Improvements in Sperm Motility Following Low- or High-Intensity Dietary Interventions in Men With Obesity.

Sara Abou Sherif, Sukhbinder Minhas, Sruthi Ramaraju, Hannah Lewis, Dalia Khalifa, Anavi Prakash, Rama Jha, Olivia Holtermann Entwistle, Cara Go, Thilipan Thaventhiran, Anastasia Dimakopolou, Ralf Henkel, Nikoleta Papanikolaou, Gary Frost, Harvinder Chahal, Aditi Sharma, Adrian Brown, Sanjay Purkayastha, Rong Luo, Waljit S Dhillo, Channa N Jayasena, Anthony R Leeds

Journal: The Journal of clinical endocrinology and metabolism 2024;109(2):449-460

PMID: 37656983

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Plain Language Summary

This randomised controlled trial examined the effects of two different dietary interventions on sperm motility (the ability of sperm to move effectively) in men with obesity. Obesity is known to increase the risk of male infertility, and while weight-loss surgery has been shown not to improve sperm quality, earlier uncontrolled studies suggested that a low-energy diet might help. A total of 67 men, aged between 18 and 60, were recruited and divided according to their sperm count into two subgroups: those with a normal sperm count (n=24) and those with oligozoospermia, meaning a low sperm count (n=43). Within each subgroup, men were randomised to either a low-energy diet (LED), or a brief dietary intervention (BDI), a short, single session of healthy eating advice used as the control comparison. The researchers measured changes in weight and sperm motility.

The results showed that men on the LED lost significantly more weight compared to those on the BDI. Despite the large difference in weight loss, both dietary interventions led to significant improvements in sperm motility. In men with a normal sperm count, motility improved significantly in both the LED and BDI groups. In men with a low sperm count, the LED produced significant improvements in motility, while the BDI showed improvements in some but not all measures of motility. Critically, there were no significant differences in sperm motility improvements between the LED and BDI groups in either subgroup.

In conclusion, dietary interventions resulting in even modest weight loss may be sufficient to improve sperm motility in men with obesity, with the potential to improve fertility outcomes. Healthcare professionals working with men experiencing obesity-related infertility may use these findings to support dietary interventions as a first-line approach, recognising that even a relatively low-intensity intervention may offer meaningful benefit to sperm motility.

Abstract

INTRODUCTION

Obesity increases risks of male infertility, but bariatric surgery does not improve semen quality. Recent uncontrolled studies suggest that a low-energy diet (LED) improves semen quality. Further evaluation within a randomized, controlled setting is warranted.

METHODS

Men with obesity (18-60 years) with normal sperm concentration (normal count) (n = 24) or oligozoospermia (n = 43) were randomized 1:1 to either 800 kcal/day LED for 16 weeks or control, brief dietary intervention (BDI) with 16 weeks' observation. Semen parameters were compared at baseline and 16 weeks.

RESULTS

Mean age of men with normal count was 39.4 ± 6.4 in BDI and 40.2 ± 9.6 years in the LED group. Mean age of men with oligozoospermia was 39.5 ± 7.5 in BDI and 37.7 ± 6.6 years in the LED group. LED caused more weight loss than BDI in men with normal count (14.4 vs 6.3 kg; P < .001) and men with oligozoospermia (17.6 vs 1.8 kg; P < .001). Compared with baseline, in men with normal count total motility (TM) increased 48 ± 17% to 60 ± 10% (P < .05) after LED, and 52 ± 8% to 61 ± 6% (P < .0001) after BDI; progressive motility (PM) increased 41 ± 16% to 53 ± 10% (P < .05) after LED, and 45 ± 8% to 54 ± 65% (P < .001) after BDI. In men with oligozoospermia compared with baseline, TM increased 35% [26] to 52% [16] (P < .05) after LED, and 43% [28] to 50% [23] (P = .0587) after BDI; PM increased 29% [23] to 46% [18] (P < .05) after LED, and 33% [25] to 44% [25] (P < .05) after BDI. No differences in postintervention TM or PM were observed between LED and BDI groups in men with normal count or oligozoospermia.

CONCLUSION

LED or BDI may be sufficient to improve sperm motility in men with obesity. The effects of paternal dietary intervention on fertility outcomes requires investigation.

Address: Department of Metabolism, Digestion and Reproduction, Imperial College, London W12 0NN, UK.; Centre for Obesity Research, University College London, London, UK.; Clinical Research Unit, Parker Institute, Frederiksberg Hospital, Copenhagen, Denmark.; Department of General and Bariatric Surgery, Imperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK.; Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, Hammersmith, London, UK.

DOI: 10.1210/clinem/dgad523