Background: Obesity, defined by the World Health Organization (WHO) as “abnormal or excessive fat accumulation that may impair health .The effects of obesity on male reproduction have been less well studied than those on female reproduction, but there is a growing body of evidence suggesting that obesity has an adverse effect on male reproduction However, a little is known about the effect of obesity on male reproductive system and infertility. Infertility is defined as inability to achieve conception within one year. It has not yet been clearly established how excess adiposity relates to the biological changes that underlie male infertility, although there are several theories worth exploring. The endocrine abnormalities associated with obesity in women are well known with an increase in androgen metabolism and changing in reproductive hormones in over weight and obese men. Objective: The study aim at assessing the role of obesity in infertile males through measurement of BMI, some of sex hormones. Methods: This study was carried out in Tikrit Teaching Hospital, on the adult male population aged 17-45 years, from September 2013 to April 2014. The recruited cases divided into 90 infertile obese male and 30 normal weights infertile as pathological control group and 30 normal weight fertile men as normal control group.The serum samples willed collect of the patients and measure the concentrations of the sex hormones (FSH, LH, INHB) by using ELISA technique. Body Mass Index Calculation Height (m) and weight (kg). Results: There was no significant correlation between BMI (30.1±93.45, 21.40±5.24,23.24±1.42)kg/m2 in patients group, pathological control group and control group and serum LH level (22.35±12.79, 19.31±9.94, 13.90±8.33) ml U/ml in all three group respectively. There was a significant negative correlation (P< 0.03) between BMI (23.24±1.42)kg/m2 and serum FSH level (7.10±3.77) ml U/ml, in control group. While there was no significant correlation between BMI (30.19±3.45,21.40 ±5.24) kg/m2 and serum FSH level (13.59±15.72, 11.58±14.06) ml U/ml in both patients' group and pathological control group respectively.There was no significant correlation between BMI (30.19±3.45, 21.40±5.24,23.2±1.42) kg/m2and serum INHB level in the patients group, pathological control group and control group (88.8±57.96, 108.51±78.39, 141.65±63.95) pg/ml respectively. Conclusions: The BMI did not correlated with some reproductive hormones (LH, FSH,INHB) in obese infertile males, but there was a significant correlation between the FSH and BMI in control group. In infertile obese group found the highest level of LH, FSH, and the lowest level of INHB comparing with other group in this study.
Background: Obesity has been defined as abnormal or excessive fat accumulation that may impair health while the Body mass index (BMI) is a simple index of the weight-to-height ratio that is commonly used in classifying overweight and obesity in adult populations. Many semen parameters alteration can be ascribed to obesity like decreased sperm concentration, abnormal morphology, compromised chromatin integrity and abnormal motility. Many evidences showed an adverse effect of excess body fat on spermatogenesis. Methods: A total sample size composed of (70)infertile men were grouped into three groups according to published BMI ranges as follows: normal weight, overweight and obese.A single semen sample was collected for each infertile men.Heightin (m) and weight in (kg) were recorded on day of semen collection.BMI was calculated as BMI= Kg\m2. Sperm parameters evaluated according to World Health Organization guidelines.Quantitation of the IL-6 in seminal plasma were accomplished using commercially available ELISA kit. Results: In the current study, a positive correlation was found between body mass index and IL-6, on the contrary, a significant negative correlation was found among IL-6 level and progressive sperm motility and sperm concentration as well. Conclusion: There is an increase of IL-6 from the adipose tissue with increasing BMI. The IL-6 cause reduction of the sperm motility by increasing the level of ROS. The obesity reduces the spermatogenesis by androgenic deficiency results in low sperm concentration and motilitywhich it may be the main reason of their infertility.
