Influence of body mass index and waist–hip ratio on male semen parameters in infertile men in the real world: a retrospective study

Abstract

BackgroundIt is suggested that body mass index (BMI) can affect male semen quality; however, the results remain controversial. In addition, most studies have focused on the effect of obesity on semen quality. Evidence on the relationship of underweight or waist-hip ratio (WHR) with semen quality is rare. This study aimed to assess the association of BMI and WHR with semen quality.MethodsData, including BMI and WHR, was collected from 715.00 men who underwent a fertility evaluation. BMI (kg/m2) was categorized as <18.50 (underweight), 18.50–24.90 (normal), 25.00–27.90 (overweight), and ≥28.00 (obese) kg/m2 for analysis. WHR was categorized as <0.81 (normal) and ≥0.81 (high). Semen volume, sperm concentration, progressive motility, and total motile sperm count were detected by experienced clinical technicians.ResultsSpearman’s correlation showed that BMI was weakly associated with sperm progressive motility (r = 0.076, P < 0.05), while WHR showed no relationship with semen parameters. The azoospermia rate was significantly higher (33.33% vs. 2.10%, P < 0.001) and the sperm concentration was lower (P < 0.05) in the underweight group. The nonlinear correlation analysis showed that BMI was negatively associated with sperm concentration while BMI was more than 22.40 kg/m2 (P < 0.05), while WHR was negatively related to sperm progressive motility within 0.82 to 0.89 (P < 0.05). Furthermore, the multivariate logistic analysis showed that follicular stimulating hormone (FSH) was an independent risk factor for normal sperm concentration (odds ratio [OR]: 0.791, P = 0.001) and morphology (OR: 0.821, P = 0.002), BMI was an independent risk factor for normal sperm progressive motility, and testosterone was an independent risk factor for sperm morphology (OR: 0.908, P = 0.023).ConclusionBMI and WHR were significantly associated with semen parameters, while BMI was an independent risk factor for normal sperm progressive motility. Reproductive hormones, including FSH and testosterone, had a significant influence on sperm concentration and sperm morphology.

Self-Rated Health and Semen Quality in Men Undergoing Assisted Reproductive Technology

“…Moreover, it is possible that the effect of overweight or obesity on semen quality may weaken or mask the association between SRH and semen quality among men with higher BMIs. Obesity can impair semen quality by regulating fatty acid metabolism in the testes and increasing mitochondrial damage in spermatozoa to reduce sperm concentration, viability, and normal morphology …”

“…Obesity can impair semen quality by regulating fatty acid metabolism in the testes and increasing mitochondrial damage in spermatozoa to reduce sperm concentration, viability, and normal morphology. 57 , 58 , 59 …”

“…Obesity can impair semen quality by regulating fatty acid metabolism in the testes and increasing mitochondrial damage in spermatozoa to reduce sperm concentration, viability, and normal morphology. [57][58][59] The biological mechanisms underlying the association between poorer SRH and lower semen quality have not been elucidated. It has been suggested that environmental stressors trigger an increase of glucocorticoids that can impair the hypothalamic-hypophysis-gonadic axis, resulting in reproductive dysfunction.…”