INVITED REVIEW
Obesity and male infertility: Mechanisms and management
Kristian Leisegang,
Pallav Sengupta,
Ashok Agarwal,
Ralf Henkel,
Corresponding Author
Kristian Leisegang
School of Natural Medicine, University of the Western Cape, Cape Town, South Africa
Correspondence
Kristian Leisegang, School of Natural Medicine, University of the Western Cape, Cape Town, South Africa.
Email: [email protected]
Search for more papers by this authorPallav Sengupta
Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Selangor, Malaysia
Search for more papers by this authorAshok Agarwal
American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
Search for more papers by this authorRalf Henkel
American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
Department of Medical Bioscience, University of the Western Cape, Cape Town, South Africa
Search for more papers by this authorKristian Leisegang,
Pallav Sengupta,
Ashok Agarwal,
Ralf Henkel,
Corresponding Author
Kristian Leisegang
School of Natural Medicine, University of the Western Cape, Cape Town, South Africa
Correspondence
Kristian Leisegang, School of Natural Medicine, University of the Western Cape, Cape Town, South Africa.
Email: [email protected]
Search for more papers by this authorPallav Sengupta
Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Selangor, Malaysia
Search for more papers by this authorAshok Agarwal
American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
Search for more papers by this authorRalf Henkel
American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
Department of Medical Bioscience, University of the Western Cape, Cape Town, South Africa
Search for more papers by this authorAbstract
Obesity is considered a global health problem affecting more than a third of the population. Complications of obesity include cardiovascular diseases, type 2 diabetes mellitus, malignancy (including prostatic cancer), neurodegeneration and accelerated ageing. In males, these further include erectile dysfunction, poor semen quality and subclinical prostatitis. Although poorly understood, important mediators of obesity that may influence the male reproductive system include hyperinsulinemia, hyperleptinemia, chronic inflammation and oxidative stress. Obesity is known to disrupt male fertility and the reproduction potential, particularly through alteration in the hypothalamic-pituitary-gonadal axis, disruption of testicular steroidogenesis and metabolic dysregulation, including insulin, cytokines and adipokines. Importantly, obesity and its underlying mediators result in a negative impact on semen parameters, including sperm concentration, motility, viability and normal morphology. Moreover, obesity inhibits chromatin condensation, DNA fragmentation, increases apoptosis and epigenetic changes that can be transferred to the offspring. This review discusses the impact of obesity on the male reproductive system and fertility, including associated mechanisms. Furthermore, weight management strategies, lifestyle changes, prescription medication, and complementary and alternative medicine in the management of obesity-induced subfertility is discussed.
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