Male Infertility and Obesity

Recent studies have found a link between male fertility problems and obesity. In fact, being overweight or obese is one of the central causes of male infertility and more specifically, of sperm health problems. But how exactly does a man’s weight affect his fertility and what types of male fertility problems does being obese cause?

A study found that men with a higher body mass index (BMI) had a significantly higher risk of being infertile compared with men considered to be normal weight. In fact, the study found that an increase of just 20 lbs. could increase the chance of male infertility by approximately 10%.

BMI is a tool that measures weight proportionate to height and helps to calculate an individual’s body fat. Individuals with a lot of muscle sometimes have higher BMIs due to the fact that muscle tissue weighs more than fat tissue.

A BMI of 18.5 to 24.9 is considered to be normal for adults while a BMI of more than 25 is considered to be overweight. Obesity is defined as having a body mass index of more than 30 while morbid obesity is characterized by a BMI of 40 or higher.

A separate study found that a link between obesity and sperm health. The study compared male BMI to DNA fragmentation in sperm. As BMI, so too did the fragmentation of sperm DNA in the participants. Deteriorated sperm quality increased significantly as BMI passed 25 and was acute in participants whose BMI was over 30. Fragmented sperm DNA is linked to reduced fertility as well as an increased risk of miscarriage.

• In addition, obesity can have a number of other effects on male fertility:

• low sperm count and concentration

• hormonal imbalance

• increased scrotal temperature

• decreased libido

 As such, it is important to maintain good overall health in order to reduce the risk of male fertility problems and in order to maintain good reproductive health. Following a healthy diet and exercising regularly are important steps in reducing weight can help to achieve a healthy weight as well as improve sperm health. Talk to your doctor about starting a healthy exercise regimen and for advice on healthy eating in order to make important lifestyle changes that can help to increase your fertility.

Sperm Health

Sperm health is vital to increasing a couple’s chances of getting pregnant. While certain genetic conditions might affect a man’s sperm health, there are a variety of factors, ranging from environmental to lifestyle, that also influence male fertility. As such, men can follow simple sperm health tips in order to increase fertility so as to improve their partner’s chances of getting pregnant.

Sperm Health Tips that Can Help Improve Male Fertility

The following tips can help to alleviate male fertility problems so as to improve a couple’s chances of getting pregnant:

• don’t smoke. Smoking is linked to sperm health problems. While smoking has not been linked to a lowered sperm count, it does cause damage to sperm DNA, which results in an increased risk of birth defects in a man’s children. Because it takes three months for sperm to fully form, it is imperative to quit smoking at least three months prior to trying to get pregnant in order to reduce the risk of birth abnormalities

• don’t do drugs. Drug use also negatively influences sperm health. For example, marijuana increases the number of abnormal sperm produced, as well as lowers overall sperm count.

• limit your alcohol intake. Reducing your alcohol consumption to no more than two drinks a day is also important to male fertility. In fact, excessive drinking can lead to impotence.

• try herbal solutions. Herbal remedies, such as green tea and gingko, are excellent male infertility solutions. Gingko helps to improve sperm healthy by promoting blood circulation to the capillaries while green tea helps to improve overall health, including reproductive health.

• maintain a healthy weight. Because being either overweight or underweight can influence sperm health, maintaining a healthy weight is crucial in order to increase male fertility. A BMI of less than 20 or of more than 25 can reduce a man’s sperm count by 22%. Your BMI can be calculated by dividing your weight in kilograms by your height in meters squared. Following a healthy diet that is low in saturated and trans fats and that is high in folic acid, zinc, vitamins A, C and E is essential to staying healthy. Exercise can also help to maintain good weight.

• get sun exposure. A healthy amount of sun exposure is linked to increased levels of testosterone, which in turn is connected to healthy sperm production. In addition, sun exposure is linked to lower levels of melatonin, which are known to negatively impact male fertility.

• don’t overdo it. Studies have shown that ejaculating more than twice a day can have a negative effect on male fertility. This is because it takes some time for sperm levels to rise again following ejaculation. Nonetheless, it is important to have intercourse with your partner on a regular basis because sperm that is not ejaculated becomes old and less fertile, thereby reducing the chances of getting pregnant.

