What is the Effect of Visceral Fat on Male Fertility?
— By Dawn M. Sweet, Ph.D
Men with higher levels of abdominal adipose tissue are at greater risk of fertility problems.
For patients with obesity, health risks extend beyond metabolic syndromes such as type 2 diabetes, heart disease, or stroke. As noted in a recent study,1 there are adverse effects on reproductive function for men with obesity due to hormonal disturbances, increased testicular heat and inflammation. For men with higher levels of abdominal adipose fat, the risks of infertility may be higher.
Abdominal Fat and Male Fertility
Research has shown that how weight is distributed can play a role in fertility. For example, men with more abdominal adipose tissue were shown to experience more infertility issues than healthy weight counterparts.2 Additionally, a higher waist circumference has been found to negatively affect sperm concentration and motility counts.4 Visceral fat contains more insulin and androgen receptors, so men with elevated levels of visceral fat are prone to be more insulin resistant, so their testosterone levels are lower2. Abdominal fat has also been found to be associated with oxidative stress, which is known to affect male fertility.4
A recent study investigated how reducing abdominal fat affected sperm health.4 Results suggest that reducing abdominal adipose tissue yielded improvement in sex hormones, namely testosterone. Another study2 investigated the relationship between visceral adiposity index (VAI) and sperm parameters and found that the visceral adipose index (VAI) is a good indicator of male fertility. VAI is calculated using body mass index, waist circumference, triglyceride, and high-density lipoprotein cholesterol.
In a study investigating the relationship of VAI and infertility in a group of 278 men being treated for infertility1, there was a significant correlation between BMI and testosterone and a negative correlation between waist circumference and testosterone. Additionally, the researchers found a negative correlation between visceral adipose index and sperm parameters such as sperm concentration, total sperm count, progressive and total motility, total serum testosterone. Thus, it was concluded that increased visceral adiposity may adversely affect male fertility because of its metabolic and hormonal effects.
Mitigating the Effects of Obesity on Male Infertility
For clinicians treating men with obesity for fertility concerns, it is important to focus on how lifestyle changes such as diet and exercise could improve fertility. Male patients with obesity should be counseled to reduce their weight to improve fertility. Clinicians should work with their patients to develop a plan to reduce abdominal adipose tissue. A supervised weight loss intervention should be considered as an important part of their clinical care. Lifestyle changes, combined with a supervised Very Low Calorie Diet (VLCD), could mitigate infertility challenges for men with obesity that wish to become fathers.
- Relationship between visceral adiposity index and male fertility
- BMI and male fertility
- In subfertile couple, abdominal fat loss in men is associated with improvement of sperm quality and pregnancy: a case-series
- Paternal obesity negatively affects male fertility and assisted reproduction outcomes: A systematic review and meta-analysis