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Obesity: modern man's fertility nemesis
Open accessAbstract
The obesity pandemic has grown to concerning proportions in recent years, not only in the Western World, but in developing countries as well. The corresponding decrease in male fertility and fecundity may be explained in parallel to obesity, and obesity should be considered as an etiology of male fertility. Studies show that obesity contributes to infertility by reducing semen quality, changing sperm proteomes, contributing to erectile dysfunction, and inducing other physical problems related to obesity. Mechanisms for explaining the effect of obesity on male infertility include abnormal reproductive hormone levels, an increased release of adipose-derived hormones and adipokines associated with obesity, and other physical problems including sleep apnea and increased scrotal temperatures. Recently, genetic factors and markers for an obesity-related infertility have been discovered and may explain the difference between fertile obese and infertile obese men. Treatments are available for not only infertility related to obesity, but also as a treatment for the other comorbidities arising from obesity. Natural weight loss, as well as bariatric surgery are options for obese patients and have shown promising results in restoring fertility and normal hormonal profiles. Therapeutic interventions including aromatase inhibitors, exogenous testosterone replacement therapy and maintenance and regulation of adipose-derived hormones, particularly leptin, may also be able to restore fertility in obese males. Because of the relative unawareness and lack of research in this area, controlled studies should be undertaken and more focus should be given to obesity as an etiolgy of male infertility.
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“As testosterone treatment impairs spermatogenesis, it is contraindicated in obese men seeking to have children who are already at increased risk of impaired fertility.114”
From Lowered testosterone in male obesity: Mechanisms, morbidity and management (2014) · cites this paper as [114]
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“The excessive conversion of testosterone to estrogen in peripheral adipose tissue has been known to cause secondary hypogonadism through hypothalamic-pituitarygonadal axis inhibition (Cabler et al., 2010).”
BackgroundInfluentialOrlistat reverses intratesticular lactate transport decline and infertility in male obese rats
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Adiponectin/AdipoRs signaling as a key player in testicular aging and associated metabolic disorders
Choubey, M., Ranjan, A. K., & Krishna, A. (2021) · Vitamins and hormones · doi:10.1016/bs.vh.2020.12.024 · Cited by 19
INFLUENCE OF MALE OBESITY ON FERTILITY
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Has fertility declined in recent decades?
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‘To[o] much eating stifles the child’: fat bodies and reproduction in early modern England
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Effect of postnatal overfeeding on the male and female Wistar rat reproductive parameters
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PACAP ameliorates the fertility of obese mice through PAC1/PKA/ERK/Nrf2 signal axis
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Unmasking the Epigenome: Insights into Testicular Cell Dynamics and Reproductive Function
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“Research indicates that men’s lifestyles and environmental factors can cause epigenetic changes in sperm, potentially transmitting changes to offspring and affecting post-fertilization development [77,107,196,199,200].”
High-Fat Diets Disturb Rat Epididymal Sperm Maturation
Valderrama, L. R., Mendoza-Sánchez, J. E., Rodríguez‐Tobón, E., Arrieta‐Cruz, I., González‐Márquez, H., Salame-Méndez, P. A., Tarragó-Castellanos, R., Barberena, E. C., Tobón, A. R., & Arenas‐Ríos, E. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26051850 · Cited by 13
“It is characterized by an abnormal accumulation of adipose tissue, which is often accompanied by a significant inflammatory component that contributes to the development of various comorbidities, including cardiovascular diseases, type 2 diabetes, and certain cancers [1,2].”
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“Until recently, scientists begin to realise that populations with obesity or overweight exhibit a high incidence of infertility [3—7].”
Body Mass Index Effects Kruger's Criteria in Infertile Men.
Üstün, Y. E., Yılmaz, N., Akgün, N., Aktulay, A., Tuzluoğlu, A. D., & Bakırarar, B. (2018) · PubMed Central · doi:10.22074/ijfs.2018.4888 · Cited by 12
“Furthermore; there are other outcomes such as impaired erectile function, and other physical problems, such as increased scrotal temperatures and sleep apnea (3, 4).”
