Impact of Diabetes and obesity on Human Fertility and Semen Quality
DOI:
https://doi.org/10.21271/ZJPAS.33.1.6Keywords:
Semen quality; Fertility; Sex hormones; Obesity; Diabetes; Spermatozoa.Abstract
The present study was done to assist the effect of obesity and diabetes on semen quality and fertility of adult males in Erbil city. For this purpose, one hundred twenty adult males were used in this study. The subjects were divided into four groups. The control group included 30 healthy males, the obese group included 30 males with BMI ≥ 30. The diabetes group included 30 males with diabetes mellitus type 2 (T2 DM)and obese and the diabetes group included 30 males with both BMI ≥ 30 and T2 DM. Semen analysis and sex hormones were determined to evaluate semen quality and fertility. The incidence of abnormal viscosity in patient groups is significantly higher than that of the control group. Semen volume, sperm concentration, normal morphology, total motility, and grade activity in the control group is significantly higher than that of the other 3 groups. Lower sex hormones LH, FSH, and testosterone were recorded in a group of obese with diabetes group. A lower concentration of the serum malondialdehyde (MDA) is recorded in the control group. Despite the decreasing of the semen volume, sperm concentration, normal morphology, and motility in the patient's groups, all these values are not threshold and within the normal ranges which were recommended by World Health Organization (WHO). In our results concluded that obesity and diabetes have a minor effect and not detrimental to the fertility of males.
References
ABDULLAH, A. E., MORSI, A. N., ELHASSAN FARAGALLA, M. & ELSAYED, M. 2014. The Association Between Male Infertility And Diabetes Mellitus. J Pharm Biomed Sci, 4, 1097-1102.
ADA, A. D. A. 2014. Diagnosis and classification of diabetes mellitus. Diabetes care, 37, S81-S90.
AGBAJE, I., ROGERS, D., MCVICAR, C., MCCLURE, N., ATKINSON, A., MALLIDIS, C. & LEWIS, S. 2007. Insulin dependant diabetes mellitus: implications for male reproductive function. Human Reproduction, 22, 1871-1877.
AHMED, R. 2005. The physiological and biochemical effects of diabetes on the balance between oxidative stress and antioxidant defense system. Med. J. Of Islamic Academy of Sci, 15, 31-42.
ALAHMAR, A. T., ALI, Z., MUHSIN, Z. & QASIM, H. 2018. The impact of obesity on seminal fluid in men with infertility. Middle East Fertility Society Journal, 23, 346-349.
ALI, S., SHAIKH, R., ASHFAQSIDDIQI, N. & SIDDIQI, P. 1993. Serum and urinary levels of pituitary-gonadal hormones in insulin-dependent and non-insulin-dependent diabetic males with and without neuropathy. Archives of andrology, 30, 117-123.
ALI, S. T. & RAKKAH, N. I. 2007. Neurophysiological role of sildenafil citrate (Viagra) on seminal parameters in diabetic males with and without neuropathy. Pakistan journal of pharmaceutical sciences, 20, 36-42.
ALLEN, N. E., APPLEBY, P. N., DAVEY, G. K. & KEY, T. J. 2002. Lifestyle and nutritional determinants of bioavailable androgens and related hormones in British men. Cancer Causes & Control, 13, 353-363.
ALSHAHRANI, S., AHMED, A. F., GABR, A., ABALHASSAN, M. & AHMAD, G. 2016. The impact of body mass index on semen parameters in infertile men. Andrologia, 48, 1125-1129.
AMIRI, I., KARIMI, J., PIRI, H., GOODARZI, M. T., TAVILANI, H., KHODADADI, I. & GHORBANI, M. 2011. Association between nitric oxide and 8-hydroxydeoxyguanosine levels in semen of diabetic men. Systems biology in reproductive medicine, 57, 292-295.
ANDERSON, Y. C., WYNTER, L. E., MOLLER, K. R., CAVE, T. L., DOLAN, G. M., GRANT, C. C., STEWART, J. M., CUTFIELD, W. S. & HOFMAN, P. L. 2015. The effect of a multi-disciplinary obesity intervention compared to usual practice in those ready to make lifestyle changes: design and rationale of Whanau Pakari. BMC obesity, 2, 1-10.
BELLOC, S., COHEN-BACRIE, M., AMAR, E., IZARD, V., BENKHALIFA, M., DALLÉAC, A. & DE MOUZON, J. 2014. High body mass index has a deleterious effect on semen parameters except morphology: results from a large cohort study. Fertility and sterility, 102, 1268-1273.
