One of the most common causes of male infertility is obesity. This is the name of a condition in which the body mass index exceeds 30. If the body mass index is in the range from 25 to 29.9, then we are talking about overweight.

Studies have shown that couples in which a partner is overweight or obese were 1.19 times more likely to fail to become pregnant within 12 months than couples in which a man was of normal body weight.

How are obesity and fertility related?

Being overweight negatively affects fertility, and this effect is multifaceted.

The hormonal background changes.

With obesity, the hormonal balance changes. First of all, testosterone levels decrease, and it is the main male hormone. This is due to an increase in the concentration of aromatase, an enzyme that converts androgens (male sex hormones) into estrogens (female sex hormones). An excess of female hormones in the male body leads to suppression of spermatogenesis, decreased libido and potency.

Obese men often develop loss of cell sensitivity to the action of insulin and high insulin levels. An excess of insulin inhibits the synthesis of globulin, which is necessary for the binding of sex hormones.

The production of luteinizing hormone is also reduced, which stimulates the production of other sex hormones and follicle-stimulating hormone, which regulates the functions of the gonads.

Erectile dysfunction develops.

One of the common consequences of male obesity is erectile dysfunction, that is, the inability to maintain a persistent erection for full sexual intercourse.

This is associated with several processes at once.

The functions of the vascular endothelium are impaired. Endothelium is the layer of cells that form the inner surface of blood vessels. It is these cells that are responsible for the narrowing and expansion of blood vessels, filling them with blood.

The production of nitric oxide, which is responsible for the contraction and relaxation of smooth muscles, is reduced.

The content of fatty acids in the blood increases. They damage endothelial cells, making muscle relaxation impossible. Also, fatty acids increase oxidative stress.

The qualitative and quantitative characteristics of the sperm deteriorate.

With obesity, the normal course of sperm maturation processes is disrupted. As a result, the main indicators of the spermogram deteriorate:

• The concentration of sperm in the ejaculate decreases.
• Reduced sperm motility as a result of a lack of polyunsaturated fatty acids (they are necessary for the formation of the sperm membrane).
• Ripening spermatozoa have an irregular structure.
• The acrosomal reaction is impaired, that is, the sperm cannot destroy the vitelline membrane of the egg in order to penetrate, so fertilization does not occur. This, like structural pathologies, a decrease in mobility, is the result of a large amount of cholesterol.
• The sperm genetic material is damaged due to oxidative stress.

In addition, due to the increase in adipose tissue in the scrotum, overheating of the testicles occurs. As a result, the vitality of spermatozoa worsens, their mobility decreases, and the likelihood of conception decreases.

Can the situation be changed?

For obese men, doctors recommend normalizing body weight. As a rule, physical activity and a balanced diet provided by a nutritionist are sufficient for weight loss. However, one must expect that this process will take several months, and in severe cases, even years.

If a man has plans to conceive a child, then in addition to diet and physical activity, specialized complexes should be taken to improve spermatogenesis.

In most cases, weight loss and taking complexes to improve male fertility lead to the restoration of male reproductive capabilities.