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

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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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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES), Finance Code 001.

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Authors and Affiliations

  1. Division of Urology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255 – 7° andar – sala 7175, Sao Paulo, SP, 05403-000, Brazil

    Guilherme Jacom Abdulmassih Wood, Bruno C. Tiseo, Davi V. Paluello, Hamilton de Martin, William Nahas, Miguel Srougi & Marcello Cocuzza

  2. Huntington Medicina Reprodutiva, São Paulo, SP, Brazil

    Guilherme Jacom Abdulmassih Wood

  3. Hospital Israelita Albert Einstein, São Paulo, SP, Brazil

    Bruno C. Tiseo

  4. Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

    Marco Aurelio Santo

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  1. Guilherme Jacom Abdulmassih Wood
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  2. Bruno C. Tiseo
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  3. Davi V. Paluello
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  4. Hamilton de Martin
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Correspondence to Guilherme Jacom Abdulmassih Wood.

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Wood, G.J.A., Tiseo, B.C., Paluello, D.V. et al. Bariatric Surgery Impact on Reproductive Hormones, Semen Analysis, and Sperm DNA Fragmentation in Men with Severe Obesity: Prospective Study. OBES SURG 30, 4840–4851 (2020). https://doi.org/10.1007/s11695-020-04851-3

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