title: Influence of increasing body mass index on semen and reproductive hormonal parameters in a multi-institutional cohort of subfertile men.
abstract: OBJECTIVE
  To determine whether obesity affects serum and seminal measures of male reproductive potential among a multi-institutional cohort.
  
  
  METHODS
  Retrospective multi-institutional cohort study.
  
  
  METHODS
  Infertility clinics.
  
  
  METHODS
  All men referred for male infertility evaluation from 2002 to 2014 (n = 4,440).
  
  
  METHODS
  None.
  
  
  METHODS
  Collected reproductive parameters included hormonal (gonadotropins, T, E2, PRL) and semen analysis (ejaculate volume, sperm concentration, motility, normal morphology) data. Body mass index (BMI) was calculated for all patients with comparisons to reproductive parameters using univariate and multiparametric models.
  
  
  RESULTS
  Based on World Health Organization definitions, 30.9% of the cohort was normal weight (BMI 18.5-24.9), 45.1% overweight (25-29.9), and 23.3% obese (>30). Neither FSH nor LH demonstrated significant correlations with BMI on multivariate analysis. Total T (r = -0.27) and the T:E2ratio (r = -0.29) inversely varied with BMI, whereas E2(r = 0.13) had a direct correlation. On univariate analyses, BMI had weak but significant negative correlations with ejaculate volume (r = -0.04), sperm concentration (r = -0.08), motility (r = -0.07), and morphology (r = -0.04). All parameters remained significant on multivariate modeling with the exception of sperm motility. Rates of azoospermia and oligospermia were also more prevalent among obese (12.7% and 31.7%, respectively) compared with normal weight men (9.8% and 24.5%).
  
  
  CONCLUSIONS
  In one of the largest cohorts of male fertility and obesity, serum hormone and semen parameters demonstrated mild but significant relationships with BMI, possibly contributing to subfertility in this population.
authors.affiliation: Department of Urology, Hartford Hospital, Hartford, Connecticut. Electronic address: jared.bieniek@hhchealth.org.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Bieniek
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, New York.
authors.forename: James A
authors.initials: JA
authors.lastname: Kashanian
authors.affiliation: Division of Urology, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Deibert
authors.affiliation: Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ethan D
authors.initials: ED
authors.lastname: Grober
authors.affiliation: Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kirk C
authors.initials: KC
authors.lastname: Lo
authors.affiliation: Department of Urology, Northwestern University, Chicago, Illinois.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Brannigan
authors.affiliation: Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Jay I
authors.initials: JI
authors.lastname: Sandlow
authors.affiliation: Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Jarvi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D048430:Cell Shape; D016009:Chi-Square Distribution; D004958:Estradiol / Q000097:blood; D005298:Fertility; D006062:Gonadotropins / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D007248:Infertility, Male / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009656:North America / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011388:Prolactin / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000473:pathology*; D013739:Testosterone / Q000097:blood
chemical_list: D015415:Biomarkers; D006062:Gonadotropins; D006728:Hormones; D013739:Testosterone; D004958:Estradiol; D011388:Prolactin
keywords: Body mass index; endocrinology; male infertility; obesity; semen analysis