Bariatric surgery associated with semen abnormalities and reduced fertility in men

A meta-analysis of studies in which men underwent Roux-en-Y gastric bypass (RYGB) procedures found frequent sperm aberrations and lower fertility rates despite improvements in weight, androgen levels, and sexual quality of life following the procedure. Researchers discuss the possible impact of RYGB on male reproductive capability in the article "Semen Analysis and Fertility Rates After Bariatric Surgery in Males," published in Bariatric Surgical Practice and Patient Care.

Alberto Rosenblatt, MD, PhD, Joel Faintuch, MD, PhD, Denis Pajecki, MD, PhD, Marco Aurélio Santo, MD, PhD, and Ivan Cecconello, MD, PhD, Hospital das Clinicas, ICHC, São Paulo, Brazil, and Salomão Faintuch, MD, New England Deaconess Medical Center, Harvard Medical School, Boston, MA, compared the long-term effects of weight loss following RYGB among a group of sexually active men attempting to conceive with a partner to the semen parameters and fertility of obese men who did not undergo bariatric surgery and to a control group of lean men. The researchers identified elevated levels of the estrogen hormone estradiol and deficient vitamin D as factors that could negatively impact semen and fertility among the RYGB group.

"This study is one important piece in solving the puzzle of male infertility. The challenge is to see if correcting hormonal and micronutrient aberrations are enough to reverse male infertility," says Editor-in-Chief Edward Lin, DO, MBA, Surgical Director, Emory Bariatrics and Director, Gastroesophageal Treatment Center, Emory University School of Medicine, Atlanta, GA.