• avoid heat. Overheating of the testicles can reduce sperm health. It is important for men to avoid wearing tightly fitting pants and undergarments, as well as to avoid hot baths and hot tubs. Also, placing a laptop on a table or desk as opposed to directly on the body also reduces the risk of sperm health damage.

• reduce stress. Stress is a major contributing factor to sperm health problems. In fact, 15% of men experience decreased libido because of stress, while 5% of men experience impotence because of it. Practicing relaxation methods such as Pilates can help to minimize stress, as does participating in regular exercise.

Obese Couples Risk Lower Fertility

Study Shows Weight of Both Partners May Affect Conception

March 7, 2007 -- A couple trying to conceive may face an extra challenge when both the man and the woman are overweight or obese, new research suggests.

Compared with normal-weight couples, obese couples participating in a Danish study were almost three times as likely to take more than a year to achieve a pregnancy.

Previous studies have shown that weight can affect fertility in women, but the Danish study is the first to examine the impact of overweight or obesity in couples.

The findings strongly suggest, but do not prove, a causal association between excess weight in both partners and decreased fertility

“Because of the study design we cannot say for a fact that it is extra body fat that makes people less fertile, but it certainly appears that this is the case,” she says. “If a couple is overweight and wants to have a child it may be beneficial for both partners to attempt weight loss.”

Weight Loss Reduced Time to Conception

The researchers analyzed data from 47,835 couples who participated in a nationwide study of pregnancy outcomes in Denmark. Women in the study completed four interviews over a period of two years, giving information for both themselves and their partners on weight, height, previous pregnancies, smoking, and socioeconomic status.

The findings are published in the March issue of the journal Human Reproduction.

A total of 8.2% of the women, 6.8% of the men, and 1.4% of the couples in the study were obese, defined as having a body mass index (BMI) of 30 or more. BMI looks at weight in relation to height and is used as an indicator of body fat.

As measured by BMI, a 5-foot-2-inch person who weighs 165 pounds or more is considered obese, as is a 6-foot-tall person who weighs 220 or more.

Just over half of the men and two-thirds of the women in the study were normal weight.

Ramlau-Hansen and colleagues from Denmark’s University of Aarhus evaluated the time it took the couples to become pregnant. Sub-fertility was defined as failure to conceive for at least a year after initiating unprotected sex with the goal of conceiving.

Obese women had a 78% greater risk of being sub-fertile than normal-weight women, and obese men had a 49% increased risk for sub-fertility than normal-weight men.

The risk of taking more than a year to achieve a pregnancy was 2.74 times higher when both partners were obese than for a normal-weight couple.

The researchers further examined 2,374 couples who had more than one pregnancy. When they converted the length of time that it took the women to get pregnant into days, they concluded that for overweight or obese women, every 2.2 pounds of weight loss reduced the time to conception by an average of 5.5 days.

Heavier Men Have Less Sex

The suggestion that weight loss seems to improve fertility for both women and, to a lesser extent, men has important potential public health implications, says epidemiologist Donna Baird, PhD, of the National Institute of Environmental Health Sciences (NIEHS).

Baird co-authored a 2006 NIEHS study that linked obesity to infertility in men. The researchers concluded that a 3-unit increase in BMI increased the risk of infertility by about 10%.

At least one other study has linked obesity in men to a decline in sperm quality, but Baird says more research is needed to confirm the association between body weight and infertility in men.

She adds that the decline in fertility among overweight and obese men may have more to do with sexual function than sperm quality.

“There are a lot of gaps in what we know,” she tells. “We didn’t have data on the frequency of sexual intercourse among men, and we know that obesity can certainly impact sexual function. Low libido and erectile dysfunction, for example, are much more common in obese men.”

Infertilityis a medical condition characterized by a diminished or absent ability to produce offspring. It does not imply (either in the male or the female) the existence of as serious or irreversible a condition as sterility. Although infertility is a common condition, it is often hard to pin down its source. Men and women may each have risk factors that can contribute to infertility, and those risk factors can be genetic, environmental or related to lifestyle. One of the most common and well documented risk factors for infertility in both men and women is obesity.

Obese Women and Infertility

Numerous studies report that women who are overweight or obese tend to have a more difficult time becoming pregnant than normal-weight women. Moreover, once pregnancy occurs, obese women have a higher rate of pregnancy loss.

