BMI or WC) and semen concentration, motility, vitality, morphology or DNA fragmentation index. A structured approach to the most-effective clinical management of all forms of male infertility. Banting lecture 1988. Insulin resistance causes. 2020 Sep 29;18(1):95. doi: 10.1186/s12958-020-00652-6. The main factors implicated in the association may be insulin excess and insulin resistance. J Hypertens 1989;7:181-7. Diabetes —more than half of women with PCOS develop type 2 diabetes by age 40. Found insideRegenerative medicine can repair and reverse aging in all body cells. Thus, the body's own repair mechanisms may struggle with aging and age-related diseases. Research is promising and suggests that human aging will be eradicated on earth. Andrologia 2007;39:203-15. Pharmacol Res 2004;50:137-42. The resulting higher insulin levels lead to more fat storage (obesity) and also disrupt proper ovarian hormone production (increased male hormone), thus preventing ovulation. Insulin resistance is a common condition, affecting 10% of young adults and nearly 44% of adults in mid-life. Ali ST, Shaikh RN, Siddiqi NA, Siddiqi PQ (1993) Semen analysis in insulindependent/non-insulin-dependent diabetic men with/without neuropathy. It also increases the sex hormone binding globulin (SHBG) which is the main cause of infertility. (1993) Sex hormones and hemostatic risk factors for coronary heart disease in men with hypertension. Popular books. J Am Geriatr Soc 2003;51:1627-32. Stellato RK, Feldman HA, Hamdy O, Horton ES, McKinlay JB. Our mission is to provide an access to knowledge globally. Zhonghua Nan Ke Xue. Int Urol Nephrol 2009;41:777-84. The interconnected complexities of this disorder may varies from, life threatening risk of cardiovascular atherosclerotic diseases, type 2 diabetes, and hypertension to many of other metabolic diseases like male or female infertility. Found insideObesity is a global epidemic and an urgent health crisis impacting human health and health services, with the economic consequences of loss of human capital. The Tromsø Study. Background. Reproductive function abnormalities, such as obesity-related secondary hypogonadism, erectile dysfunction and infertility, represent other abnormalities negatively . Eur J Endocrinol 2006;154:899-906. Insulin resistance can make it difficult to get pregnant. Am J Epidemiol 1996;143:889-97. In addition, diabetic neuropathy seems to cause atonia of seminal vesicles, bladder, and urethra. In the studies, Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) levels were normal or low in obese men [6,7,10].Aromatase is important in men’s health, obesity, the metabolic syndrome, type 2 diabetes and aging. The MetS includes the clustering of abdominal obesity, insulin resistance, dyslipidemia and elevated blood pressure and is associated with other comorbidities including the prothrombotic state, proinflammatory state, nonalcoholic fatty liver disease and reproductive disorders. Endogenous sex hormones and the development of type 2 diabetes in older men and women: The Rancho Bernardo study. Elevated Free Fatty Acids (FFAs), associated with dyslipidemia in MetS, can cause endothelial dysfunction through increased free radical production and inhibition of NO synthesis.Infertility, defined as the inability to conceive after one year of unprotected intercourse, affects approximately 15% of couples. Diagnosis and Management of Polycystic Ovary Syndrome is a comprehensive clinical reference work for primary care physicians, internists, general endocrinologists, obstetricians, gynecologists and students. 2021 Jul 28;12:681939. doi: 10.3389/fendo.2021.681939. Because of insulin resistance, women with PCOS are at increased risk for impaired glucose tolerance and diabetes mellitus. Effect of alpha-tocopherol and simvastatin on male fertility in hypercholesterolemic rats. However, one body system is often overlooked: the reproductive system. Hyperinsulinaemia and hyperleptinaemia are associated with increased seminal insulin and leptin concentrations, which may negatively impact male reproductive function in obesity. Failure of emission and retrograde ejaculation also result from autonomic neuropathy, with an estimated 32% of men with DM affected by some degree of ejaculatory dysfunction [24]. This book provides an unparalleled description of current practices to enhance readers' knowledge and practice skills. This work was