The potential role of central obesity in male infertility: body mass index versus waist to hip ratio as they relate to selected semen parameters

Abstract

Background: Little is known about the potential role of central obesity among men. Our first aim was to confirm what is already known from prior research, namely that both BMI and WHR are inversely associated with selected semen parameters. Our second aim was to examine the potential role of central obesity by assessing if there was a difference between BMI and WHR regarding their relationships to these selected semen parameters. Methods: In this cross-sectional study between January 2011 to January 2018, we analyzed semen samples from 1169 patients who visited an andrology clinic in Budapest for infertility reasons. Variables assessed were: body measurements (height, weight, waist circumference, and hip circumference), and the results of semen analysis (sperm concentration, total sperm count, progressive sperm motility, and normal sperm morphology). Results: The mean height and weight were 180.6 cm and 87.3 kg, respectivelythe mean BMI was 26.8. The mean waist and hip circumferences were 100.9 cm and 94.8 cm, respectivelythe mean waist to hip ratio was 0.94. The mean sperm concentration, total sperm count, and percents of progressive motility and normal morphology were 48.7 M/ml, 165 million, 21.2, and 4.8%, respectively. Both BMI and WHR were significant correlates in all semen parameter regression models. When comparing the parameter estimates for BMI with those for WHR for each semen parameter, the parameter estimate for WHR was significantly lower (indicating a stronger negative association) than that for BMI for progressive motility and total sperm count, but not for normal morphology or concentration. Conclusions: Our study is the first to examine, using a large patient sample, the potential role of central obesity by comparing the difference between BMI and WHR as they relate to selected semen parameters. Our findings indicate a potential role of central obesity for progressive motility and total sperm count, but not for normal morphology and concentration. Despite the limitations and the exploratory nature of this study, we can conclude that our results point to a potential role of central obesity in male infertility, but this finding should be confirmed and further explored in future research.

The Prevalence and Components of Metabolic Syndrome in Men from Infertile Couples and Its Relation on Semen Analysis

“…In 2010, a cross-sectional study by Keszthelyi et al analyzing 1169 semen samples of infertile couples in Budapest showed that both BMI and WHR were significantly related to semen concentration and total sperm count. 25 This finding was different from our results and their mean BMI and WHR were significantly higher compared to our data (26.8 kg/m 2 versus 23.2 kg/m 2 ; 0.94 versus 0.88, respectively). However, other studies demonstrated that MetS did not affect to quality of sperm, similar to our conclusion.…”

A New Treatment for Local Adiposity with Ascorbic Acid and Ascorbyl-Palmitate Solution: Clinical and Histological Study

“…For this reason, the waist-to-hip ratio (WHR), waist circumference divided by the hip circumference, was proposed as this index takes into account the differences in body structure, fat distribution and has more sensitivity in the prediction of several diseases that can cause mortalities [ 3 , 4 ]. Furthermore, it is increasingly evident that excess abdominal fat is closely associated with the development of metabolic disturbances [ 5 – 7 ] while accumulation of fat in the lower body is associated with a protective glucose and lipid profile after adjustment for total body fat mass [ 8 , 9 ].…”

The impact of metabolically healthy obesity in primary infertile men: Results from a cross‐sectional study

“…However, it is known that obesity per se can negatively affect human fertility, for instance through its detrimental impact toward HPG axis. 19,23,34 Although our observations would seem counterintuitive, it is true that our analysis has taken into consideration not only the concept of obesity, but it is much more complex in its definition of overall health status. Our study is not devoid of limitations.…”

“…Similarly, the recent meta‐analysis conducted by Campbell JM et al 33 did not report any difference in total sperm count or sperm morphology between subjects with BMI above or below 30 kg/m 2 . However, it is known that obesity per se can negatively affect human fertility, for instance through its detrimental impact toward HPG axis 19,23,34 . Although our observations would seem counterintuitive, it is true that our analysis has taken into consideration not only the concept of obesity, but it is much more complex in its definition of overall health status.…”

“…Our interest was fueled by previous studies which had reported growing prevalence and incidence rates of obesity both in the general population 1,2 and in infertile men 19 ; moreover, our attention was captured by the increased interest about the potential impact of MHO on male sexual and reproductive health, [20][21][22][23] mostly giving the epidemiologically established lower general health in subfertile male individuals. 21,[24][25][26][27] As a whole, our finding confirmed previous observations, [20][21][22][23][24] but the main strength of the current cross-sectional study was that only infertile men belonging to primary infertile couples associated with pure male factor infertility have been considered. Furthermore, using a much stringent definition for MHO (as for the NCEP-ATPIII criteria), while lowering the number of subjects in each group, it eventually increased the clinical significance of the study.…”