Being overweight can also lead to abnormal hormone issues affecting reproductive processes for both women and men. Abnormal hormone signals, as a result of excess weight, negatively impact ovulation and sperm production. In women, it can cause the overproduction of insulin, which may cause irregular ovulation. There is also a link between obesity, excess insulin production and the infertility condition known as polycystic ovarian syndrome (PCOS). PCOS is a specific medical condition associated with irregular menstrual cycles, anovulation (decreased or stopped ovulation), obesity and elevated levels of male hormones.

Obese Men and Infertility

Obesity does not solely affect women’s fertility though. Most recently, studies conducted at the U.S. National Institute of Environmental Health Sciences (NIEHS) are confirming that men with increased body mass indexes (BMI) are significantly more likely to be infertile than normal-weight men. The NIEHS data suggests that a 20-pound increase in a man’s weight may increase the chance of infertility by about 10 percent.

Hormone irregularities in men affect stimulation of the testicles that inhibit sperm production. Excess fat actually causes the male hormone, testosterone, to be converted into estrogen, and those estrogens decrease testicle stimulation. Researchers from Reproductive Biology Associates report that a high BMI in men correlates with reduced testosterone levels. The study showed overweight men to have testosterone levels 24 percent lower than men of normal weight, and obese men to have levels 26 percent lower. Men with high BMIs typically are found to have an abnormal semen analysis as well.

Hormones

Excess body fat also impacts production of the gonadotropin releasing hormone (GnRH), which is essential to regular ovulation in women, and to the production of sperm in men. Specifically, GnRH triggers release of the luteinizing hormone (LH) and follicle-stimulating hormone (FSH), both critical to the development of eggs and sperm.

In Vitro Fertilization

When one or both of the partners suffer from infertility, whether or not related to obesity or hormonal imbalances, often they turn to in vitro fertilization (artificially assisted) for help in conceiving. A recent research study comparing the success rates of 5,800 in vitro fertilization attempts with the BMI of the female participants found that obese women with a BMI more than 35 had lower success rates compared with overweight (BMI of 25-30) or normal weight women (BMI of 20-25).

Additionally, obese women were found to have a lower rate of success with embryo implantation (13 percent vs. 19 percent among healthy weight women). They were also less likely to become pregnant after in vitrofertilization (22 percent became pregnant vs. more than 30 percent of normal weight women). Researchers suggest that doctors should encourage their patients to reach a healthy weight before attempting in vitro fertilization.

Keeping the Weight Off

Even when mild, obesity substantially increases poor pregnancy outcomes. Many patients seek to follow the advice of their physicians and lose weight before becoming pregnant. When one is 100 or more pounds overweight, however, the time frames involved in taking off such a significant amount of weight, and the fear of it returning with pregnancy are daunting at best. Many infertile individuals, especially women, turn to weight-loss surgery options to help them reduce their weight, and give them a tool to use along with newly learned skills to keep the weight off.

Weight-loss Surgery and Pregnancy

Women seeking surgical intervention for their obesity issues are advised not to become pregnant for at least 18 months following surgery. However, some women do become pregnant while still in the active weight-loss phase post-surgery.

After any weight-loss surgery that restricts food intake and/or has a malabsorptive component, some basic precautions should be taken before becoming pregnant. Severe iron deficiency anemia and vitamin B12 deficiency resulting from malabsorption can complicate pregnancy following gastric bypass surgery for morbid obesity. In general, vitamin B12 deficiency responds to parenteral treatment (IV or injection), and mild to moderate iron deficiency best responds to oral iron supplementation caused by the malabsorption component of the bypass.

Additionally, pregnant women should be aware of the levels of vitamin A in their post-surgical vitamin regimen. Women having had gastric bypass with a malabsorptive component should ask their doctors for a prescription for a non-acid dependent prenatal vitamin to ensure maximum absorbability.

While pregnancy is not recommended during the period of rapid weight-loss in the initial post-operative period, it can be managed effectively with the assistance of both the bariatric surgeon and OB/GYN who specializes in high risk pregnancies. Data indicates that a pregnancy which develops after the period of rapid postoperative weight-loss also shows that neither the mother nor the developing fetus is unduly endangered if appropriate precautions, monitoring and nutritional care are provided.

Conclusion

Obesity is a major health issue associated with infertility and many other co-morbid conditions. Studies show weight-loss is extremely valuable in the management of such patients, can enhance fertility, and lead to successful full term pregnancies.

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