Lack of Improvement of Sperm Characteristics in Obese Males After Obesity Surgery Despite the Beneficial Changes Observed in Reproductive Hormones
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Even though obesity surgery normalizes circulating testosterone concentrations in males with obesity-associated secondary hypogonadism, its impact on spermatogenesis remains controversial. We aimed to evaluate sperm characteristics in obese men after bariatric surgery as well as changes in reproductive hormones.
Twenty severely obese men (body mass index (BMI) ≥ 35 kg/m2) were evaluated before and 2 years after bariatric surgery. The serum was assayed for insulin, leptin, kisspeptin, and inhibin B, among other hormones. Homeostasis model assessment of insulin resistance (HOMA-IR) was estimated. We used World Health Organization reference values for sperm analysis.
After surgery, serum total testosterone, calculated free testosterone, inhibin B, and kisspeptin increased, whereas fasting insulin, HOMA-IR, and leptin concentrations decreased. Despite these improvements, sperm volume showed a small decrease after surgery, while the rest of sperm characteristics remained mostly unchanged. Abnormal sperm concentration persisted in 60% of the patients.
Sperm characteristics may not improve after bariatric surgery despite the beneficial changes of reproductive hormones.
KeywordsObesity Bariatric surgery Kisspeptin Leptin Semen analysis Male infertility
We thank the nurses of the Department of Endocrinology and Nutrition for their help with the anthropometric measurements and blood sampling of the patients.
Supported by Grants PI18/00132, PI18/01122, and PI1600154 from Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness. Supported in part by the FondoEuropeo de Desarrollo Regional (FEDER) from the European Union. CIBERDEM and CIBEROBN are also initiatives of Instituto de Salud Carlos III. Dr. Calderón received a grant from MESCYT, Dominican Republic Ministry of Superior Education.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed 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.
Written informed consent was obtained from all the participants included in the study.
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