published by Saint Philip Street Press pursuant to a Creative Commons license permitting commercial use. Examines polycystic ovary syndrome (PCOS), linking it to a variety of bodywide metabolic irregularities, and introduces a targeted approach to help women balance and repair overall health, overcome symptoms, and restore fertility. J Androl 2008;29:251-9. This book offers detailed guidance on the use of imaging in the context of bariatric surgery. Male infertility may represent in some patients with MetS. Though limited, these data suggest sperm dysfunction in some men with NIDDM. The prevalence of diabetes was estimated at 347 million individuals worldwide in 2008 and is expected to continue to rise . Aging Male 2003;6:1-7. Insulin resistance is often cited as a large contributing factor to obesity, Dr. Tantibhedhyangkul says. Diabetes Care 2000;23: 490-4. Insight on pathogenesis of varicoceles: Relationship of varicocele and body mass index. Obes Res 1993;1:206-22. Robust epidemiologic, clinical, genetic, epigenetic, and nonhuman animal data support these findings. Shafik A, Olfat S. Scrotal lipomatosis. Agbaje IM, Rogers DA, McVicar CM, McClure N, Atkinson AB, Mallidis C. Haffner SM, Shaten J, Stern MP, Smith GD, Kuller L. Low levels of sex hormone-binding globulin and testosterone predict the development of non-insulin-dependent diabetes mellitus in men. Physiological role of adipose tissue: White adipose tissue as an endocrine and secretory organ. Glass AR, Swerdloff RS, Bray GA, Dahms WT, Atkinson RL (1977) Low serum testosterone and sex-hormone-binding-globulin in massively obese men. Serum and semen samples were collected and assayed for insulin, leptin and glucose. Furthermore, DM is associated with an increased oxidative stress, which damages sperm nuclear and mitochondrial DNA [19].A growing body of literature has detailed the relationship between hypogonadism and type 2 diabetes mellitus including 3 epidemiological studies that suggest hypogonadismis a risk factor for diabetes [20-22].Ali and associates evaluated 314 men with NIDDM and neuropathy, they reported a higher sperm concentration and lower sperm motility compared with diabetic men without neuropathy and controls [23]. Found insideThe book also includes a number of chapters defining a detailed description of the associated morbidities of PCOS and its long-term sequelae. Since PCOS is quite prevalent globally, the book is also of great interest to the public. The Metabolic Syndrome (MetS) is a constellation of various risk factors, including obesity, dyslipidemia, hypertension, and impaired glucose metabolism, with insulin resistance as the hypothesized underlying pathogenic mechanism. We aim to discuss summarize current evidence in the infertile male patients with MetS in the literature. Med Hypotheses 70: 358-360. In patients with KS, the risks of obesity, metabolic syndrome, and type 2 diabetes mellitus increase from adolescence to adulthood. Decreased Testosterone Levels. It is estimated that infertility affects 8-12% of couples globally, with a male factor being a primary or contributing cause in approximately 50% of couples. Diabetes Care 25: 55-60. This review aims to address this observation through studying the relationship between MetS and male reproductive health. Oh JY, Barrett-Connor E, Wedick NM, Wingard DL; Rancho Bernardo Study. Inflammation. The authors report no conflicts of interest in this work. Urol Clin North Am 1994;21:517-29. Han RY, Ma J, Ma J, Liu WJ, An XT, Zhang ZD, Wang SS. Glass AR, Swerdloff RS, Bray GA, Dahms WT, Atkinson RL. With age, it is common for insulin resistance to become more of an issue for both men and women. Luboshitzky R, Lavie L, Shen-Orr Z, Herer P. Altered luteinizing hormone and testosterone secretion in middle-aged obese men with obstructive sleep apnea. Also in healthy subjects, infusion of FFA causes increased oxidative stress and insulin resistance, which can be reversed by infusion with antioxidants such as glutathion [36]. A systemic pro-inflammatory state in combination with hyperglycemia, insulin resistance, oxidative stress and activation of the renin angiotensin system are systemic disturbances in obese individuals that contribute independently and synergistically to decreasing NO bioavailability [35]. Obesity was associated with increased serum and seminal insulin and leptin, with no significant difference in seminal glucose. Although