormone concentrations: a prospective study

Abstract

Obesity has become a major health concern, with a prevalence rate approaching epidemic states. An inverse relationship between men's body weight and semen parameters has been observed, suggesting a favourable role for weight loss in improving fertility. This prospective study included 46 patients undergoing sleeve gastrectomy, who were investigated with semen analysis and serum hormone tests before and 12 months after surgery. Patients were divided into three groups according to their initial sperm concentration; median loss of body mass index was used as a cut-off to further classify patients according to extent of weight loss. Patients' preoperative seminal investigations revealed azoospermia in 13 (28.3%), oligospermia in 19 (41.3%) and normal sperm concentration in 14 (30.4%). Overall, only serum testosterone significantly increased after surgery (P < 0.001). Between study groups, the increase in sperm concentration was statistically significant in men with azoospermia and oligospermia (both P < 0.05), whereas serum testosterone was statistically significant in all groups (P < 0.001). Changes in semen and hormone tests were not affected by the extent of weight loss experienced by patients. Weight loss from bariatric surgery had a favourable effect on serum testosterone levels and semen parameters of patients with pre-existing azoospermia and oligospermia.

Association between obesity and sperm quality

“…A meta‐analysis that included studies based on lifestyle changes and surgical interventions including bariatric surgery found similar results of better testosterone profiles in those who underwent these interventions (Corona et al., ). Additionally, a recent prospective study found improvement in semen parameters in azoospermic and oligospermic men after bariatric surgery (El Bardisi et al., ). Furthermore, reverting to nonobese states normalised sperm microRNA profiles and metabolic syndrome in the offspring of obese fathers was observed (McPherson, Fullston, Aitken, & Lane, ; McPherson, Owens, Fullston, & Lane, ).…”

“…If BMI ≥40 kg/m 2 , bariatric surgery is the choice of treatment as several studies shown beneficial effects in patients who underwent gastric bypass surgeries with resultant improvement in increased serum testosterone and sperm count (Reis et al. , El Bardisi et al., ).…”

Association between body mass index and sperm quality and sperm DNA integrity. A large population study

“…Given the adverse consequences of obesity and the possible negative role of male BMI, the benefits of weight reduction should be discussed when counselling couples interested in fertility treatment. Analogous to some clinical conditions such as cardiovascular diseases or diabetes, it is believed that weight loss can benefit male fertility, helping to restore normality of hormonal profiles (ASRM, ; El Bardisi et al., ). However, existing data on the benefits of weight loss are unclear, and it should be noted the lack of well‐designed studies that demonstrate improvement in seminal quality with BMI reduction (ASRM, ; El Bardisi et al., ).…”

“…Analogous to some clinical conditions such as cardiovascular diseases or diabetes, it is believed that weight loss can benefit male fertility, helping to restore normality of hormonal profiles (ASRM, ; El Bardisi et al., ). However, existing data on the benefits of weight loss are unclear, and it should be noted the lack of well‐designed studies that demonstrate improvement in seminal quality with BMI reduction (ASRM, ; El Bardisi et al., ). On the other hand, abrupt weight loss with restriction of intake/absorption of important nutrients can lead to worsening seminal quality (El Bardisi et al., ; Sermondade, Massin, et al., ).…”

Men and obesity: what are the issues?

“…4 Higher adiposity and weight gain are strong risk factors for gout in men, while weight loss is protective. 5 Obesity adversely affects male fertility and can induce azoospermia, oligospermia and reduced testosterone levels; however, a 6 Sexual function is known to be problematic in obesity, erectile dysfunction in particular. 7 Although obesity is linked to an increased risk of several cancers, including colon, gallbladder, kidney, and pancreas, its role in prostate cancer aetiology remains uncertain, with inconsistent data.…”