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01-12-2020 | Infertility | Original Contributions

Bariatric Surgery Impact on Reproductive Hormones, Semen Analysis, and Sperm DNA Fragmentation in Men with Severe Obesity: Prospective Study

Authors: Guilherme Jacom Abdulmassih Wood, Bruno C. Tiseo, Davi V. Paluello, Hamilton de Martin, Marco Aurelio Santo, William Nahas, Miguel Srougi, Marcello Cocuzza

Published in: Obesity Surgery | Issue 12/2020

Abstract

Purpose

Growing evidence in the literature suggests that obesity is capable of altering reproductive hormone levels and male fertility. Effects on classic semen parameters and sperm DNA fragmentation (SDF), however, have not been properly established. Additionally, the impact of bariatric surgery (BS) on those parameters is still controversial.

Materials and Methods

In Phase 1, 42 patients with obesity and 32 fertile controls were submitted to reproductive hormone evaluation, semen analysis, and SDF testing. In Phase 2, patients with obesity were submitted to BS or clinical follow-up and were invited to 6-month revaluation.

Results

Phase 1: Men with obesity have higher levels of estradiol, LH, and FSH and lower levels of total testosterone (TT) when compared with eutrophic fertile men. Additionally, they present worse semen parameters, with reduction in ejaculated volume and sperm concentration, worse sperm motility and morphology, and higher SDF. Phase 2: 32 patients returned to revaluation. Eighteen were submitted to BS (group S) and 14 were not submitted to any specific therapeutic regimen (group NS). In group S, TT more than doubled after surgery (294.5 to 604 ng/dL, p < 0.0001). Worsening of sperm concentration and total ejaculated sperm count were also noticed, and 2 patients became azoospermic after BS. SDF, however, improved after the procedure. No changes in the variables studied were observed in non-operated patients.

Conclusion

In this prospective study, we have found that BS results in improvements in reproductive hormone levels and SDF after 6-month follow-up. Sperm concentration, however, reduced after the procedure.

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Title: Bariatric Surgery Impact on Reproductive Hormones, Semen Analysis, and Sperm DNA Fragmentation in Men with Severe Obesity: Prospective Study
Authors: Guilherme Jacom Abdulmassih Wood
Bruno C. Tiseo
Davi V. Paluello
Hamilton de Martin
Marco Aurelio Santo
William Nahas
Miguel Srougi
Marcello Cocuzza
Publication date: 01-12-2020
Publisher: Springer US
Keywords: Infertility
Obesity
Obesity
Bariatric Surgery
Bariatric Surgery
Infertility
Testosterone
Published in: Obesity Surgery / Issue 12/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-020-04851-3

At a glance: The STEP trials

Springer Medicine

Bariatric Surgery Impact on Reproductive Hormones, Semen Analysis, and Sperm DNA Fragmentation in Men with Severe Obesity: Prospective Study

Abstract

Purpose

Materials and Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

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