How tackling obesity solves fertility problems in men
Wednesday October 20 2021
For most couples, the desire to have children usually ranks high in their 'want' list. Having their offspring is often met with joy and happiness and is viewed as achieving a great milestone in the relationship.
But attaining this dream may be an uphill task for some couples struggling with infertility challenges that make it difficult for them to conceive and have babies.
This is the case for 40-year-old Ian (not his real name) and his wife that have been struggling to have children for five years.
"It's been a painful journey that would have crushed both of us, had it not been for the strong bond that we have together as a couple. We have tried various treatment options but nothing seems to work. Nevertheless, we have chosen to remain positive and hope for the best. If it happens that will be great. If not, we will move on and maybe adopt in the future," he says.
The battle with infertility can be long, tiring and agonising for those affected, especially if the cause of the problem remains elusive to themselves as well as health experts who many believe should have all the answers.
"This experience has taught us to take life as it is and become patient with ourselves. When you are dealing with a challenge whose cause can't be found, it's frustrating because you can’t fix it and you are therefore not also able to find closure. You are basically hanging in there,” he says.
Even though it may not be possible to unravel all mysteries behind infertility complications, doctors note that people can be sensitised on some known risk factors such as obesity that are largely preventable.
A new study presented at the Annual European Society for Paediatric Endocrinology Conference indicates that the impact of the condition on fertility can start earlier on, during childhood, at the point when the male reproductive hormones or organs are developing.
The researchers note that during puberty, there is usually increased activity in different cells in the testes, which are central to the fertility of men.
The cells – known as Leydig and Sertoli - are critical for the production of healthy sperm and several reproductive hormones that are essential for sperm maturation.
Research shows that obesity during puberty can alter the proper functioning of these cells between the ages of 12 and 14.
This can result in sperm abnormalities or a low count in adulthood, which are the commonest causes of fertility problems among men.
Nevertheless, the new study indicates that despite the alterations, the reproductive function in boys may be improved through weight loss, which could protect their fertility in adulthood.
Based on the results of the study, even short-term weight loss alterations in reproductive function could be partially reversed in young boys with obesity.
This indicates that early management of obesity in childhood could help prevent future fertility problems in men.
And this is an important finding, at a time when childhood obesity cases are considered to be rising in Kenya due to unhealthy diets consumed by children from most middle-class families, coupled with inactivity among children that stay indoors to play computer games, watch television programmes and browse phones for other forms of entertainment.
“These findings underline the need to consider childhood obesity as a factor in future fertility issues. We strongly recommend that early management of childhood obesity is necessary to reverse these impairments, and to help prevent future reproductive problems, as well as lowering the risks of other debilitating diseases,” Dr Solène Rérat, the lead author of the study from the Angers University Hospital in France.
During the study, the researchers assessed 34 boys, aged between 10 and 18 who were undergoing a twelve-week educational weight loss programme.
The boys had a healthy, balanced diet. They undertook physical activity for at least one hour daily, based on international recommendations. They also had weekly individual sessions with a dietician.
Before and after the programme, levels of reproductive hormones, body fat composition and blood glucose levels were measured for comparison.
The results of the study showed that the weight reduction reversed the damage that had been caused to the Leydig cells which play a key role in the production of healthy sperm. It also led to increased testosterone levels, which is a key male sex hormone.
The team now plans to measure the reproductive function of the group more long-term and to expand it to include more participants to gather more data that will confirm and extend these findings.
“Our study only evaluated the effects in a small number of obese boys after a twelve-week therapeutic educational program. Further studies with longer follow-up are needed to help us fully study the effect of weight reduction on reproductive function,” states Dr Rérat.
Aside from the link to fertility problems, childhood obesity is also discouraged as it can have some profound effects on future health in adulthood, including a greater risk of cancer, heart disease and type 2 diabetes.