Obesity Surgery Improves Hypogonadism and Sexual Function in Men without Effects in Sperm Quality

Abstract

(1) Background: Obesity is associated with hypogonadism, sexual dysfunction, and impaired fertility in men. However, its effects on semen parameters or sexual function remain debatable. (2) Methods: This paper involves a longitudinal study in men submitted for obesity surgery at a university tertiary hospital. Patients were studied at baseline and at 6, 12, and 18 months after obesity surgery. At each visit, anthropometry measures were collected and hormonal and semen parameters were studied. Sexual function was evaluated with the International Index of Erectile Function (IIEF). (3) Results: A total of 12 patients were included. The average body mass index of patients decreased from 42.37 ± 4.44 to 29.6 ± 3.77 kg/m2 at 18 months after surgery (p < 0.05). Hormonal parameters improved after obesity surgery. The proportion of sperm cells with normal morphology tended to decrease from baseline and became most significant at 18 months (5.83 ± 4.50 vs. 2.82 ± 2.08). No significant changes were found in the remaining semen parameters. Erectile function improved significantly at six months after surgery. (4) Conclusions: The authors believe that, in general, the effects of obesity surgery on fertility may be limited or even deleterious (at least in the short and midterm follow-up).

Long-term effect of sleeve gastrectomy surgery on Hormonal Profile, Semen Parameters and sexual functions of obese infertile men; a prospective observational study

“…Another study by Inka et al [30] showed no effect of bariatric surgery on sperm count or sperm attention at any time during the study period. Likewise, there is little information on the effect of Diet-Induced Weight Loss on sperm parameters.…”

“…It concluded that it did not affect sperm volume, alertness, total number, morphology, motility or viability [ 29 ]. Another study by Inka et al [ 30 ] showed no effect of bariatric surgery on sperm count or sperm attention at any time during the study period. Likewise, there is little information on the effect of Diet-Induced Weight Loss on sperm parameters.…”

“…For the evaluation of Sexual function, we utilized the International Index of Erectile Function (IIEF) questionnaire to assess sexual desire, erectile, and orgasmic functions, and evaluate the patient's satisfaction. The total possible score for the erectile function domain ranges from 1 to 30, and we classified erectile dysfunction into four categories: no erectile dysfunction (26)(27)(28)(29)(30), mild (17)(18)(19)(20)(21)(22)(23)(24)(25), moderate (11)(12)(13)(14)(15)(16), and severe (6-10) [14]. Laparoscopic sleeve gastrectomy was performed on all patients by the same surgical team according to the method described by Gagner et al, [15].…”

Semen quality and metabolic profile in people with type 1 diabetes with and without erectile dysfunction: a cross-sectional study

“…Moreover, in a Japanese cross-sectional study of 564 newlywed men, subjects with poor semen quality showed higher age, BMI, and higher fasting blood glucose [ 31 ]; erectile function resulted as an independent predictor for poor semen, confirming the association between the two variables in non-diabetic men. Furthermore, in a recent longitudinal study of 12 patients undergoing obesity surgery, sexual function improved after 18 months of follow-up, without effects on semen parameters even after a significant weight loss (from 42.37 ± 4.44 to 29.6 ± 3.77 kg/m 2 ) [ 32 ].…”

The Complexity of Bariatric Patient’s Pharmacotherapy: Sildenafil Biopharmaceutics and Pharmacokinetics before vs. after Gastric Sleeve/Bypass

“…As of 2023, there are several bariatric surgery procedures commonly performed, including sleeve gastrectomy (SG), one-anastomosis gastric bypass (OAGB), and Roux-en-Y gastric bypass (RYGB). Bariatric surgery was also shown to have a positive effect on sexual satisfaction and erectile function [ 3 , 4 , 5 , 6 ]. This may be related to weight loss [ 7 , 8 ] and overall improved body image [ 9 , 10 ].…”