Obesity in men can affect their semen quality due to a reduction in sperm count, low sperm motility and increased morphological alterations.
For all these reasons, obesity is a cause of male infertility, just as it is a cause of female infertility.
Weight loss with a healthy lifestyle and a balanced diet can help these men regain their sperm quality and have children naturally. Otherwise, the probability of becoming a father is reduced.
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Obese men
A man is obese when his Body Mass Index (BMI) is greater than 30. In addition, obesity is considered morbid when the BMI exceeds 45.
BMI is obtained by dividing weight in kilograms by height in meters squared: BMI = Weight (kg) / Height2 (m2).
A high BMI has multiple negative consequences for the body, including infertility.
In the case of women, the impact of obesity on their fertility is much more evident, as it causes alterations in the menstrual cycle and can affect ovulation. If the egg is not released, fertilization and, therefore, natural pregnancy will not occur.
On the other hand, not all obese men will present sterility, because as long as there is sufficient production of good spermatozoa, these men will be able to become pregnant.
What has been observed is that there is a general decrease in semen quality in men with obesity. Specifically, obese men have about 9 million fewer sperm per milliliter in the ejaculate than men with a normal BMI.
Effects of obesity on fertility
Multiple studies have linked male obesity to a worsening of semen quality, which increases the risk of infertility in these men.
In addition, since weight gain affects the production of sex hormones, obese men may also suffer from other types of sexual disturbances.
Poorer sperm quality
When performing a semen analysis in a man with obesity, there is a higher probability of observing poor quality semen because these men may have impaired spermatogenesis (sperm production in the testes).
In general, the most affected parameters are the following:
- Lower seminal volume
- Lower sperm concentration
- Worst sperm mobility
- Increased number of sperm malformations
- Increased sperm DNA fragmentation rate
We recommend that you visit the following article for more information about semen quality: Is it possible to improve sperm quality - Recommendations.
Alterations in the male reproductive system
Another effect of obesity on the male body is a decrease in the hormone testosterone.
Testosterone is the most important male sex hormone, as it is responsible for regulating the entire process of spermatogenesis (sperm production). In addition, testosterone is responsible for the growth of the testes and the appearance of secondary sexual characteristics at puberty.
Therefore, a decrease in testosterone levels can have consequences on male sexuality such as the following:
- Erectile dysfunction
- Decreased libido or sexual desire.
In addition, weight gain is also related to an increase in scrotal temperature in the male, causing sperm damage.
Consequently, these dysfunctions of the male reproductive system also hinder the couple's sexual relations and the achievement of pregnancy.
Causes
The main cause of male sterility due to obesity is the hormonal alteration that this causes in the male organism.
Specifically, an increase in BMI is related to an increase in serum leptin, a hormone that regulates energy homeostasis and neuroendocrine function, and therefore also plays an important role in reproductive function.
Much of the leptin is produced in adipose tissue. Therefore, its levels depend on body fat stores, food intake and energy consumed.
Numerous studies suggest that increased leptin affects the function of the Leydig cells in the testes, so that there is not enough production of the hormone testosterone and this ends up affecting sperm production and maturation.
In addition, serum leptin has also been shown to be higher in obese infertile men than in obese fertile men.
In conclusion, men with a BMI over 30 have lower androgen levels, especially testosterone, leading to a situation of hypogonadotropic hypogonadism that ultimately affects sperm production.
Treatment to achieve pregnancy
The first action to try to improve seminal parameters and recover male fertility should be to lose weight through diet and physical exercise.
Weight loss will depend on each individual and his or her BMI, so it is recommended to seek the advice of a nutritionist.
If seminogram values improve after the male has achieved a lower BMI, a natural pregnancy could be achieved without problems.
Although the reasons are unknown, if weight loss occurs through surgery such as stomach reduction or gastric balloon insertion, seminal parameters do not improve.
