Massive Weight Loss Obtained by Bariatric Surgery Affects Semen Quality in Morbid Male Obesity: a Preliminary Prospective Double-Armed Study
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The aim of this study is to evaluate the effect of massive weight loss on the seminal parameters at 6 months from bariatric surgery.
Two-armed prospective study performed in 31 morbidly obese men, undergoing laparoscopic roux-en-Y-gastric bypass (n = 23) or non-operated (n = 8), assessing sex hormones, conventional (sperm motility, morphology, number, semen volume), and non-conventional (DNA fragmentation and seminal interleukin-8), semen parameters, at baseline and after 6 months from surgery or patients’ recruitment.
In operated patients only, a statistically significant improvement in the sex hormones was confirmed. Similarly, a positive trend in the progressive/total sperm motility and number was observed, though only the increase in semen volume and viability was statistically significant (Δ = 0.6 ml and 10%, P < 0.05, respectively). A decrease in the seminal interleukin-8 levels and in the sperm DNA fragmentation was also present after bariatric surgery, whereas these parameters even increased in non-operated subjects. Age-adjusted multivariate analysis showed that the BMI variations significantly correlated with the changes in the sperm morphology (β = −0.675, P = 0.025), sperm number (β = 0.891, P = 0.000), and semen volume (r = 0.618, P = 0.015).
The massive weight loss obtained with bariatric surgery was associated with an improvement in some semen parameters. The correlations found between weight loss and semen parameter variations after surgery suggest that these might occur early downstream of the testis and more slowly than the changes in the sex hormones.
KeywordsLongitudinal study Body mass index Weight loss Semen analysis Male infertility Hypogonadism
The authors thank Dr. Ilaria Natali (Seminology Laboratory, Azienda USL3 Pistoia, Pistoia) for support in semen analysis. Moreover, we also thank all patients involved in the study.
This paper is dedicated to our colleague and friend Loredana Gandini (University of Rome “La Sapienza”) who gave so much to the field of male infertility, and too prematurely left us.
JS performed patients recruitment, data collection, and hormone analysis; GC performed hormone measurements and data analysis; FL was in charge of andrological follow-up of the obese men enrolled in the study and recipient of the SIR project funding; AD performed statistical analysis; SD performed IL-8 measurement in semen samples and seminal analysis; LT measured DNA fragmentation in sperm samples; EM andrological evaluation of the patients; ErFi performed semen analysis; EnFa performed bariatric surgery and follow-up of obese patients; MaLu performed bariatric surgery and follow-up of obese patients; MoMu carried out sperm DNA fragmentation analysis; GF was the referent for the study protocol; EB critically discussed and interpret sperm DNA fragmentation data; MaMa and MiLu provided the conception of design of the study, drafted the article, and interpreted the data. All authors made substantial contributions in critically revising the article.
Compliance with Ethical Standards
Conflict of Interest
All authors have nothing to disclose.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
The study was supported by funds from PRIN2010-11 (prot. 2010C8ERKX, Italian Ministry of University and Research), Ente Cassa di Risparmio di Firenze (prot. 2014/0764; 2013/0326), and SIR project (protocol number: RBSI14LFMQ, Italian Ministry of University and Research).
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