Mechanisms linking obesity to male infertility.
BACKGROUND
Obesity in men is associated with infertility in numerous studies. The current trend for decline in semen parameters parallels the increasing prevalence of obesity worldwide. In addition to impaired semen quality, fertility among obese men may be affected by sexual dysfunction, endocrinopathy, aromatization activity, psychological and thermal effects, sleep apnea, leptin and minor toxins, and possibly the inflammatory and obstructive elements of epididymitis pathology. The variable degrees of certainty associated with these causes parallel the levels of supporting evidence. This search aims to shed lights on different conditions that obese men suffer from; as that makes the treatment of infertility more categorized.


METHODS
A PubMed search was conducted to identify clinical and pathological mechanisms linking obesity to male infertility.


RESULTS
Among the myriad of publications reviewed in this paper, impaired spermatogenesis and sexual dysfunction have been shown to drive other variables towards poor fertility potentials. The paper presented a new, detailed flow chart showing more factors and further interactions among conditions leading to infertility.


CONCLUSIONS
The prime hormonal defect in obese men is hypotestosteronaemia, which results in impaired spermatogenesis leading to poor fecundability. Studies have shown that most mechanisms accounting for reduced fertility potentials in overweight men are reversible.
Department of Urology and Department of Andrology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
Atif
A
Katib
body mass index; erectile dysfunction; hypogonadism; male infertility; obesity; spermatogenesis