BHASIN, S., CUNNINGHAM, G. R., HAYES, F. J., MATSUMOTO, A. M., SNYDER, P. J., SWERDLOFF, R. S. & MONTORI, V. M. 2010. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 95, 2536-2559.
BHATTACHARYA, S. M., GHOSH, M. & NANDI, N. 2014. Diabetes mellitus and abnormalities in semen analysis. Journal of Obstetrics and Gynaecology Research, 40, 167-171.
BIENIEK, J. M., KASHANIAN, J. A., DEIBERT, C. M., GROBER, E. D., LO, K. C., BRANNIGAN, R. E., SANDLOW, J. I. & JARVI, K. A. 2016. Influence of increasing body mass index on semen and reproductive hormonal parameters in a multi-institutional cohort of subfertile men. Fertility and sterility, 106, 1070-1075.
CASTRO-FERNANDEZ, C., OLIVARES, A., SODERLUND, D., LÓPEZ-ALVARENGA, J., ZAMBRANO, E., VELDHUIS, J. D., ULLOA-AGUIRRE, A. & MÉNDEZ, J. 2000. A preponderance of circulating basic isoforms is associated with decreased plasma half-life and biological to immunological ratio of gonadotropin-releasing hormone-releasable luteinizing hormone in obese men. The Journal of Clinical Endocrinology & Metabolism, 85, 4603-4610.
CHANDEL, A., DHINDSA, S., TOPIWALA, S., CHAUDHURI, A. & DANDONA, P. 2008. Testosterone concentration in young patients with diabetes. Diabetes care, 31, 2013-2017.
CHAVARRO, J. E., TOTH, T. L., WRIGHT, D. L., MEEKER, J. D. & HAUSER, R. 2010. Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic. Fertility and sterility, 93, 2222-2231.
COMHAIRE, F. & VERMEULEN, L. 1995. Human semen analysis. Human reproduction update, 1, 343-362.
DELFINO, M., IMBROGNO, N., ELIA, J., CAPOGRECO, F. & MAZZILLI, F. 2007. Prevalence of diabetes mellitus in male partners of infertile couples. Minerva urologica e nefrologica= The Italian journal of urology and nephrology, 59, 131-135.
DIAZ-ARJONILLA, M., SCHWARCZ, M., SWERDLOFF, R. & WANG, C. 2009. Obesity, low testosterone levels and erectile dysfunction. International journal of impotence research, 21, 89-98.
DUBEUX, V. T., RENOVATO, T., ESTEVES, A. C., ANDRÉ, L., DE OLIVEIRA, A. & PENNA, I. A. 2016. The impact of obesity on male fecundity: a Brazilian study. JBRA assisted reproduction, 20, 137-141.
EISENBERG, M. L., KIM, S., CHEN, Z., SUNDARAM, R., SCHISTERMAN, E. F. & BUCK LOUIS, G. M. 2014. The relationship between male BMI and waist circumference on semen quality: data from the LIFE study. Human reproduction, 29, 193-200.
ERDEMIR, F., ATILGAN, D., MARKOC, F., BOZTEPE, O., SUHA-PARLAKTAS, B. & SAHIN, S. 2012. The effect of diet induced obesity on testicular tissue and serum oxidative stress parameters. Actas Urológicas Españolas (English Edition), 36, 153-159.
ESCOBAR-MORREALE, H. F., SANTACRUZ, E., LUQUE-RAMÍREZ, M. & BOTELLA CARRETERO, J. I. 2017. Prevalence of ‘obesity-associated gonadal dysfunction’in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis. Human Reproduction Update, 23, 390-408.
FUI, M. N. T., DUPUIS, P. & GROSSMANN, M. 2014. Lowered testosterone in male obesity: mechanisms, morbidity and management. Asian journal of andrology, 16, 223-231.
FURUKAWA, S., FUJITA, T., SHIMABUKURO, M., IWAKI, M., YAMADA, Y., NAKAJIMA, Y., NAKAYAMA, O., MAKISHIMA, M., MATSUDA, M. & SHIMOMURA, I. 2017. Increased oxidative stress in obesity and its impact on metabolic syndrome. The Journal of clinical investigation, 114, 1752-1761.
