Keywords
bariatric surgery
semen analysis
Sperm DNA Fragmentation
How to Cite
Abstract
Study question: Does Bariatric surgery modifies sex hormone profile and seminal quality in morbidly obese young males? Summary response: along with the sudden loss of weight after Bariatric surgery, an improvement in sex hormones with a deleterious effect in seminal quality, is observed. What is already known: There is a close relationship between obesity and male infertility. Study design: Prospective matched study performed in 24 months. Materials and Methods: Young men (n=9) with morbid obesity (BMI≥ 40 kg/ m2), evaluated before and 6-10 months after Bariatric surgery, were included. Seminal study was conducted according to WHO (2010) standards using a computerized motion analysis system. The teratozoospermia index, DNA fragmentation state, and nuclear immaturity were also evaluated. The profile of FSH, LH, Total and Free Testosterone and SHBG were assayed by ECLIA. All patients signed a written consent. Results: The sudden loss of weight after Bariatric surgery was associated with an increase in FSH and SHBG and a decrease in seminal quality reflected in the decrease in seminal volume, total sperm count, curvilinear velocity and lateral head amplitude. The variation in BMI correlated positively with seminal volume and SHBG. The glycolipid profile showed a decrease in insulin-resistance indicated by HOMA-IR and in non-HDL cholesterol values. Study limitations: Since patients were recruited from the Bariatric and Metabolic Surgery Service, and because they did not present infertility problems, they lack prior uro/andrological evaluation. Implications of the findings: The results suggest recommending reproductive counseling in order to alert young obese males to possible risks of diminishing fertile potential in the short term after Bariatric surgery. More studies looking at possible post-surgical nutritional deficiencies and a longer evaluation period (12-24 months) are required to confirm the observed effects and the reversibility.
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