it is more commonly associated with obesity, it is also found in normal-weight women with PCOS (J. Clin Endocrinol & Metab 1996;81 pp.2854-2964). Found insideThe first authoritative book on the subject, Insulin Resistance: The Metabolic Syndrome X illuminates the special importance of insulin resistance as a major cause of hypertension, heart disease, and polycystic ovary syndrome. A review article. Control group comprised 500 healthy women referred for male factor infertility evaluation during the same period as the PCOS women. Keywords: Diabetes, hypogonadism, male infertility, metabolic syndrome. Obesity is the main cause of hypogonadism at present, which associates with impaired gonadal function in males . Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency. Jope T, Lammert A, Kratzsch J, Paasch U, Glander HJ. The potential mechanisms linking obesity to altered gonadal function are not known but may speculatively include an altered adipokine milieu, but further research is required. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome: A comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Bethesda, MD 20894, Copyright Nicolosi A, Moreira ED Jr, Shirai M, Bin Mohd Tambi MI, Glasser DB. Sharlip ID, Jarow JP, Belker AM, Lipshultz LI, Sigman M, Thomas AJ. Interestingly, it has been suggested . Obesity is becoming an increasingly common cause for infertility and it is a cardinal feature of MetS. Erectile dysfunction as a predictor of the metabolic syndrome in aging men: Results from the Massachusetts Male Aging Study. Most infertility issues can be handled with ease through assisted reproductive technology, using in vitro fertilisation techniques and other fertility treatment options. Herald Scholarly Open Access is a leading, internationally publishing house in the fields of Sciences. Anti-hormone receptor antibodies. Circulation 2005; 111:1448-54. Fertil Steril 68: 519-524. 3. Found insideThe first fertility-boosting guide to feature the cutting-edge research results on fertility from the Nurses’ Health Study More than 6 million women in the United States alone experience infertility problems User-friendly, medically ... Diet, body composition, and exercise levels are also major causes, explaining the growing incidence of this disorder with modern lifestyles. When blood sugar levels become too high, fat cells in the body store blood sugar as body fat. Y1 - 2015/5/1. J Urol 2006;176:2138-40. By synthesizing new and old data, the authors of this Review offer a completely novel perspective on the relationship . Insulin resistance is one of the important diabetology factors impacting hyperglycemia in a majority of women with PCOS (60-80 %). PCOS women ( n = 250) were more insulin resistant than controls ( n = 500) even after adjustment for age and body mass index (BMI) ( P = 0.03). Thus, male factor infertility is present in approximately half of all infertile couples. Genetic abnormalities. Although abdominal obesity is closely associated with insulin resistance (hyperinsulinaemia), hyperleptinaemia and glucose dysfunction, changes in seminal plasma concentrations of insulin, leptin and glucose in obese males has not previously been investigated. While the obesity that is often associated with PCOS may contribute to insulin resistance, many women who have PCOS but who are not obese are still insulin resistant. A low-calorie diet and exercise may lead to weight loss, regular menstrual cycles, and ovulation. The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. Infertility is another complication of obesity, made evident by irregular menstrual cycles, reduced pregnancy rates (spontaneous and assisted), and increased miscarriage rates. Overweight and obesity are associated with several chronic complications, such as type 2 diabetes, arterial hypertension and atherosclerotic cardiovascular diseases, with relevant consequences for patients and public health systems. Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A. Kupelian V, Shabsigh R, Araujo AB, O'Donnell AB, McKinlay JB. Urology 1993;42:171-4. Various mechanisms may explain the sperm damage observed in patients with DM. For most people, however, BMI is an indication used worldwide to estimate nutritional status. Extensive research shows that elevated galectin-3 is involved in insulin resistance and metabolic problems related to diabetes, obesity and more. