Being overweight or obese, by itself is harmful and has a definite negative impact on the overall health. The direct correlation between weight and the prevalence of hypertension (high blood pressure) diabetes (Type 2 Diabetes Mellitus), cholesterol disorders, and heart-related ailments (cardio-vascular disease) is well documented and understood. But what has missed the attention and is rarely discussed in public spaces is the effect of overweight or obesity on male fertility. On World IVF Day, let’s talk about it.
Obese couples who consider themselves to be healthy, actually do not believe that their inability to conceive may be due to their weight. Only after the doctors explain to them the relationship between obesity and infertility, that they are convinced and start to repair the damage. Published studies have shown that obese men were more likely to have a low sperm count and nearly 40 percent more likely to have no sperm in their ejaculate.
The need for an ethnic Indian definition of obesity and being overweight stems from our genetic construct, which will have some differences from the other parts of the western world. The definition of obesity in India, arrived after a thorough consensus development process involving over a hundred medical experts, has three measures:
Body Mass Index (BMI)
A BMI between 18.0-22.9 kg/m2 is classified as normal, between 23.0 and 24.9 kg/m2 as overweight, and a BMI >25 kg/m2 is classified as obese. Learn whether BMI or body weight is a better indicator of health.
Waist Circumference (WC)
The consensus for Waist Circumference at 78 cm for men and 72 cm for women is classified as Action 1 and 90 cm for men and 80 cm for women is classified as Action 2.
Waist to Hip ratio (WHR)
The Waist to Hip ratio cut-offs for men and women are 0.88 and 0.81 respectively.
Impact of obesity on fertility
The negative impact of high BMI or WC on male fertility is generally overlooked. Obesity has a definitive impact on male fertility as obese men tend to have;
* Lower testosterone
* Lower sperm count
* Poor sperm morphology
* Lower sperm motility
Each of these is an independent contributor towards infertility. When fertility experts take the weight, they do it with intent. Weight is a helpful surrogate marker and can be a starting point for the treatment of infertility, even before we start the patient on medication.
Patients are counselled to lose weight, and suggested not to go for crash diets. Instead, they are urged to work towards gradual weight loss, under the supervision of a treating physician and a qualified dietitian.”
It is much easier to manage weight through a combination of diet, exercise, sleep, and stress reduction. Weight and its relationship with infertility is not just a woman’s problem, it affects men’s reproductive health too.
How to curb obesity and improve male fertility
Lifestyle modification may be the key to health and healthy living. The need is to break the vicious cycle of poor diet, stress, weight gain and low self-esteem leading to further weight gain.
Unsupervised use of body-building anabolic steroids or consumption of drugs also negatively affects fertility.
Alcohol and smoking are independent contributors to weight gain and infertility. Men need to control their consumption of alcohol and if possible quit smoking.
Our body function is kept stable by carefully and precisely balancing and complementing the various demands put on it throughout the day. Weight is one such demand put on our bodies daily. Maintaining a healthy weight is essential to leading a wholesome life. Balance is the key.