The Obesity-Fertility Link in Men
the MPR take:
For men, obesity-related conditions can include heart disease, stroke, type 2 diabetes, and certain types of cancers. A new study published in the journal Clinical Endocrinology now adds possible infertility to the list of problems associated with obesity. Reduced fertility in obese men can be a product of hormonal, mechanical, and psychosocial issues. With regards to hormones, serum testosterone levels tend to be lower in obese men but increasing testosterone levels via testosterone replacement therapy may have a negative impact on fertility. Clinicians should discuss this potentially adverse effect with men before starting testosterone therapy. Sperm concentrations and quality are also affected by obesity; this study, however, was not able to establish whether losing weight helped correct this issue. Finally, more research needs to be done to see whether estrogen receptor modulators and aromatase inhibitors may play a role in treating male hypogonadism and/or infertility.
Summary: Adiposity is associated with reduced fertility in men. The aetiology is multifactorial, with obese men at greater risk of suffering from impaired spermatogenesis, reduced circulating testosterone levels, erectile dysfunction and poor libido. The diagnosis and treatment of reduced fertility observed in obese men therefore requires insight into the underlying pathology, which has hormonal, mechanical and psychosocial aspects.