Laureate Medical Group, Atlanta, GA, USA.
Reprod Sci. 2011 Apr;18(4):391-7. doi: 10.1177/1933719110385708. Epub 2010 Oct 19.
Male infertility affects approximately 6% of reproductive-aged men. It has been suggested that overweight men or men with obese body mass index (BMI) experience prolonged time to pregnancy, though the influence of male BMI on fertility remains understudied.
We hypothesized that BMI is inversely correlated with fertility, manifested by reduced sperm concentration, motility, and morphology.
Males of age 18 to 50 with semen analyses and self-reported BMI were included (n = 530). Patient parameters analyzed included age, BMI, smoking, urological, and fertility history. Leutinizing hormone (LH), Follicle-stimulating hormone, testosterone, steroid hormone-binding globulin (SHBG) and free androgen index (FAI) levels (n = 55), and selective serotonin reuptake inhibitor (SSRI) use (n = 12) were also measured.
The men in this study had a mean BMI of 28.2 ± 4.9 kg/m(2) (range = 15-60), which is considered overweight, and a mean semen concentration of 55.4 ± 46.8 million/mL, which is in normal range, according to WHO standard. No consistent relationship was observed between increasing BMI and sperm concentration, motility, or morphology, although the testosterone levels trended downward with increasing BMI; there was a suggestion for decreased sperm concentration in current smokers. Men treated with combination SSRI and other psychotropic agent therapy (n = 12) had significantly reduced sperm motility (P = .009). Not unexpectedly, prior urological surgery (n = 77) was associated with lower sperm concentration (P = .0001) and morphology (P = .0008). When in vitro fertilization-embryo transfer (IVF-ET) was used as a treatment modality (n = 121), male BMI was not a significant predictor of clinical pregnancy (P = .06).
In our study, we did not observe a significant association between male BMI and sperm concentration, motility or morphology, or clinical pregnancy following IVF-ET. Significantly, SSRI use may affect sperm parameters negatively.
男性不育影响约 6%的育龄男性。有研究表明，超重或肥胖男性（BMI）的妊娠时间延长，尽管男性 BMI 对生育力的影响仍有待研究。
我们假设 BMI 与生育力呈负相关，表现为精子浓度、活力和形态下降。
纳入年龄在 18 至 50 岁之间、精液分析和自我报告 BMI 的男性（n = 530）。分析患者参数包括年龄、BMI、吸烟史、泌尿科病史和生育史。测量黄体生成素（LH）、卵泡刺激素、睾酮、性激素结合球蛋白（SHBG）和游离雄激素指数（FAI）水平（n = 55）和选择性 5-羟色胺再摄取抑制剂（SSRI）的使用情况（n = 12）。
该研究中的男性平均 BMI 为 28.2 ± 4.9 kg/m2（范围 15-60），根据世卫组织标准，这被认为是超重，平均精子浓度为 55.4 ± 46.8 百万/ml，处于正常范围。虽然随着 BMI 的增加，睾酮水平呈下降趋势，但并未观察到 BMI 与精子浓度、活力或形态之间的一致关系；目前吸烟者的精子浓度呈下降趋势。接受 SSRI 联合其他精神药物治疗的男性（n = 12）的精子活力显著降低（P =.009）。不出所料，先前的泌尿科手术（n = 77）与精子浓度降低（P =.0001）和形态降低（P =.0008）有关。当使用体外受精-胚胎移植（IVF-ET）作为治疗方式时（n = 121），男性 BMI 不是临床妊娠的显著预测因素（P =.06）。
在我们的研究中，我们没有观察到男性 BMI 与精子浓度、活力或形态，或 IVF-ET 后的临床妊娠之间存在显著关联。值得注意的是，SSRI 的使用可能会对精子参数产生负面影响。
