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Hum. Reprod. Advance Access originally published online on April 7, 2009
Human Reproduction 2009 24(7):1561-1568; doi:10.1093/humrep/dep075
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Associations between andrological measures, hormones and semen quality in fertile Australian men: inverse relationship between obesity and sperm output

T.M. Stewart1,4, D.Y. Liu1, C. Garrett1, N. Jørgensen2, E.H. Brown3 and H.W.G. Baker1

1 Department of Obstetrics and Gynaecology, The University of Melbourne and Melbourne IVF Reproductive Services, The Royal Women’s Hospital, Melbourne, Australia 2 Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark 3 School of Human Biosciences, La Trobe University, Melbourne, Australia

4 Correspondence address. Tel: +61-3-8345-3723; Fax: +61-3-8345-3702 E-mail: tstewart{at}unimelb.edu.au

BACKGROUND: The World Health Organization developed a time to pregnancy (TTP) study (number of menstrual cycles taken to conceive) to determine whether the average TTP is increasing and semen quality decreasing with time. The present study describes clinical, semen and hormone characteristics obtained from male partners of pregnant women in Melbourne, Australia, and examines the associations between these characteristics.

METHODS: Male partners (n = 225) of pregnant women (16–32 weeks) who conceived naturally had physical examination, health and lifestyle questionnaires, semen and hormone (FSH, LH, sex hormone-binding globulin, testosterone and Inhibin B) analyses.

RESULTS: Previously known associations between semen, hormone and clinical variables were confirmed as significant: sperm numbers (concentration and total sperm count) correlated positively with Inhibin B and inversely with FSH and left varicocele, while total testicular volume correlated positively with sperm numbers and Inhibin B and inversely with FSH. However, only abstinence, total testicular volume, varicocele grade and obesity (BMI > 30 kg/m2) were independently significantly related to total sperm count. Compared with those with BMI < 30 (n = 188), obese subjects (n = 35) had significantly lower total sperm count (mean 324 versus 231 million, P = 0.013) and Inhibin B (187 versus 140 pg/ml, P < 0.001) but not FSH (3.4 versus 4.0 IU/l, P = 0.6).

CONCLUSIONS: Obese fertile men appear to have reduced testicular function. Whether this is cause or effect, i.e. adiposity impairing spermatogenesis or reduced testicular function promoting fat deposition, remains to be determined.

Key words: fertile men/semen quality/gonadal hormones/time to pregnancy/obesity

Submitted on September 25, 2008; resubmitted on February 27, 2009; accepted on March 3, 2009.


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