El Salam Mohamed Ahmed Abd
Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt.
Oman Med J. 2018 Jan;33(1):3-6. doi: 10.5001/omj.2018.02.
Obesity is a highly prevalent non-communicable disease worldwide and is commonly associated with male infertility. Several etiopathological theories have been mentioned in the literature by which obesity affects spermatogenesis, thus affecting the male fertility potential. Mechanisms for explaining the effect of obesity on male infertility include endocrinopathy, increased aromatization activity, associated erectile dysfunction, psychological and thermal effects, obstructive sleep apnea, increased leptin and oxygen free radicals, and associated inflammatory and obstructive elements of epididymitis. Treatment of such a complex problem includes weight reduction (by lifestyle modification and increased physical activity), optimization of altered testosterone-to-estradiol ratio using aromatase inhibitors and/or gonadotropins, treatment of associated comorbidities by phosphodiesterase inhibitors for erectile dysfunction, and insulin-sensitizing agents for the management of diabetes. The aim of this mini-review is to highlight the pathological basis of this problem and to focus on obesity as an etiology of male infertility.
肥胖是一种在全球范围内高度流行的非传染性疾病，通常与男性不育有关。文献中提到了几种病因病理理论，通过这些理论，肥胖会影响精子发生，从而影响男性的生育潜力。解释肥胖对男性不育影响的机制包括内分泌病、芳香化活性增加、相关的勃起功能障碍、心理和热效应、阻塞性睡眠呼吸暂停、瘦素和氧自由基增加，以及附睾炎相关的炎症和阻塞因素。治疗这样一个复杂的问题包括减轻体重（通过改变生活方式和增加体育活动），使用芳香化酶抑制剂和/或促性腺激素优化睾酮与雌二醇比例的改变，用磷酸二酯酶抑制剂治疗勃起功能障碍相关的合并症，以及用胰岛素增敏剂治疗糖尿病。本综述的目的是强调这一问题的病理基础，并关注肥胖作为男性不育的一个病因。
