The Effect of Increased Body Mass Index on Reproductive Hormones and Semen Analysis in Primary Infertile Men

Abstract

Being overweight and obesity are among the most significant health problems in our era. World Health Organization (WHO) described as overweight a patient with body mass index (BMI) (25.0–29.9 kg/m2), and as obese a patient with BMI ≥30 kg/m2. According to WHO data, 35% of the young patients, who are in their twenties, are overweight and11% of them are obese. Infertility is another health problem affecting 15% of the couples in developed countries. Several studies document that increased male body mass index (BMI) is associated with decreased plasma concentrations of sex hormone binding globulin (SHBG) testosterone, and a concomitant increased plasma concentration of estrogen. Lower testosterone and higher estrogen concentrations have long been associated with subfertility and reduced sperm counts through disruption of the negative feedback loop of the HPG axis, and are, therefore, common clinical markers of male fertility. Obesity has been reported to create a state of systemic oxidative stress, a situation that is likely to extend to the testicular micro-environment. Obese individuals are in a chronic state of inflammation due to adipose tissue production of pro-inflammatory cytokines such as IL-6 and TNFα, which can stimulate leucocyte production of reactive oxygen species. This study aimed to examine the relationships between reproductive hormones (FSH, LH, total testosterone, estradiol, prolactin) and semen parameters with increased Body Mass Index on primary infertile men.