Background: Polycystic ovarian syndrome (PCOS) constitutes the most common endocrinopathy of women of reproductive age. Women with PCOS manifest hyperandrogenemia, hyperinsulinemia, and hypothalamic-pituitary-ovarian axis aberrations. Objective: The objective of the present study was to find the prevalence and the presenting features of PCO patients and associated manifestations in relation to biochemical and anthropometric parameters in adult obese women attending obesity research and therapy unit. Methods: Patients diagnosed as PCOS according to Androgen Excess and PCOS Society/2009 criteria were grouped into two groups: those with BMI less than 30kg/m2 and those with BMI 30kg/m2 and more. Blood was drawn for biochemical and hormonal assay. Information tabulated, means and percentages used, and the results were analyzed. Results: The number of adult females 20-40 years of age attending Obesity research and therapy unit (ORTU) during February 2013 to February 2014 was 756, (14.3%) of them had PCOS, (65%) were diagnosed during examination. (94.4%) had menstrual disturbances, (63.8%) had hirsutism and (91.7%) had PCOS ultrasound findings. Mean BMI of the patients with PCOS was 33.62 (SD 4.21). Mean LH exceeded mean FSH in patients with PCOS and it was more evident with increasing BMI where it was doubled in those with BMI more than 30 kg/m2. LH/FSH ratio for BMI above 30 was 2.1, and although testosterone level was elevated showed no statistical relation to BMI. The fasting glucose level, cholesterol and triglycerides levels showed the same pattern of elevation that with increasing BMI. Conclusions: The prevalence of PCOS in females (20-40y) attending ORTU was 14%, of them 65% were undiagnosed before, 63% had hirsutism, 94% had menstrual disturbances and 90% had ultrasonic features of polycystic ovary. These findings suggest the need to stress on diagnosing PCOS in adult female during management of obesity.
Background: Polycystic ovary syndrome is the most common, yet complex, endocrine disorder with principal features of anovulation, amenorrhea, ovulation-related infertility, polycystic ovaries, and obesity. Number of metabolic aberrations is now well recognized as a growing public health problem in PCOS as glucose intolerance, hyperinsulinemia and dyslipidemia. Objective: To investigate and analyze the anthropometric, hormonal profile and metabolic abnormalities of obese and non-obese women with this disorder. Materials and Methods: Sixty-five healthy Iraqi women serves as the control group and eighty-four infertile women divided into two subgroups depending on the BMI (< and ≥30 kg/m2) were studied. BMI, waist to hip ratio and waist to thigh ratio were measured. Serum levels of luteinizing hormone, follicle stimulating hormone, estradiol, testosterone, fasting blood glucose, and oral glucose tolerance test, and total lipid profile were measured. Results: BMI, waist/hip, waist/thigh ratio were significantly higher in PCOS than control women. Lower FSH level, higher LH and E2 levels, LH/FSH ratio, and lower E2/testosterone ratio was found in obese and non-obese PCOS. Higher blood sugar level, high cholesterol, triglyceride, LDL, VLDL and lower HDL levels in PCOS compared to control women. Conclusion: Obesity is a common finding of women with PCOS, but it is not part of the diagnostic criteria. Women with PCOS usually have the so-called centralobesity (Visceral adiposity), and therefore tend to have an increased waist-hip ratio (WHR) and waist to thigh ratio, regardless of the weight factor (i.e., in obese and non-obese). PCOS patients exhibited abnormal hormonal status and biochemical indices also regardless of obesity.
Obesity induces metabolic dysfunctions in bodily systems and is a significant health challenge. Excessive adipose tissue accumulation encompasses dynamic, endocrine, and biologically active processes. The fundamental pathogenic mechanism of obesity is chronic low-grade inflammation exacerbated by pro-inflammatory biomarkers such as free fatty acids, lipopolysaccharides, adipokines, and cytokines. The rising prevalence of obesity over the past forty years has led to an increase in associated comorbidities, including polycystic ovarian syndrome (PCOS). To clarify the impact of increasing body mass index (BMI) in PCOS and non PCOS on the ICSI outcomes of 143 infertile Iraqi females, dividing them into two main groups: PCOS and non PCOS and each group into normal weight and overweight/obese group. Group 1= normal BMI PCOS, group 2= overweight/ obese PCOS, group 3= normal BMI non PCOS, group 4= overweight/obese non PCOS. Significant differences in ICSI outcomes were observed in the PCOS groups compared to the non-PCOS groups concerning the total number of harvested, MI, MII oocytes, GV, abnormal and fertilised oocytes, total and D3 grade I embryos alongside higher number of arrested and transplanted embryos. There are numerically higher number of D3 grade II and III embryos, morula and blastocyst with no significant difference seen. The rates of maturation and fertilisation exhibited no significant disparities. The biochemical pregnancy rate was higher in group 2 compared to group 1, and in group 4 compared to group 3, with a statistically significant difference. A higher BMI among younger PCOS individuals may be associated with better pregnancy outcomes.
