Obesity increases risks of male infertility, but bariatric surgery does not improve semen quality. Recent uncontrolled studies suggest that low energy diet (LED) improves semen quality. Further evaluation within a randomized, controlled setting is warranted.
Men with obesity (18-60 years) with normal sperm concentration (normal-count) (n = 24) or oligozoospermia (n = 43) were randomised 1:1 to either 800Kcal/day LED for 16-weeks, or control, brief dietary intervention (BDI) with 16-weeks' observation. Semen parameters were compared at baseline and 16-weeks.
Mean age of normal-count men was 39.4 ± 6.4 in BDI and 40.2 ± 9.6 years in LED group. Mean age of oligozoospermic men was 39.5 ± 7.5 in BDI and 37.7 ± 6.6 years in LED group. LED caused more weight loss compared with BDI in normal-count (14.4 vs 6.3 kg; P < 0.001) and oligozoospermic men (17.6 vs 1.8 kg; P < 0.001). Compared with baseline, in normal-count men total motility (TM) increased 48 ± 17% to 60 ± 10% (P < 0.05) after LED, and 52 ± 8% to 61 ± 6% (P < 0.0001) after BDI; progressive motility (PM) increased 41 ± 16% to 53 ± 10% (P < 0.05) after LED, and 45 ± 8% to 54 ± 65% (P < 0.001) after BDI. In oligozoospermic men compared with baseline: TM increased 35%[26] to 52%[16] (P < 0.05) after LED, and 43%[28] to 50%[23] (P = 0.0587) after BDI; PM increased 29%[23] to 46%[18] (P < 0.05) after LED, and 33%[25] to 44%[25] (P < 0.05) after BDI. No differences in post-intervention TM or PM were observed between LED and BDI groups, in normal-count or oligozoospermic men.
LED or BDI may be sufficient to improve sperm motility in men with obesity. The effects of paternal dietary intervention on fertility outcomes require investigation.
The Journal of clinical endocrinology and metabolism. 2023 Sep 01 [Epub ahead of print]
Aditi Sharma, Nikoleta Papanikolaou, Sara Abou Sherif, Anastasia Dimakopolou, Thilipan Thaventhiran, Cara Go, Olivia Holtermann Entwistle, Adrian Brown, Rong Luo, Rama Jha, Anavi Prakash, Dalia Khalifa, Hannah Lewis, Sruthi Ramaraju, Anthony R Leeds, Harvinder Chahal, Sanjay Purkayastha, Ralf Henkel, Sukhbinder Minhas, Gary Frost, Waljit S Dhillo, Channa N Jayasena
Department of Metabolism, Digestion and Reproduction, Imperial College, 6th Floor Commonwealth building, 150 Du Cane Road, London, W12 0NN, UK., Centre for Obesity Research, University College London, London, UK., Clinical Research Unit, Parker Institute, Frederiksberg Hospital, Copenhagen, Denmark., Department of General and Bariatric Surgery, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK., Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, Hammersmith, London, UK.