Role of Metabolic Syndrome in Male Fertility: Is It a Risk Factor?

Abstract

Background: Metabolic syndrome (MetS) is a significant health issue linked to male infertility through mechanisms such as aromatisation, hormonal imbalance, increased scrotal temperature, decreased testicular blood flow and increased DNA damage. This study evaluated the serum hormone levels and sperm parameters in men with idiopathic infertility on the basis of the presence or absence of MetS.

Methods: Infertile men were included. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. Blood pressure and biochemical parameters, including serum hormone levels, blood sugar, lipid profiles and semen analysis after 3–5 days of abstinence, were assessed. Participants were divided into two groups on the basis of the International Diabetes Federation criteria: Those with MetS (group I) and those without MetS (group II). Parameters were statistically compared between groups. Risk factors were assessed using logistic regression.

Results: A total of 518 infertile men were included, of whom 227 (43.8%) had MetS (group I) and 291 (56.2%) did not (group II). Significant differences were observed in all MetS criteria except low-density lipoprotein levels (p = 0.240). Serum testosterone levels were significantly lower in group I (p = 0.001). Although sperm parameters were lower in group I, but the differences were not statistically significant (p > 0.05). Age (odds ratio (OR): 1.075; 95% confidence interval (CI): 1.042–1.109; p < 0.001), medication use (OR: 1.675; 95% CI: 1.131–2.481; p = 0.01) and ejaculate volume (OR: 0.869; 95% CI: 0.772–0.978; p = 0.02) were found to be risk factors for MetS in regression analysis.

Conclusions: MetS may negatively influence the male reproductive system through various mechanisms. Further research is required to clarify the effect of MetS on male infertility.

Key words

male infertility / metabolic syndrome / testosterone / body mass index / hormonal imbalance