title: The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis.
abstract: BACKGROUND
  It has been suggested that body mass index (BMI), especially obesity, is associated with subfertility in men. Semen parameters are central to male fertility and reproductive hormones also play a role in spermatogenesis. This review aimed to investigate the association of BMI with semen parameters and reproductive hormones in men of reproductive age.
  
  
  METHODS
  MEDLINE, EMBASE, Biological Abstracts, PsycINFO and CINAHL databases and references from relevant articles were searched in January and February 2009. Outcomes included for semen parameters were sperm concentration, total sperm count, semen volume, motility and morphology. Reproductive hormones included were testosterone, free testosterone, estradiol, FSH, LH, inhibin B and sex hormone binding globulin (SHBG). A meta-analysis was conducted to investigate sperm concentration and total sperm count.
  
  
  RESULTS
  In total, 31 studies were included. Five studies were suitable for pooling and the meta-analysis found no evidence for a relationship between BMI and sperm concentration or total sperm count. Overall review of all studies similarly revealed little evidence for a relationship with semen parameters and increased BMI. There was strong evidence of a negative relationship for testosterone, SHBG and free testosterone with increased BMI.
  
  
  CONCLUSIONS
  This systematic review with meta-analysis has not found evidence of an association between increased BMI and semen parameters. The main limitation of this review is that data from most studies could not be aggregated for meta-analysis. Population-based studies with larger sample sizes and longitudinal studies are required.
authors.affiliation: School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand.
authors.forename: A A
authors.initials: AA
authors.lastname: MacDonald
authors.forename: G P
authors.initials: GP
authors.lastname: Herbison
authors.forename: M
authors.initials: M
authors.lastname: Showell
authors.forename: C M
authors.initials: CM
authors.lastname: Farquhar
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D042341:Gonadal Hormones / Q000097:blood*; D006801:Humans; D007248:Infertility, Male / Q000097:blood / Q000209:etiology*; D028322:Inhibin-beta Subunits / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications*; D012661:Semen / Q000737:chemistry* / Q000166:cytology; D055101:Semen Analysis; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D042341:Gonadal Hormones; C422402:INHBB protein, human; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D028322:Inhibin-beta Subunits