GAPSTUR, S. M., GANN, P. H., KOPP, P., COLANGELO, L., LONGCOPE, C. & LIU, K. 2002. Serum androgen concentrations in young men: A longitudinal analysis of associations with age, obesity, and race.: The CARDIA male hormone study. Cancer Epidemiology and Prevention Biomarkers, 11, 1041-1047.
GUIDET, B. & SHAH, S. V. 1989. Enhanced in vivo H2O2 generation by rat kidney in glycerol-induced renal failure. American Journal of Physiology-Renal Physiology, 257, F440-F445.
HADJKACEM LOUKIL, L., HADJKACEM, H., BAHLOUL, A. & AYADI, H. 2015. Relation between male obesity and male infertility in a T unisian population. Andrologia, 47, 282-285.
HAMMOUD, A. O., GIBSON, M., PETERSON, C. M., MEIKLE, A. W. & CARRELL, D. T. 2008. Impact of male obesity on infertility: a critical review of the current literature. Fertility and sterility, 90, 897-904.
HAN, R., MA, J., LIU, W., AN, X., ZHANG, Z.-D. & WANG, S. 2018. Correlation of reproductive hormone levels and seminal plasma oxidative stress with semen quality in obese males. Zhonghua nan ke xue= National journal of andrology, 24, 419-424.
HSIEH, Y.-Y., CHANG, C.-C. & LIN, C.-S. 2006. Seminal malondialdehyde concentration but not glutathione peroxidase activity is negatively correlated with seminal concentration and motility. International Journal of Biological Sciences, 2, 23-29.
IBRAHIM, N. E., RIDA, M. & ABDRABO, A. A. 2018. Evaluation of Semen Quality in Type 2 Diabetes Mellitus Sudanese Patients Compared to Non-Diabetic Subjects. The Open Clinical Biochemistry Journal, 8, 20-25.
JENSEN, T. K., ANDERSSON, A.-M., JØRGENSEN, N., ANDERSEN, A.-G., CARLSEN, E. & SKAKKEBÆK, N. E. 2004. Body mass index in relation to semen quality and reproductive hormonesamong 1,558 Danish men. Fertility and sterility, 82, 863-870.
JENSTERLE, M., PODBREGAR, A., GORICAR, K., GREGORIC, N. & JANEZ, A. 2019. Effects of liraglutide on obesity-associated functional hypogonadism in men. Endocrine connections, 8, 195-202.
JEQUIER, A. M. & CRICH, J. P. 1986. Semen analysis: a practical guide, Blackwell Scientific Publications; St. Louis, MO, USA. Distributors, USA, Blackwell Mosby Book Distributors.
JIANG, W., SUN, H., ZHANG, J., ZHOU, Q., WU, Q., LI, T., ZHANG, C., LI, W., ZHANG, M. & XIA, X. 2015. Polymorphisms in Protamine 1 and Protamine 2 predict the risk of male infertility: a meta-analysis. Scientific reports, 5, 1-11.
KAPOOR, D., ALDRED, H., CLARK, S., CHANNER, K. S. & JONES, T. H. 2007. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabetes care, 30, 911-917.
KARAOUZENE, N., MERZOUK, H., ARIBI, M., MERZOUK, S., BERROUIGUET, A. Y., TESSIER, C. & NARCE, M. 2011. Effects of the association of aging and obesity on lipids, lipoproteins and oxidative stress biomarkers: a comparison of older with young men. Nutrition, Metabolism and Cardiovascular Diseases, 21, 792-799.
LA VIGNERA, S., CONDORELLI, R., VICARI, E., D’AGATA, R., SALEMI, M. & CALOGERO, A. 2012. High levels of lipid peroxidation in semen of diabetic patients. Andrologia, 44, 565-570.
LAZAROS, L., HATZI, E., MARKOULA, S., TAKENAKA, A., SOFIKITIS, N., ZIKOPOULOS, K. & GEORGIOU, I. 2012. Dramatic reduction in sperm parameters following bariatric surgery: report of two cases. Andrologia, 44, 428-432.
LÉGARÉ, C., DROIT, A., FOURNIER, F. D. R., BOURASSA, S., FORCE, A., CLOUTIER, F., TREMBLAY, R. & SULLIVAN, R. 2014. Investigation of male infertility using quantitative comparative proteomics. Journal of proteome research, 13, 5403-5414.
LEVINE, H., JØRGENSEN, N., MARTINO-ANDRADE, A., MENDIOLA, J., WEKSLER-DERRI, D., MINDLIS, I., PINOTTI, R. & SWAN, S. H. 2017. Temporal trends in sperm count: a systematic review and meta-regression analysis. Human reproduction update, 23, 646-659.
