Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Hum Reprod. 2022 May 3;37(5):902-921. doi: 10.1093/humrep/deac039.
Rapid weight loss promoted by bariatric surgery (BS) can release accumulated lipophilic endocrine-disrupting chemicals (EDCs), making these chemicals systemically available. Men typically have a higher EDC body burden and lose more weight post-BS than women, which may put male BS patients at high risk for testicular toxicity. In this review, we analyze the impacts of BS on semen parameters with a particular focus on the potential effects of EDCs. After BS, serum EDC concentrations progressively increase; and there is evidence that semen parameters deteriorate after BS. Although elevated serum EDC concentrations are associated with inferior sperm parameters, links between semen parameters and EDCs post-BS have not been studied. Understanding these potential associations requires adequately powered studies, particularly within prospective longitudinal cohorts with long-term follow-up for sperm parameters, nutritional status, sex-hormones levels and serum EDC concentrations. Studying BS patients prospectively provides the important opportunity to evaluate dose-response effects of EDC serum concentrations on sperm quality and function. Research is also needed to identify critical chemical exposure periods post-BS to inform reproductive decisions, including consideration of sperm preservation before surgery.
减重手术（BS）可促进体重迅速下降，从而释放出蓄积的亲脂性内分泌干扰化学物质（EDCs），使这些化学物质在体内广泛分布。男性通常体内 EDC 负荷更高，且减重幅度大于女性，这可能使男性 BS 患者面临较高的睾丸毒性风险。在本综述中，我们分析了 BS 对精液参数的影响，特别关注 EDC 对其的潜在影响。BS 后，血清 EDC 浓度逐渐升高；且有证据表明，BS 后精液参数恶化。尽管血清 EDC 浓度升高与精子参数较差相关，但 BS 后精液参数与 EDC 之间的关联尚未得到研究。要了解这些潜在的关联，需要进行足够大样本量的研究，特别是在具有长期随访的前瞻性纵向队列研究中，需要对精子参数、营养状况、性激素水平和血清 EDC 浓度进行研究。前瞻性研究 BS 患者为评估 EDC 血清浓度对精子质量和功能的剂量反应效应提供了重要机会。还需要研究 BS 后确定关键的化学暴露期，以便为生殖决策提供信息，包括考虑手术前的精子保存。
