Background: A high body mass index (BMI) has been associated with reduced semen quality and male\r\nsubfecundity, but no studies following obese men losing weight have yet been published. We examined semen\r\nquality and reproductive hormones among morbidly obese men and studied if weight loss improved the\r\nreproductive indicators.\r\nMethods: In this pilot cohort study, 43 men with BMI > 33 kg/m2 were followed through a 14 week residential\r\nweight loss program. The participants provided semen samples and had blood samples drawn, filled in\r\nquestionnaires, and had clinical examinations before and after the intervention. Conventional semen characteristics\r\nas well as sperm DNA integrity, analysed by the sperm chromatin structure assay (SCSA) were obtained. Serum\r\nlevels of testosterone, estradiol, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating\r\nhormone (FSH), anti-M�¼llerian hormone (AMH) and inhibin B (Inh-B) were measured.\r\nResults: Participants were from 20 to 59 years of age (median = 32) with BMI ranging from 33 to 61 kg/m2. At\r\nbaseline, after adjustment for potential confounders, BMI was inversely associated with sperm concentration (p =\r\n0.02), total sperm count (p = 0.02), sperm morphology (p = 0.04), and motile sperm (p = 0.005) as well as\r\ntestosterone (p = 0.04) and Inh-B (p = 0.04) and positively associated to estradiol (p < 0.005). The median (range)\r\npercentage weight loss after the intervention was 15% (3.5 - 25.4). Weight loss was associated with an increase in\r\ntotal sperm count (p = 0.02), semen volume (p = 0.04), testosterone (p = 0.02), SHBG (p = 0.03) and AMH (p =\r\n0.02). The group with the largest weight loss had a statistically significant increase in total sperm count [193\r\nmillions (95% CI: 45; 341)] and normal sperm morphology [4% (95% CI: 1; 7)].\r\nConclusion: This study found obesity to be associated with poor semen quality and altered reproductive\r\nhormonal profile. Weight loss may potentially lead to improvement in semen quality. Whether the improvement is\r\na result of the reduction in body weight per se or improved lifestyles remains unknown.
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