Considered as the biggest public health problem, the pandemic growth of obesity is associated to decline of male fertility potential over the last 50 years. Thus far, the effect of weight loss on semen parameters is still controversial and poorly understood. In this study we report the effect of significant weight loss on semen parameters of two obese men with metabolic syndrome. The patients followed to a very low-calorie ketogenic diet (VLCKD) according to a commercial weight loss program (Pronokal® Method), wich includes lifestyle and behavioral modification support. Seminal analysis was performed in according to World Health Organization guidelines, using Maklef counting chamber. Sperm morphology was analized by WHO guidelines and strict criteria (fabric for sperm concentration, motility and morphology). Clinical and hormonal data pre- and post-dietary intervention are presented below. Patient 1, weight: 127.8/101.4 kg, BMI: 42.7/33.9 kg/m2, body fat 41.9/33.9%, triglycerides 286/157, HOMA-IR 11.6/3.0; total testosterone 256/623 ng/dl. Patient 2, weight: 99.5/90.3 kg, BMI: 31.4/28.5 kg/m2, body fat 21.2/26.3%, triglycerides 197/88 mg/dl, HOMA-IR 2.63/1.29; total testosterone 388/351 ng/dl. All semen characteristics expressively improved in both patients. The sperm total and progressive motility increased respectively by 46.4% and 62%% in Patient 1 and by 2.63% and 24.5% in Patient 2. Normal sperm morphology increased from 5% to 8% in patient 1 and from 1% to 5%, in patient 2. In addition, total motile sperm count increased by 20% and 40% in patients 1 and 2, respectively, after dietary intervention. In conclusion, besides the significant improvement in metabolic and hormonal profiles, our results seem to support the potential benefit of weight loss by VLCKD in improving sperm motility and morphology of obese patients. Further cohort studies involving a larger number of patients should be performed to verify this hypothesis.
05 - 09 Sep 2020
European Society of Endocrinology