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Obesity is associated with an increased incidence of male factor infertility. In summary, oxidative stress may also result in lipid peroxidation of the sperm membrane, leading to decreased motility and membrane dysfunction; excessive oxidative stress may also result in sperm DNA damage, with diminished genetic viability of the affected sperm. The metabolic syndrome and male infertility. Lima N, Cavaliere H, Knobel M, Halpern A, Medeiros-Neto G. Decreased androgen levels in massively obese men may be associated with impaired function of the gonadostat. This is associated with a steroidogenetic defect in Leydig cells. Epub 2020 Jan 24. Semen analysis in insulin-dependent/non-insulin-dependent diabetic men with/without neuropathy. Obesity: preventing and managing the global epidemic. Similarly, the total sperm count showed a negative linear association with WC. PopUp = window.open( location,'RightsLink','location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); }, Source of Support: None, Conflict of Interest: None. These males may be at risk of developing the same complications associated with PCOS, including obesity, metabolic syndrome, insulin resistance, cardiovascular diseases, and infertility. Hedley et al., estimated the current prevalence of obesity at 30.6 % [2].Multiple reports have described the effects of obesity on male fertility [3-5]. Reprod Biol. Strain GW, Zumoff B, Kream J, Strain JJ, Deucher R, et al. No significant relationship was seen between body size (i.e. Gerontology 1994;40:260-7. Svartberg J, von Mühlen D, Schirmer H, Barrett-Connor E, Sundfjord J, et al. Found inside – Page iThis case-based guide is written from the clinician's perspective, dealing with a defined male infertility problem, tracing the actual clinical pathway arriving at the diagnosis, and discussing the treatment options and the likely outcome. Kley HK, Deselaers T, Peerenboom H, Krüskemper HL. Eur J Endocrinol 2004;150:65-71. Bringing together experts from a variety of specialties to examine the issues and challenges of obesity, this book discusses how obesity affects fertility, reproduction and pregnancy. There are many causes for male infertility, among which endocrine disorder is an important factor. This state-of-the-art laboratory manual includes 20 clinical protocols used daily for the investigation of the infertile male, presented with easy to understand, step-by-step methodology. 2017 Nov 1;28(4):141-150. doi: 10.1684/ecn.2018.0403. Yang FL, Wei YX, Liao BY, Wei GJ, Qin HM, Pang XX, Wang JL. Found insideAntioxidants inhibit the formation and spread of free radicals which can be damaging in biological systems. Int J Urol 2006;13:385-8. Heart disease —women with PCOS are at higher risk, and risk increases with age. Fertil Steril 90: 897-904. Prevalence of erectile dysfunction in patients with metabolic syndrome. Clin Endocrinol (Oxf). Nielsen ME, Zderic S, Freedland SJ, Jarow JP. Elevated androgen levels in PCOS lead to deposition of visceral fat, leading to insulin resistance and hyperinsulinemia, further stimulating ovarian and adrenal androgen production in a . Cohen PG (2008) Obesity in men: the hypogonadal-estrogen receptor relationship and its effect on glucose homeostasis. J Urol 2000;163:460-3. Hofny ER, Ali ME, Abdel-Hafez HZ, Kamal Eel-D, Mohamed EE, Abd El-Azeem HG. Insulin resistance, diabetes, and infertility. Stokes VJ, Anderson RA, George JT (2014) How does obesity affect fertility in men - and what are the treatment options? The association between abdominal obesity, insulin resistance, systemic hypertension, and dyslipidemia are each examined with regard to their interconnected deleterious effects on male fertility. J Androl 29: 251-259. Dyslipidemia with increased oxidative stress in the testicular microenvironment may further decrease fertility. Several studies examining hypertensive men demonstrated a significant inverse relationship between blood pressure and total serum testosterone, which could be associated with impaired reproductive potential [29-31], free testosterone [32-34] and SHBG [34]. Phillips GB, Jing TY, Resnick LM, Barbagallo M, Laragh JH, et al. Antinozzi C, Lista M, Caponecchia L, Salacone P, Minganti C, Battaglia FA, Di Luigi L, Sgrò P. Front Endocrinol (Lausanne). Treatment of abnormalities of ejaculation. No evidence-based treatment that increases the likelihood of pregnancy for the