BackgroundThe Influence of Obesity on Puberty and Insulin Resistance in Mexican Children
Cardenas‐Vargas, E., Nava, J. A., Veloz, I. G., Torres-Castañeda, M. C., Galvan-Tejada, C. E., Cid-Báez, M. A., Castañeda-Arteaga, R. E., Ortiz‐Castro, Y., Ortiz, P. M. T., Araujo-Espino, R., et al. (2018) · International Journal of Endocrinology · doi:10.1155/2018/7067292 · Cited by 12
“Mechanisms explaining the effect of obesity on male fertility include abnormal reproductive hormone levels, increased release of adipose-derived hormones and adipokines associated with obesity, and other physical problems including sleep apnea and increased scrotal temperatures [39].”
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Seminal plasma adipokines: involvement in human reproductive functions
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The Role of Obesity in ROS Generation and Male Infertility
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“Although it has been well documented that obese-infertile men show signifi cantly lower testosterone levels than obese-fertile men, genetic mutations may exist to clarify this discrepancy [ 10 ] .”
BackgroundInfluentialSelf-citationMale Infertility and Assisted Reproductive Technology: Lessons from the IVF
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Management of weight loss in obesity-associated male infertility: a spotlight on bariatric surgery
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“In the post-modern Era, men are more obese [27] and sedentary, exercise less [28], sleep less [29], and live indoors, and consequently are less exposed to sunlight [12], eat ultraprocessed food, drink excessive amounts of alcohol [30], increased steroids abuse [31], including other drugs [32], and are exposed to a var…”
BackgroundDiet-induced obesity alters kinematics of rat spermatozoa
Oyeyipo, I. P., Maartens, P. J., & du Plessis, S. S. (2015) · Asian Pacific Journal of Reproduction · doi:10.1016/j.apjr.2015.06.008 · Cited by 10
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“…quantification in both the testes and epididymides that could impact sperm morphology and generate changes in spermatogenesis and epididymal sperm maturation that would result in poor sperm quality [5, 34, 69–71] induced by the reduction in protein synthesis caused by low T concentrations [2, 72].”
The impact of obesity on male reproduction: its biological significance
Martini, A. C., Molina, R. I., Tissera, A. D., Ruiz, R. D., & de Cúneo, M. F. (2013) · Expert Review of Endocrinology & Metabolism · doi:10.1586/eem.13.8 · Cited by 9
Role of Irisin Administration in Modulating Testicular Function in Adult Obese Albino Rats
REHAM H. IBRAHIM, M. D. ;. N. F. E.-M. (2018) · The Medical Journal of Cairo University/The Medical Journal of Cairo University · doi:10.21608/mjcu.2018.65747 · Cited by 9
Gender Obesity Report – Einfluss von Adipositas auf Reproduktion und Schwangerschaft
Harreiter, J., & Kautzky‐Willer, A. (2015) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-015-0410-5 · Cited by 9
Metadata
- Authors
- Cabler, S., Agarwal, A., Flint, M., & Du Plessis, S. S.
- Affiliations
- Cleveland Clinic (US)
- Stellenbosch University (ZA)
- Venue
- Asian Journal of Andrology
- Published
- 2010-06-07
- Volume
- 12
- Issue
- 4
- Pages
- 480-489
- ISSN
- 1008-682X (ISSN-L)
- 1745-7262
- PMC
- PMC3739371
- OpenAlex
- W2124388193
- Cited by
- 184
- References
- 65
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 10 · 2022: 8 · 2021: 8 · 2020: 13 · 2019: 11 · 2018: 19 · 2017: 15 · 2016: 9 · 2015: 18 · 2014: 16 · 2013: 17 · 2012: 16
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Asian Journal of Andrology (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- obesity, male infertility, male fertility, semen quality, sperm proteome, erectile dysfunction, adipokines, reproductive hormones, sleep apnea, scrotal temperature, bariatric surgery, weight loss, aromatase inhibitors, testosterone replacement therapy, leptin
- MeSH terms
- Fertility, Humans, Erectile Dysfunction, Infertility, Male, Life Style, Male, Obesity, Gonadal Steroid Hormones, Body Mass Index, Aromatase Inhibitors, Adipokines, Semen Analysis, Waist Circumference
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