If seminal quality cannot be improved and alterations such as oligospermia, asthenospermia or teratospermia are present, it will be necessary to resort to assisted reproduction techniques to achieve pregnancy.
Thanks to in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI), it is possible to select the best looking sperm to fertilize the eggs.
However, in obese men it can happen that the DNA of their sperm is fragmented and this leads to defective embryos that could cause implantation failure or even miscarriages.
FAQs from users
Why does obesity make semen worse?
The deterioration of sperm quantity and mobility occurs mainly as a consequence of alterations in hormonal balance. Obesity, mainly, translates into a greater number of fat cells or adipose tissue in the body; and it can produce hormones (leptin) that alter both normal hormonal secretion at the brain level and sperm production directly in the testicle. In addition, there is a higher temperature at the level of the testicles and a greater production of pro-inflammatory substances (adipokines). Both will contribute to greater oxidative stress in the testicle and this will increase DNA fragmentation.
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Can men who are a little overweight also have their fertility affected?
According to the World Health Organization (WHO), a man is considered overweight when his BMI is between 25 and 30, while obesity appears when the BMI is greater than 30.
Studies focused on the effect that weight gain has on male fertility have shown that the semen parameters of overweight men have similar values to those with a normal BMI (between 18 and 25).
Therefore, men who are slightly overweight do not usually have their sperm quality affected for this specific reason.
Can childhood obesity also lead to male infertility?
Yes. Obese children, in addition to being at greater risk of suffering from cardiovascular diseases, respiratory disorders or diabetes, can also have their fertility affected.
This is mainly due to the fact that obesity alters hormonal levels in the body, so there may be a delay in puberty in these children and defects in spermatogenesis.
What are the causes of male infertility due to obesity?
Men who are overweight or obese may have altered semen quality. It is possible that the quantity, mobility and morphology of your sperm is altered, which would cause problems in becoming parents.
In addition, obesity also causes alterations at the hormonal level and a reduction in testosterone occurs. Therefore, sperm production is reduced, as is sexual desire. This alteration in testosterone levels also causes erectile dysfunction in men.
Suggested for you
As mentioned above, BMI can affect the fertility of men and women in different ways. If you are interested in more information on this topic, you can access the following post: Infertility due to alterations in BMI.
Throughout the article we have talked about seminal quality in the male and its parameters. If you want to know more details about how it is measured or how it can be improved, we recommend you continue reading here: Sperm quality.
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References
Aggerholm AS, Thulstrup AM, Toft G, Ramlau-Hansen CH, Bonde JP. Is overweight a risk factor for reduced semen quality and altered serum sex hormone profile? Fertil Steril. 2008 Sep;90(3):619-26 (View)
Aiceles V, da Fonte Ramos C. A link between hypothyroidism, obesity and male reproduction. Horm Mol Biol Clin Investig. 2016 Jan;25(1):5-13
De La Fuente G, Pacheco A, García Velasco JA, Requena A. Influence of male obesity on pregnancy rates in couples undergoing oocyte donation. Andrology (Male Fertility, Spermatogenesis), Human Reproduction, Volume 25, Issue suppl_1, June 2010, Pages i118–i152
Hammoud A, Gibson M, Hunt SC, Adams TD, Carrell DT, Kolotkin RL, Meikle AW. Effect of Roux-en-Y gastric bypass surgery on the sex steroids and quality of life in obese men. J Clin Endocrinol Metab. 2009 Apr;94(4):1329-32 (View)
Hofny ER, Ali ME, Abdel-Hafez HZ, Kamal Eel-D, Mohamed EE, Abd El-Azeem HG, Mostafa T. Semen parameters and hormonal profile in obese fertile and infertile males. Fertil Steril. 2010;94(2):581-4 (View)
FAQs from users: 'Why does obesity make semen worse?', 'Can men who are a little overweight also have their fertility affected?', 'Can childhood obesity also lead to male infertility?' and 'What are the causes of male infertility due to obesity?'.