infertility associated with male obesity has been Muller M, Grobbee DE, den Tonkelaar I, Lamberts SW, van der Schouw YT. Hum Reprod 2001;16:1768-76. J Hypertens 1988; 6:329-32. Hormonal changes in elderly men with non-insulin-dependent diabetes mellitus and the hormonal relationships to abdominal adiposity. Kodama H, Yamaguchi R, Fukuda J, Kasai H, Tanaka T (1997) Increased oxidative deoxyribonucleic acid damage in the spermatozoa of infertile male patients. Additional studies are needed to fully clarify the pathophysiologic link and evidence between the components of MetS and male infertility. Int J Androl 2003;26:335-41. Obesity has reached epidemic proportions globally, and all this evidence suggests that the situation is likely to get worse ahead. MacDonald AA, Herbison GP, Showell M, Farquhar CM (2010) The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. This issue of the Endocrinology and Metabolism Clinics of North America focuses on metabolic diseases and disorders unique to the male body, with an eye toward diagnosis and treatment options. La Vignera S, Condorelli R, Vicari E, D'Agata R, Calogero AE (2012) Diabetes mellitus and sperm parameters. Oxidative stress arises when an excess concentration of Reactive Oxidative Species (ROS), molecules harboringan unpaired electron, are present in a particular physiologic environment. Andersen P, Seljeflot I, Herzog A, Arnesen H, Hjermann I, Holme I. Ali ST, Shaikh RN, Siddiqi NA, Siddiqi PQ. Overeating, consuming junk food and avoiding exercise can all contribute to further increasing the problem. This prospective case-control study aimed to test the presence of insulin resistance (IR) in men with unexplained infertility. N Engl J Med 1995;333: 853-61. (2002) Effect of antihypertensive treatment with valsartan or atenolol on sexual activity and plasma testosterone in hypertensive men. The study population included 72 men from a single clinic for assisted reproduction who had been categorized into 3 groups: Male Factor Subfertility (MFS), Female Factor Subfertility (FFS), and Idiopathic Subfertility (IS), with semen analyzed per World Health Organization (WHO, 1999) criteria. Disclaimer, National Library of Medicine Effect of obesity and fertility status on sex steroid levels in men. When examining semen parameters, ejaculate volume showed a linear decline with increasing BMI and Waist Circumference (WC). Role of insulin resistance in human disease. Found inside“Dr. Jason Fung has done it again. In easy to follow, simple steps and rules, Dr. Fung gives you the tools to rid yourself of diabetes forever. Get this book!” —Dr. Furthermore, patients in the MFS group had a significantly higher BMI (27.8 [range, 21.8-38.6]) compared with those in the FFS group (25 [range, 19.7-45.6]). insulin resistance in the context of fertility in the obese male. Few studies have demonstrated perturbation in the hypothalamic-pituitary-gonadal axis in obese men with resultant significant decrease in sex hormone-binding globulin and total testosterone [6-11]. -. Laaksonen DE, Niskanen L, Punnonen K, Nyyssönen K, Tuomainen TP, Salonen R. Malik S, Wong ND, Franklin S, Pio J, Fairchild C, Chen R. Cardiovascular disease in U.S. patients with metabolic syndrome, diabetes, and elevated C-reactive protein. eCollection 2020. J Clin Endocrinol Metab 45: 1211-1219. J Androl 2006;27:335-47. -, World Health Organisation. In: Lipschultz LI, Howards SS, editors. ED in patients with NIDDM stems in part from autonomic neuropathy and vascular disease. Elevated estrogens, made by aromatization of androgens in peripheral adipose tissue in obese men, provide a possible explanation for suppression of the hypothalamic-pituitary axis [9,10]. Hypertens Res 1998;21:279-82. T1 - Metabolic syndrome and infertility in men. Kort HI, Massey JB, Elsner CW, Mitchell-Leef D, Shapiro DB, Witt MA. See this image and copyright information in PMC. Supplementary acquisition particularly addressing the components of metabolic syndrome and their impact on male reproduction will enhance our understanding of the underlying pathophysiology.
