Obesity, endocrine disruption and male infertility

Obesity has become a global pandemic since the last few decades with prevalence in more than one-third of the population in the United States. Another concurrent global health concern is the declining trend in male fecundity in terms of semen quality. Male infertility etiology is multifactorial with obesity serving as one of the major causatives. An array of research is directed in unveiling the potential mechanism underlying the obesity-induced male subfertility or infertility. Obesity may alter the hormonal milieu of the hypothalamic-pituitary-gonadal axis, its crosstalks with other metabolic hormones, upregulates secretion of adipose tissue-derived hormones and other factors, thus influencing the endocrine regulation of male reproduction. Obesity may also directly impair testicular functions by inducing genetic and epigenetic alterations in spermatozoa, disrupting sperm morphology and functions. Given the complexity of the condition of obesity and the multivariate etiopathology of male subfertility/infertility, this review is aimed to provide an updated concept on how obesity mediated hormonal modulation may affect male fertility parameters.