Background: Male obesity is associated with physiological changes that can negatively affect male fertility. Obese men have demonstrated a 3-fold increase in the prevalence of oligozoospermia when compared with men with normal Body Mass Index (BMI). Objective: To find the correlation between Aromatase enzyme with the following hormones (follicle stimulating hormone(FSH), Luteinizing hormone(LH), Estradiol(E2), and testosterone) in the obese infertile male. Subjects, Materials and Methods: Seventy obese infertile male (patients) and twenty obese fertile male (control) are enrolled in this study. Aromatase enzyme, FSH, LH, E2 and testosterone hormones were measured in their serum. All serum samples were measured by ELISA method. Results: Median human cytochrome enzyme level was significantly higher in patients than in control group, 87.55+ 12.48 pg./ml versus 56.95+9.88 pg./ml, P= 0.014. In patients group, a significant positive correlation was found between human cytochrome enzyme, FSH, and LH. Conclusions: The present study showed clearly that male obesity negatively affects fertility through changes in hormone levels. The results suggest that increased estrogen because of aromatization in the fatty tissue, reflected through the increase in human cytochrome enzyme (aromatase), may be an important mechanism for the hypoandrogenemia and altered sperm parameters.
Background: Male obesity is associated with physiological changes that can negatively affect male fertility. Obese men have demonstrated a 3-fold increase in the prevalence of oligozoospermia when compared with men with normal Body Mass Index (BMI). Objective: To estimate the role of aromatase enzyme in decreasing sperm parameters in obese infertile men. Subjects, Materials and Methods: Seventy obese infertile male (patients) and twenty obese fertile male (control) are enrolled in this study. Seminal fluid analysis done according to criteria of WHO (2010). Results: A significant negative correlation was found between human cytochrome enzyme and sperm concentration, progressively motile sperm, non-progressively motile sperm, immotile sperm and normal morphology. Conclusion: The present study showed clearly that male obesity negatively impacts fertility through direct association between increased (BMI) and semen parameters. The results suggest that increased estrogen as a result of aromatization in the fatty tissue, reflected through the increase in human cytochrome enzyme (aromatase), may be an important mechanism for the hypoandrogenemia and altered sperm parameters.
There is a relation between adipose tissue and macrophages. These macrophage cells influence adipose tissue by releasing many bioactive chemicals, including the wingless-type MMTV integration site family 5a (wnt5a) glycopeptides and the more traditional cytokines. Healthy adipocytes can release the wnt5a inhibitor Secreted frizzled-related protein 5(SFRP5). However, this protective effect was found to be reduced in obesity. This study aimed to assess the effect of follicular and serum levels of SFRP5 as well as serum and follicular levels of wnt5a on ICSI outcome and determine the potential roles of SFRP5 as a predictor of positive pregnancy in Iraqi infertile females undergoing ICSI with different body mass index .Ninety infertile females who received intracytoplasmic sperm injection and had various infertility factors between 18 and 45 years participated in this prospective clinical cross-sectional study. Follicular fluid, serum SFRP5, and serum and follicular fluid wnt5a levels were measured for all participants on the day of ovum pickup. In addition, ICSI outcomes were determined. There was a significant difference in the mean total gonadotrophin dose used among the three studied groups (p = 0.023), higher in overweight and obese females than normal-weight females. There was a positive significant correlation between serum plus follicular fluid wnt5a and total gonadotropin dose. Serum and follicular fluid SFRP5 levels were significantly higher in normal-weight females. There were higher serum (p-value=0.002) and follicular fluids (p-value=0.005) SFRP5 levels in pregnant females. Both SFRP5 and wnt5a glycoproteins were detected in infertile women's serum and follicular fluid. Serum and follicular fluid secreted frizzled-related protein 5 level positively associated with ICSI outcome. The cutoff values for serum and follicular fluid SFRP5 were ≥15.86 (ng/ml) and ≥ 11.3(ng/ml), respectively, as predictors of positive pregnancy in women undergoing IVF/ICSI cycles. Obesity, BMI, SFRP5, wnt5a, ICSI Outcome