LI, C.-J., TZENG, C.-R., CHEN, R.-Y., HAN, B.-C., YEH, C.-Y. & CHIEN, L.-C. 2016. Decline in semen quality in men in northern Taiwan between 2001 and 2010. Chin J Physiol, 59, 355-365.
LI, W., ZHENG, H., BUKURU, J. & DE KIMPE, N. 2004. Natural medicines used in the traditional Chinese medical system for therapy of diabetes mellitus. Journal of ethnopharmacology, 92, 1-21.
M. AL‐ALI, B., GUTSCHI, T., PUMMER, K., ZIGEUNER, R., BROOKMAN‐MAY, S., WIELAND, W., FRITSCHE, H. & AZIZ, A. 2014. Body mass index has no impact on sperm quality but on reproductive hormones levels. Andrologia, 46, 106-111.
MACDONALD, A., HERBISON, G., SHOWELL, M. & FARQUHAR, C. 2010. The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. . Hum Reprod Update, 16, 293-311.
MACDONALD, A., STEWART, A. & FARQUHAR, C. 2013. Body mass index in relation to semen quality and reproductive hormones in New Zealand men: a cross-sectional study in fertility clinics. Human reproduction, 28, 3178-3187.
MAKLER, A., ITSKOVITZ, J., BRANDES, J. M. & PALDI, E. 1979. Sperm velocity and percentage of motility in 100 normospermic specimens analyzed by the multiple exposure photography (MEP) method. Fertility and Sterility, 31, 155-161.
MASCARENHAS, M. N., FLAXMAN, S. R., BOERMA, T., VANDERPOEL, S. & STEVENS, G. A. 2012. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med, 9, e1001356.
MOHAMMED, M., AL-HABORI, M., ABDULLATEEF, A. & SAIF-ALI, R. 2018. Impact of metabolic syndrome factors on testosterone and SHBG in type 2 diabetes mellitus and metabolic syndrome. Journal of diabetes research, 2018, 1-8.
MOUSSA, H. N., ALRAIS, M. A., LEON, M. G., ABBAS, E. L. & SIBAI, B. M. 2016. Obesity epidemic: impact from preconception to postpartum. Future science OA, 2, 1-12.
MUSLIH, R., AL-NIMER, O. & AL-ZAMELY, M. 2002. The level of Malondialdehyde after activation with H2O2 and CuSO4) and inhibited by Desferoxamine and Molsidomine in the serum of patients with acute myocardial infection. J. Chem, 5, 148-149.
NAJAFI, M., SREENIVASA, G., AARABI, M., DHAR, M., BABU, M. & MALINI, S. 2012. Seminal malondialdehyde levels and oxidative stress in obese male infertility. Journal of Pharmacy Research, 5, 3597-3600.
OMOLAOYE, T. & DU PLESSIS, S. S. 2018. Diabetes mellitus and male infertility. Asian Pacific Journal of Reproduction, 7, 6-14.
OMU, A., AL-BADER, M., AL-JASSAR, W., AL-AZEMI, M., OMU, F., MATHEW, T. & ANIM, J. 2014. Antioxidants attenuates the effects of insulin dependent diabetes mellitus on sperm quality. Bioenergetics, 3, 1-9.
OZATA, M., MERGEN, M., OKTENLI, C., AYDIN, A., SANISOGLU, S. Y., BOLU, E., YILMAZ, M. I., SAYAL, A., ISIMER, A. & OZDEMIR, I. C. 2002. Increased oxidative stress and hypozincemia in male obesity. Clinical biochemistry, 35, 627-631.
PAL, P., RAJALAKSHMI, M., MANOCHA, M., SHARMA, R., MITTAL, S. & RAO, D. 2006. Semen quality and sperm functional parameters in fertile Indian men. Andrologia, 38, 20-25.
PELLITERO, S., OLAIZOLA, I., ALASTRUE, A., MARTÍNEZ, E., GRANADA, M. L., BALIBREA, J. M., MORENO, P., SERRA, A., NAVARRO-DÍAZ, M. & ROMERO, R. 2012. Hypogonadotropic hypogonadism in morbidly obese males is reversed after bariatric surgery. Obesity surgery, 22, 1835-1842.
RADWAN, M., JUREWICZ, J., POLAŃSKA, K., SOBALA, W., RADWAN, P., BOCHENEK, M. & HANKE, W. 2016. Exposure to ambient air pollution-does it affect semen quality and the level of reproductive hormones? Annals of human biology, 43, 50-56.