Am J Epidemiol 1990;132:895-901. Background: Obesity appears to be associated with male reproductive dysfunction and infertility, although this has been inconsistent and inconclusive. ovarian factors. Metabolism 42: 116-120. Björntorp P. Visceral obesity: A "civilization syndrome". Int J Obes Relat Metab Disord 2000;24:1433-7. Hormone imbalances. Int J Androl 2000;23:309-18. Reprod Biol Endocrinol 12: 34. Kapoor D, Goodwin E, Channer KS, Jones TH. Some miscarriages can be caused in part by hormonal problems, older age, and poor lifestyle like obesity and smoking. Seminal plasma adipokines: involvement in human reproductive functions. Urology 42: 171-174. N2 - Metabolic syndrome is a compilation of symptoms including central obesity, insulin resistance, dyslipidemia, and hypertension. (1995) Insulin regulates testosterone and sex hormone-binding globulin concentrations in adult normal weight and obese men. According to the WHO, approximately 1.6 billion adults were classed as being overweight . The impaired glucose metabolism is widely accepted as a negative effecting factor on human fertility in either gender. These hormones are also present in semen influencing sperm functions. The “Metabolic Syndrome” (MetS) is a clustering of components that reflect overnutrition, sedentary lifestyles and resultant excess adiposity. Insulin resistance is one of the important diabetology factors impacting hyperglycemia in a majority of women with PCOS (60-80 %). In recent years, the Metabolic Syndrome (MetS) is note worthy due to its association with the development of cardiovascular disease and type 2 diabetes mellitus. Eur Cytokine Netw. On the other hand, the increased androgen production in PCOS causes deposition of visceral fat, which in turn accentuates insulin resistance and hyperinsulinemia, further fueling this vicious cycle ( 13 ). Agarwal A, Nandipati KC, Sharma RK, Zippe CD, Raina R. Role of oxidative stress in the pathophysiological mechanism of erectile dysfunction. In summary, total testosterone, free testosterone and SHBG are all commonly decreased in obese males. Ann Med 1992;24:465-8. Diabetes Care 1994;17:405-11. Found insideThe aim of this book is to inform clinicians of recent advances in obesity research and provide a review of current treatment issues and strategies. Metabolic syndrome is a compilation of symptoms including central obesity, insulin resistance, dyslipidemia, and hypertension. J Hypertens Suppl 1988;6:S649-51. Lupus 2005;14:760-4. Knowing all this, it should come as no surprise that the high insulin levels that pave the way for pre-diabetes can also cause impotence in men and infertility in women. Multiple Risk Factor Intervention Trial. Increased estrogen production in obese men. At the conclusion of this manuscript, we propose a new metabolic syndrome with male infertility paradigm. These adverse effects of obesity are specifically evident in polycystic ovary syndrome. In this study, they concluded that, " Polycystic ovary syndrome (PCOS) belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Kallmann syndrome-no GnRH producing cells hypothalamic dysfunction hyperprolactinemia hypopituitarism- pituitary tumors trauma excessive exercise anorexia nervosa emotional stress wt gain or loss certain drugs. Metabolism 1990;39:897-901. The effects of obesity, dyslipidemia, hypertension, and insulin resistance on male fertility were examined and supporting evi-dence explaining the pathophysiology of sperm dysfunction with each MetS component were described. Br J Urol 1981;53:55-61. Hyperinsulinaemia and hyperleptinemia are associated with increased seminal insulin and leptin concentrations, which may negatively impact male reproductive function in obesity [16].Eisenberg ML et al., showed the relationship between semen parameters and BMI. Background. J Clin Endocrinol Metab 2005;90:2618-23. Overweight and obesity are associated with several chronic complications, such as type 2 diabetes, arterial hypertension and atherosclerotic cardiovascular diseases, with relevant consequences for patients and public health systems. Endogenous sex hormone levels in older adult men with diabetes mellitus. Eisenberg ML, Kim S, Chen Z, Sundaram R, Schisterman EF, et al. In Western countries, people are considered obese when their Body Mass Index (BMI) a measurement obtained by dividing a person’s weight by the square of the person’s height, exceeds 30 kg/m2, with the range 25-30 kg/m2 defined as overweight. Male obesity and alteration in sperm parameters. Privacy, Help PCOS is associated with obesity or overweight along with symptoms of high male hormone secretion such as hairiness, acne, high cholesterol level and insulin resistance.
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