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder with symptoms and diverse clinical manifestations. Obesity, a common comorbidity in PCOS, may exacerbate and lead to varied hormonal and inflammatory profiles. This study aimed to compare serum DHEAS, TNF-α, and IL-10 levels between obese and non-obese women with PCOS, providing insights into the intricate interplay between obesity, hormonal imbalances, and inflammation in this condition and offering potential pathways for enhancing fertility treatment outcomes in this challenging patient population. In this cross-sectional study, the data was analyzed from sixty -five women diagnosed with PCOS, categorized into two groups based on their Body Mass Index (BMI): Thirty-eight were non-obese (BMI < 30) and twenty-seven obese women (BMI ≥ 30). Serum samples were collected to measure DHEAS, TNF-α, and IL-10 levels using the ELIZA kit. These measures were then compared between the two groups to ascertain any significant differences. The study found significantly higher serum DHEAS levels in non-obese PCOS patients compared to their obese counterparts (p = 0.01). However, no significant difference was observed in serum TNF-α and IL-10 levels between the two groups (TNF-α p = 0.58; IL-10 p = 0.13). Serum DHEAS were significantly higher in non-obese compared to their obese counterparts’ women with PCOS. In contrast, no significant variance was found regarding S.TNF-α and S.IL-10 between the two groups
Glycotoxins termed as advanced glycation endproducts (AGEs) are made endogenously and exogenously. Maillard reaction is a chemical non-enzymatic process, between sugars and a free amino acid group of nucleic acids, proteins, and lipids which happens exogenously when handled with high temperature for a prolonged period and in a dry environment, resulting in glycotoxins (AGEs) formations. This reaction is responsible for the taste, color, and smell of food. Glycotoxins derived from food are absorbed in the intestine and store in cells and tissues. Also, glycotoxins are derived exogenously from smoking. While endogenous glycotoxins are generated by normal body physiology. Obesity and insulin resistance may induce glycotoxins (AGEs) accumulation. The objective of this study was to evaluate the relationship between glycotoxins (AGEs) and obesity. 66 infertile females who were undergoing intracytoplasmic sperm injection ICSI. These females were classified into three groups according to their body mass index. On the day of ova pick up the collect serum and follicular fluid for subsequent measurement of glycotoxins (AGEs) by ELISA kits. there was a significant difference in the concentration of glycotoxins in follicular fluid and serum between the three ICSI groups of patients. As well as there was a significant difference in the concentration of glycotoxins (AGEs) in follicular fluid and serum in the same ICSI groups of patients. there is a significant positive relation between glycotoxins (AGEs) and increase BMI.
The effect of maternal body mass index (BMI) on fertility outcomes in women undergoing in vitro fertilization/intracytoplasmic sperm injection cycles has been extensively evaluated and the results of these studies have shown a lot of controversial issues. Folate is a naturally occurring type of vitamin B9 crucial for reproductive health. 65 infertile couples were subjected to intracytoplasmic sperm injection cycles. Both primary and secondary types of infertility were involved, with different causes. The mean plasma folate of all infertile women was 12.71±6.52, with pregnant 11.60±5.57 and non-pregnant 11.74±8.80; with no significant difference in mean plasma folate between them. Moreover, the means of follicular fluid folate of all infertile women, pregnant women, and non-pregnant women were 8.00±5.39, 7.84±4.68, and 8.39±6.19 respectively. There was no significant statistical difference in mean follicular fluid folate between pregnant and non-pregnant women (p=0.719). Also, both plasma folate and follicular fluid folate were not significantly correlated to oocyte and embryo characteristics. Although plasma folate was higher in obese than normal and overweight women, the difference did not reach statistical significance. It appears that the correlation among maternal BMI, folate level and fertility outcomes in women undergoing intracytoplasmic sperm injection cycles are still controversial and much research work is needed to figure out such complex interaction among these variables.