CAJ | 학술논문

The increasing incidence of obesity worldwide combined with the parallel trend of declining sperm quality has given rise to the notion that obesity and infertility are linked.While investigations of sperm quality in obese individuals have yielded inconclusive results, studies of the adverse hormonal, physical, and proteomic changes induced by obesity are more definitive.Unfavorable hormonal abnormalities reported in obese males that affect reproduction are decreased levels of testosterone, inhibinB, and ghrelin and increased levels of estrogen, leptin, and resistin.Moreover, erectile dysfunction and elevated scrotal temperatures have been associated with obesity and are important physical barriers to successful male reproduction. Recently, important advances have been made in proteomics and factors have been identified in obese individuals that may impair spermatogenesis and sperm quality.Although obesity contributes to a host of adverse effects on the reproductive system, certain lifestyle modifications can be made to alleviate such effects.Natural weight loss and surgical weight loss have demonstrated favorable results in obese patients by restoring normal hormone levels and reversing the effects of both erectile dysfunction and testicular heat stress.Pharmacological interventions have also proven to be promising in combating the effects of obesity.Particularly, aromatase inhibitors such as anastrozole, letrozole, and testolactone, have been reported to decrease the aromatase over-activity and increased estrogen levels present in obese males.An understanding of abnormalities associated with obesity and possible lifestyle modifications may help clinicians effectively guide their infertile obese male patients and increase fertility rates.