title: Paternal obesity negatively affects male fertility and assisted reproduction outcomes: a systematic review and meta-analysis.
abstract: This systematic review investigated the effect of paternal obesity on reproductive potential. Databases searched were Pubmed, Ovid, Web of Science, Scopus, Cinahl and Embase. Papers were critically appraised by two reviewers, and data were extracted using a standardized tool. Outcomes were: likelihood of infertility, embryo development, clinical pregnancy, live birth, pregnancy viability, infant development, sperm; concentration, morphology, motility, volume, DNA fragmentation, chromatin condensation, mitochondrial membrane potential (MMP), and seminal plasma factors. Thirty papers were included, with a total participant number of 115,158. Obese men were more likely to experience infertility (OR = 1.66, 95% CI 1.53-1.79), their rate of live birth per cycle of assisted reproduction technology (ART) was reduced (OR = 0.65, 95% CI 0.44-0.97) and they had a 10% absolute risk increase of pregnancy non-viability. Additionally, obese men had an increased percentage of sperm with low MMP, DNA fragmentation, and abnormal morphology. Clinically significant differences were not found for conventional semen parameters. From these findings it can be concluded that male obesity is associated with reduced reproductive potential. Furthermore, it may be informative to incorporate DNA fragmentation analysis and MMP assessment into semen testing, especially for obese men whose results suggest they should have normal fertility.
authors.affiliation: The Joanna Briggs Institute, University of Adelaide, Adelaide 5000, Australia. Electronic address: jared.campbell@adelaide.edu.au.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Campbell
authors.affiliation: Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, University of Adelaide, Repromed, Adelaide 5000, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lane
authors.affiliation: Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide 5000, Australia.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Owens
authors.affiliation: Bump IVF, Mossman, Sydney, New South Wales 2088, Australia.
authors.forename: Hassan W
authors.initials: HW
authors.lastname: Bakos
mesh_terms: D053938:DNA Fragmentation; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D007248:Infertility, Male / Q000503:physiopathology*; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D055101:Semen Analysis; D013081:Sperm Motility / Q000502:physiology; D013094:Spermatozoa / Q000502:physiology*
keywords: BMI; andrology; fertility; meta-analysis; obesity; systematic review