BACKGROUND The global obesity epidemic has paralleled a decrease in semen quality. Yet, the association between obesity and sperm parameters remains controversial. The purpose of this report was to ...update the evidence on the association between BMI and sperm count through a systematic review with meta-analysis. METHODS A systematic review of available literature (with no language restriction) was performed to investigate the impact of BMI on sperm count. Relevant studies published until June 2012 were identified from a Pubmed and EMBASE search. We also included unpublished data (n = 717 men) obtained from the Infertility Center of Bondy, France. Abstracts of relevant articles were examined and studies that could be included in this review were retrieved. Authors of relevant studies for the meta-analysis were contacted by email and asked to provide standardized data. RESULTS A total of 21 studies were included in the meta-analysis, resulting in a sample of 13 077 men from the general population and attending fertility clinics. Data were stratified according to the total sperm count as normozoospermia, oligozoospermia and azoospermia. Standardized weighted mean differences in sperm concentration did not differ significantly across BMI categories. There was a J-shaped relationship between BMI categories and risk of oligozoospermia or azoospermia. Compared with men of normal weight, the odds ratio (95% confidence interval) for oligozoospermia or azoospermia was 1.15 (0.93-1.43) for underweight, 1.11 (1.01-1.21) for overweight, 1.28 (1.06-1.55) for obese and 2.04 (1.59-2.62) for morbidly obese men. CONCLUSIONS Overweight and obesity were associated with an increased prevalence of azoospermia or oligozoospermia. The main limitation of this report is that studied populations varied, with men recruited from both the general population and infertile couples. Whether weight normalization could improve sperm parameters should be evaluated further.
This study was conducted to determine a possible relationship between regular cell phone use and different human semen attributes. The history-taking of men in our university clinic was supplemented ...with questions concerning cell phone use habits, including possession, daily standby position and daily transmission times. Semen analyses were performed by conventional methods. Statistics were calculated with SPSS statistical software. A total of 371 were included in the study. The duration of possession and the daily transmission time correlated negatively with the proportion of rapid progressive motile sperm (r = − 0.12 and r = − 0.19, respectively), and positively with the proportion of slow progressive motile sperm (r = 0.12 and r = 0.28, respectively). The low and high transmitter groups also differed in the proportion of rapid progressive motile sperm (48.7% vs. 40.6%). The prolonged use of cell phones may have negative effects on the sperm motility characteristics.
The aromatase inhibitor anastrazole proved effective in the treatment of endometrial hyperplasia and postmenopausal bleeding in an obese 65-year-old woman with high operative risk. During anastrazole ...administration for 12 months, the endometrial thickness decreased from 9.8 mm to 2.4 mm and the control endometrial histology showed an atrophic endometrium. Uterine bleeding did not occur in the post-treatment, 3-year follow-up period. The endometrial thicknesses measured yearly by ultrasonography were 2.9, 3.5 and 3.3 mm. The plasma estradiol levels increased from < 73 pmol/l post-treatment to 112, 98 and 103 pmol/l. This case demonstrates that long-term aromatase inhibitor treatment can result in a refractory status of the endometrium and the estradiol produced in the adipose tissue does not exert a proliferative effect.
A total of 1144 infertile women were treated by artificial donor insemination. Unsuccessful ovulation induction was found in 96 of these cases. The obese women (BMI: 28-36) had a relative risk of ...unsuccessful ovulation induction of 2.7 (95% confidence interval (CI)=2.1-3.4) compared with women lower or normal body weight (BMI: 20-24). The effect was smaller in women with a BMI 25-27 or <19 (relative risk (RR)=1.4, 95% CI=0.9-2.1 and 1.5, 95% CI=0.8-2.5), respectively. During the AID treatment 412 pregnancies occurred. Pregnancy rate achieved by insemination was 28% (50 pregnancies per 178 cases, BMI 16-19), 42% (251/599, BMI 20-24), 33% (92/286, BMI 25-27), and 21% (19/81, BMI 28-36), respectively, in the different BMI groups.
Patients with polycystic ovary syndrome (PCOS) are highly sensitive to gonadotropins. In recent years a number of publications have shown that chronic low-dose protocols are effective in reducing ...complications, in particular ovarian hyperstimulation syndrome (OHSS), especially if recombinant human follicle stimulating hormone (rhFSH) is used. The aim of the present study was to compare the efficacy and safety of rhFSH (Gonal-F, Serono) versus urinary human FSH (uhFSH) (Metrodin, Serono) in a low-dose step-up protocol for ovulation induction in clomiphene-resistent infertile PCOS patients. Twenty PCOS patients were recruited in two centers for an open randomized comparative study. A starting dose of a 75-IU ampule of rhFSH or uhFSH was used for 14 days with an increment of 37.5 IU every 7 days. Human chorionic gonadotropin (hCG) (10,000 IU, Profasi, Serono) was administered if one to three follicles achieved a diameter of > or = 16 mm. Sonographic and hormonal (serum estradiol and progesterone) monitoring of the cycles was performed. All the six pregnancies induced were in the rhFSH group, but two of them ended with miscarriage. There were no differences between the two groups concerning the number of ampules used, the stimulation days, the estradiol levels on the day of hCG administration, and the progesterone levels 7 days after hCG administration. Three patients had grade II, and one patient grade III OHSS. In conclusion, our results support the literature data that rhFSH is superior to uhFSH regarding pregnancy rates, not only in in vitro fertilization cycles, but also with a low-dose protocol in patients with PCOS.
Endometriosis is one of the most frequent benign diseases in gynecology. It is the cause of the pelvic pain and infertility in more than 35% of women of reproductive age. The most appropriate ...treatment for endometriosis is the combination of surgery and adjuvant medical therapy with GnRH agonists. The authors demonstrate the results of 33 artificial intrauterine homolog inseminations after a 6-month GnRH analog therapy.
To evaluate the effect of body mass on the hormonal and semen profiles of subfertile men with oligozoospemia, sperm concentration and reproductive hormone levels were compared in two body mass index ...(BMI) groups: underweight or normal weight patients (BMI ≤ 25 kg/m2) vs. overweight or obese patients (BMI > 25 kg/m2). The mean BMI was 27 ± 4.6 kg/m2. The testosterone/estradiol ratio was significantly reduced in the high BMI group as compared to the low BMI group (17 ± 4 vs. 12 ± 3; p < 0.05). A similar difference was found in the sperm concentration (11.2 ± 3.16 × 106/ml vs. 8.1 ± 2.6 × 106/ml). A nonsignificant difference was found in the LH/FSH ratio (1.41 ± 0.64 vs. 1.63 ± 0.72). We concluded that obesity and the consequent estrogen excess decrease the sperm concentration by influencing the hypothalamo-pituitary system.
A total of 274 men (aged: 26 ± 4.9 years) with normozoospermia were enrolled into this study. Their body mass index (BMI: kg m2) varied between 17 and 39. According to BMI, the patients were divided ...into four groups: Group 1: 17-20, Group 2: 20.1-25, Group 3: 25.1-30 and Group 4: 30.1-39. Twenty-nine subjects were found in the first, 96 in the second, 91 in the third and 58 men in the fourth group. Sperm concentration was significantly lower in the obese group (29 × 106 ml, p < 0.05) than in the group of BMI 17-20, 20-25 and 25-30. In advance, in the obese group, sperm count continuously decreased with aging. We conclude that obesity is associated with a lower sperm count in case of normozoospermia.
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