RANGANATHAN, P., MAHRAN, A. M., HALLAK, J. & AGARWAL, A. 2002. Sperm cryopreservation for men with nonmalignant, systemic diseases: a descriptive study. Journal of andrology, 23, 71-75.
SALAS-HUETOS, A., BULLÓ, M. & SALAS-SALVADÓ, J. 2017. Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Human reproduction update, 23, 371-389.
SAYLOR, P. J. & SMITH, M. R. 2009. Metabolic complications of androgen deprivation therapy for prostate cancer. The Journal of urology, 181, 1998-2008.
SEAMAN, E., BAR-CHAMA, N. & FISCH, H. 1994. Semen analysis in the clinical evaluation of infertility. Mediguide to Urology, 7, 1-8.
SENGUPTA, P., NWAGHA, U., DUTTA, S., KRAJEWSKA-KULAK, E. & IZUKA, E. 2017. Evidence for decreasing sperm count in African population from 1965 to 2015. African health sciences, 17, 418-427.
SERMONDADE, N., FAURE, C., FEZEU, L., SHAYEB, A., BONDE, J. P., JENSEN, T. K., VAN WELY, M., CAO, J., MARTINI, A. C. & ESKANDAR, M. 2013. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Human reproduction update, 19, 221-231.
SINGH, A. K., TOMARZ, S., CHAUDHARI, A. R., SINQH, R. & VERMA, N. 2014. Type 2 diabetes mellitus affects male fertility potential. Indian J Physiol Pharmacol, 58, 403-406.
SMIT, M., ROMIJN, J. C., WILDHAGEN, M. F., WEBER, R. F. & DOHLE, G. R. 2010. Sperm chromatin structure is associated with the quality of spermatogenesis in infertile patients. Fertility and sterility, 94, 1748-1752.
TAHA, E. A., SAYED, S. K., GABER, H. D., HAFEZ, H. K. A., GHANDOUR, N., ZAHRAN, A. & MOSTAFA, T. 2016. Does being overweight affect seminal variables in fertile men? Reproductive biomedicine online, 33, 703-708.
TAJAR, A., FORTI, G., O'NEILL, T. W., LEE, D. M., SILMAN, A. J., FINN, J. D., BARTFAI, G. R., BOONEN, S., CASANUEVA, F. F. & GIWERCMAN, A. 2010. Characteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European Male Ageing Study. The Journal of Clinical Endocrinology & Metabolism, 95, 1810-1818.
TSAI, E., BOYKO, E., LEONETTI, D. & FUJIMOTO, W. 2000. Low serum testosterone level as a predictor of increased visceral fat in Japanese-American men. International journal of obesity, 24, 485-491.
TSAI, E. C., MATSUMOTO, A. M., FUJIMOTO, W. Y. & BOYKO, E. J. 2004. Association of bioavailable, free, and total testosterone with insulin resistance: influence of sex hormone-binding globulin and body fat. Diabetes care, 27, 861-868.
TSAO, C.-W., LIU, C.-Y., CHOU, Y.-C., CHA, T.-L., CHEN, S.-C. & HSU, C.-Y. 2015. Exploration of the association between obesity and semen quality in a 7630 male population. PLoS One, 10, 1-13.
WANG, E.-Y., HUANG, Y., DU, Q.-Y., YAO, G.-D. & SUN, Y.-P. 2017a. Body mass index effects sperm quality: a retrospective study in Northern China. Asian journal of andrology, 19, 234-237.
WANG, L., SOUTHERLAND, J., WANG, K., BAILEY, B. A., ALAMIAN, A., STEVENS, M. A. & WANG, Y. 2017b. Ethnic differences in risk factors for obesity among adults in California, the United States. Journal of obesity, 2017, 1-10.
WHO 2009. World Health Organisation. Laboratory manual for the examination of human semen and sperm-cervical mucus interaction.Cambridge university press.
WHO 2010. World Health Organization. Laboratory manual for the examination and processing of human semen. Fifth edititon. Geneva 27, Switzerland.
ZHU, J.-Z., DONG, X.-Y., LIANG, J.-J., ZHANG, Z.-Q., HU, X.-Y. & LI, L.-K. 2017. Effects of diabetes mellitus on semen quality in adult men: a systematic review and meta-analysis. Int J Clin Exp Med, 10, 11290-303.
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