Obesity

The prevalence of obesity has increased at soaring rates in the last 35 years with greater than a third of the US population being afflicted with the condition. Concurrent reduction in male fecundity in terms of declining semen quality is another major global concern. A growing body of research has indicated the potential role of obesity in the deterioration of male fertility. Obesity may act through alteration in the hypothalamic-pituitary-gonadal axis and its cross talks with other hormones, thus impairing the intricate orchestration of prime endocrine regulators of male reproduction. Its deleterious impact upon semen parameters may also be attributed to adipose tissue-derived factors, certain physical factors such as elevated scrotal temperature due to excessive adipose tissue accumulation, sleep apnea, and other associated disorders. Obesity may also modulate the genetic and epigenetic constitution of spermatozoa, thereby directly disrupting sperm morphology and functions. It is suggested that male obesity has a deleterious impact on the outcomes of assisted reproductive techniques (ARTs) in relevance to pregnancy rates, live births, and overall health of the offspring. This chapter discusses the overall mechanism to provide better understanding of the association of obesity with male infertility. It also puts forth the management and treatment strategies for obesity-induced male infertility.