What is the impact of obesity on male fertility? 0Obesity, when understood as a body mass index (BMI) in excess of 30kg/m2, is associated with numerous health issues including hypertension, diabetes, hypercholesterolemia and so on. It also affects fertility. In women, the impact of obesity is very clear. It generates hormonal abnormalities that have a direct impact on a woman’s ability to reproduce. As a result, obesity in women has been the subject of numerous studies and there are a large number of publications on the matter.

The search for the link between excess weight and fertility in men has been under way for many years but researchers have not reached a consensus on the subject. We know that obesity in men is linked to hormonal abnormalities that can lead to decreased semen quality. It affects factors including ejaculate volume, sperm count and spermatozoa motility.

We should also keep in mind that low testosterone levels are included in the hormonal abnormalities present in this group of males. This can lead to erectile dysfunction issues and, as a result, difficulties achieving pregnancy naturally.

It is important to point out that some of the diseases that are associated with obesity also affect fertility in two ways, as indicated below.

  • Directly: severe diabetes, for example, can lead to retrograde ejaculation. This is when semen enters the bladder instead of being ejaculated from the body.
  • Indirectly: some pharmaceutical drugs, such as the ones needed in order to keep hypertension under control, decrease the spermatozoon’s capacity to fertilise the ovum.

Intracytoplasmic spermatozoa injection (ICSI) started being used in the early ‘90s, facilitating pregnancy for couples in which the male partner has poor semen quality or ejaculation issues. Recent studies have analysed the results of treatment of this kind, comparing the results obtained when the male partner has a normal BMI with those when the male partner has an elevated BMI. The results indicate that being overweight can have a negative impact on the results obtained during treatment. There is a decreased likelihood of a successful pregnancy in couples when the male partner is obese.

Understanding the significance of living a healthy life is important in terms of having good physical and mental health and, as indicated above, in improving a couple’s reproduction prognosis.

María Carmen Tió, a biologist at Instituto Bernabeu

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