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Does weight loss improve semen quality and reproductive hormones? results from a cohort of severely obese men

EngenderHealth, a non-profit organisation that works in reproductive health, has devised a "client-orientated, provider-efficient" (COPE) approach to improve quality of care and motivate staff. COPE offers guidance for providers to assess their services, interview patients, and examine the time that they spend at clinics. This gives staff a better understanding of patients' perspectives, and enables them to develop a plan of action to improve quality. In some clinics, COPE has resulted in staff staggering their lunch breaks to reduce patients' waiting time. The approach empowers providers to have more control over their activities and. | Hảkonsen et al. Reproductive Health 2011 8 24 http www.reproductive-health-journal.eom content 8 1 24 0 REPRODUCTIVE HEALTH RESEARCH Open Access Does weight loss improve semen quality and reproductive hormones results from a cohort of severely obese men Linn Berger Hẵkonsen1 Ane Marie Thulstrup1 Anette Sterbech Aggerholm1 Jorn Olsen2 Jens Peter Bonde3 I -s I I I I z t A I 1 4 M D I I z i I I m 5 c KỲ I I I I z i Cr rh6 7 ỉt z I í I irf tn I I n 1 c M I I I z-1 Cr rl-6 7 s V Claus Yding Andersen Mona Bungum tmil Hagen Ernst Mette Lausten Hansen trik Hagen trnst and Cecilia Host Ramlau-Hansen1 2 Abstract Background A high body mass index BMI has been associated with reduced semen quality and male subfecundity but no studies following obese men losing weight have yet been published. We examined semen quality and reproductive hormones among morbidly obese men and studied if weight loss improved the reproductive indicators. Methods In this pilot cohort study 43 men with BMI 33 kg m2 were followed through a 14 week residential weight loss program. The participants provided semen samples and had blood samples drawn filled in questionnaires and had clinical examinations before and after the intervention. Conventional semen characteristics as well as sperm DNA integrity analysed by the sperm chromatin structure assay SCSA were obtained. Serum levels of testosterone estradiol sex hormone-binding globulin SHBG luteinizing hormone LH follicle-stimulating hormone FSH anti-Mullerian hormone AMH and inhibin B Inh-B were measured. Results Participants were from 20 to 59 years of age median 32 with BMI ranging from 33 to 61 kg m2. At baseline after adjustment for potential confounders BMI was inversely associated with sperm concentration p 0.02 total sperm count p 0.02 sperm morphology p 0.04 and motile sperm p 0.005 as well as testosterone p 0.04 and Inh-B p 0.04 and positively associated to estradiol p 0.005 . The median range percentage weight loss after the intervention was 15