“…However, it is unexpected that association between male infertility and a female-biased offspring sex ratio was not found (11). Moreover, many factors are sometimes associated with the sex ratio at birth, including paternal age >40 years of age (12,13), maternal age >40 years of age ( 14) multiparity (14,15), parental smoking (16,17), and assisted reproduction technology (intracytoplasmic sperm injection [18,19], blastocyst culture [20], and embryo culture media [21]). Until now, no evidence has shown an association between male BMI and the sex ratio at birth after assisted reproduction, but a large number of studies have suggested that there is an association between an elevated paternal BMI around conception with a higher BMI of offspring (22,23), and there is a potential association between the paternal health status and health of the offspring (24)(25)(26).…”