Risk of Obesity on Male Fertility in Gaza Governorate, Gaza Strip

Abstract

Obesity is a multifactorial disease characterized by an excess of adipose tissue. By 2015, approximately 700 million adults will be obese would wide. Obesity affects endocrine and exocrine functions of male reproductive system. However, the underlying mechanisms of obesity-induced male infertility have not been fully understood. Objective: To assess the risk of obesity on male fertility in Gaza Governorate, Gaza Strip. Materials and Methods: This case-control study comprised 80 obese men (mean BMI=33.4±2.5 Kg/m2) and 80 healthy normal weight men (mean mBMI=22.8±1.5 Kg/m2). Questionnaire interview was applied. Cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total testosterone, follicular stimulation hormone (FSH), luteinizing hormone (LH), sperm concentration, sperm motility and sperm morphology were determined. Data were analyzed using SPSS version 18.0. Results: Unemployment and low family income were more frequent among cases compared to controls (P=0.019 and P<0.001, respectively). Serum cholesterol, triglycerides and LDL-C were found to be higher in cases (212.6±42.4, 230.9±30.7 and 121.7±32.8 mg/dl) compared to controls (127.9±38.4, 113.8±35.6 and 93.9±22.9 mg/dl) with % differences of 49.8, 67.9 and 25.8 and P<0.001, respectively. Serum testosterone was significantly decreased in cases compared to controls (3.6±1.5 vs. 6.3±0.8 ng/ml, P<0.001), with percentage difference of 54.5%. On the other hand, serum LH and FSH were significantly increased in cases (9.7±5.3 and 12.3±6.4 mIU/ml vs. 4.7±2.6 and 4.6±1.3 mIU/ml, P=0.001, respectively), showing percentage differences of 69.4% and 91.1% respectively. There were significant decrease in semen volume, count and total count in cases (2.2±0.9 ml, 7.8±5.2 million/mL and 17.6±21.6 million) compared to controls (3.1±0.6 ml, 43.7±16.0 million/mL and 135.3±55.8 million). This decrease was significant (P<0.001), with percentage differences of 34.0,139.5 and 15.4, respectively). Sperm total motility, fast progressive and slow progressive grades of motility were significantly decreased in cases (28.7±14.8, 0.23±1.27 and 18.7±11.6 vs. 57.7±11.2, 18.9±5.4 and 28.7±7.5 with % differance = 67.0, 195.3 and 42.1, P<0.001, respectively). On the other hand, the immotile sperms were significantly higher in cases than in controls (71.3±14.8 vs. 42.4±11.2, % differances=50.9 and P<0.001). The normal forms of sperms were lower in cases (25.9±4.7 vs. 39.0±4.6, % differance=40.5, P<0.001). Body mass index was positively correlated with cholesterol, triglyceride, LDL, LH, FSH, sperm immotility and abnormal sperm (r=0.737, r=0.836, r=0.493, r=0.445, r=0.492, r=0.738 and r=0.759, respectively and P<0.001). on the other hand, total testosterone, semen volume, sperm count, total sperm count, total motility, fast progressive and slow progressive grades of motility, and normal sperm were inversely correlated with BMI (r=-0.755, P<0.001; r=-0.465, P<0.001; r=-0.774, P<0.001; r=0.742, P<0.001; r=-0.738, P<0.001; r=-0.856, P<0.001; r=-0.494, P<0.001 and r=-0.759, P<0.001, respectively). Conclusions: Obesity has a negative impact on male reproductive hormones as well as on semen quantity and quality.