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

Most male infertility specialists have faced patients submitted to bariatric surgery and severe sperm impairment. The patient is usually healthier - less or no medications for diabetes and systemic hypertension are needed anymore. He is practicing exercises more often. Even his libido has improved after surgery! Is it possible that his semen is worse than before the surgery?

The impact of obesity on male sex hormones is well-known. On the other side, the effects of bariatric surgery on sperm parameters remain controversial. Until now, studies have reached opposite conclusions. While some authors have shown improvement or no changes in semen parameters,1,2 others have shown a worrying decrease on semen quality.3

In our study, severely obese men submitted to bariatric surgery experienced worsening on their classic semen parameters, despite the marked improvement on sexual hormones. With these results, we hope to raise the red flag on urologist evaluation prior to bariatric surgery on male patients with family building ambitions.

Written by: Guilherme Jacom Abdulmassih Wood, Division of Urology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil

References: 

  1. Samavat J, Cantini G, Lotti F, Di Franco A, Tamburrino L, Degl'Innocenti S, et al. Massive Weight Loss Obtained by Bariatric Surgery Affects Semen Quality in Morbid Male Obesity: a Preliminary Prospective Double-Armed Study. Obes Surg. 2018;28(1):69-76. doi: 10.1007/s11695-017-2802-7. PubMed PMID: 28702741.
  2. El Bardisi H, Majzoub A, Arafa M, AlMalki A, Al Said S, Khalafalla K, et al. Effect of bariatric surgery on semen parameters and sex hormone concentrations: a prospective study. Reprod Biomed Online. 2016;33(5):606-11. Epub 2016/08/20. doi: 10.1016/j.rbmo.2016.08.008. PubMed PMID: 27569703.
  3. Carette C, Levy R, Eustache F, Baron G, Coupaye M, Msika S, et al. Changes in total sperm count after gastric bypass and sleeve gastrectomy: the BARIASPERM prospective study. Surg Obes Relat Dis. 2019;15(8):1271-9. Epub 2019/04/25. doi: 10.1016/j.soard.2019.04.019. PubMed PMID: 31147284.
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