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Bariatric surgery association with male gonadal dysfunction due to obesity

Obesity is an ever growing pandemic and a prevalent problem among men of the reproductive age that can both cause and exacerbate male factor infertility by means of endocrine abnormalities associated with comorbidities, and direct effects on the precision and throughput of spermatogenesis.

The current scientific literature shows that obesity, and in particular visceral/abdominal adipose tissue expansion, represents a strong factor that leads to testosterone deficiency, erectile dysfunction, changes in sperm and semen parameters which lead to overall sexual dysfunction and male infertility.

It is a well-established scientific fact that testosterone and obesity have a circular relationship in which obesity acts as a strong independent risk factor to testosterone deficiency.  Low testosterone level will lead to poor sperm production in total number and viability of each sperm and hence leading to infertility.

Testosterone deficiency also leads to difficulty in achieving and maintaining an erection.

A multivariate studies has showed that the 33% of patients who have a BMI between 30 and 35 will have erectile dysfunction.

This problem of testosterone deficiency will be magnified the higher the BMI and associated comorbidities, including diabetes and sleep apnoea.

Multiple trials and studies have confirmed scientifically that reduction in visceral/abdominal fat tissue will lead to a rise in testosterone levels and this will directly and positively impact on the formation of healthy sperms and the correction of erectile dysfunction.

Basically, bariatric surgery through sustained weight loss will improve sexual dysfunction and fertility in male obese patients, and this will be proportionate to the amount of weight loss. 

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