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Human Reproduction Update Advance Access published online on November 4, 2009
Human Reproduction Update, doi:10.1093/humupd/dmp047
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis

A.A. MacDonald1, G.P. Herbison2, M. Showell3 and C.M. Farquhar4,5

1 School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand 2 Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand 3 Cochrane Menstrual Disorders & Subfertility Group, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand 4 Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand

To whom correspondence should be addressed at: 5 Correspondence address. Tel: +64-9-373-7599; E-mail: c.farquhar{at}auckland.ac.nz

BACKGROUND: It has been suggested that body mass index (BMI), especially obesity, is associated with subfertility in men. Semen parameters are central to male fertility and reproductive hormones also play a role in spermatogenesis. This review aimed to investigate the association of BMI with semen parameters and reproductive hormones in men of reproductive age.

METHODS: MEDLINE, EMBASE, Biological Abstracts, PsycINFO and CINAHL databases and references from relevant articles were searched in January and February 2009. Outcomes included for semen parameters were sperm concentration, total sperm count, semen volume, motility and morphology. Reproductive hormones included were testosterone, free testosterone, estradiol, FSH, LH, inhibin B and sex hormone binding globulin (SHBG). A meta-analysis was conducted to investigate sperm concentration and total sperm count.

RESULTS: In total, 31 studies were included. Five studies were suitable for pooling and the meta-analysis found no evidence for a relationship between BMI and sperm concentration or total sperm count. Overall review of all studies similarly revealed little evidence for a relationship with semen parameters and increased BMI. There was strong evidence of a negative relationship for testosterone, SHBG and free testosterone with increased BMI.

CONCLUSIONS: This systematic review with meta-analysis has not found evidence of an association between increased BMI and semen parameters. The main limitation of this review is that data from most studies could not be aggregated for meta-analysis. Population-based studies with larger sample sizes and longitudinal studies are required.

Key words: body mass index / semen / reproductive hormones / systematic review / obesity

Received on June 27, 2009; revised September 11, 2009; accepted on September 28, 2009


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