In the last few months, several clinical studies have painted a frightening portrait of fertility for the obese man. Looking at the rise in overall Body Mass Index (BMI) in male patients throughout the United States, researchers have observed a strong connection between the increase in BMI and declining fertility rates. Often thought by the public to be a “woman’s issue,” infertility is now being discussed with men in doctor’s offices across the nation. Opening up the dialogue on male factors that contribute to a couple’s inability to get pregnant is important because there is much we know about the effects of high BMI on nearly every organ system in our bodies. The question is: for couples who wish to conceive, how can lowering the male partner’s BMI contribute to improved fertility? Let’s explore.

BMI and the Male Reproductive Organs

In order for normal sperm production to occur, a man’s testicles are supposed to be two degrees cooler than his core body temperature. But in obese men, the extra body fat in the thigh and groin areas actually serves as insulation, effectively raising the temperature of the testicles instead of lowering it. The result? Reduced sperm quality and quantity.

In addition, obese men often have elevated levels of female hormones, including estrogen and also tend to suffer from hypogonadism, a condition characterized by the body’s inability to produce enough of the male hormone – testosterone. The imbalance of the appropriate hormones for his gender – low levels of testosterone coupled with high levels of estrogen – negatively impact a man’s testicles and thus, lower his production of sperm.

The Weight Loss-Fertility Correlation

Over the years, many treatment strategies have been used to help obese men improve their sperm and fertility. From certain female hormone-reducing drugs and male hormone-enhancing methods, to lifestyle changes like diet and exercise, one thing is clear: barring any other medical conditions or factors, the lower a man’s BMI, the higher his fertility rate and the better his chances are for becoming a father. For obese men who wish to procreate and want to do so without the use of medication, their best options usually depend strongly on making significant lifestyle changes that include an overhaul of what they eat and how much they move. Yes, diet and exercise are key.

The Fertility Dilemma for The Severely Obese Man

For anyone who is severely obese (someone with a BMI of 40 or above), easily and effectively making lifestyle changes on their own is extremely difficult. In fact, for the people who fall into the severely obese category, traditional diets and weight-loss programs only work in roughly two percent of these cases. For the man who wants to become a father, several failed attempts at dieting and lifestyle modification can then put him and his female partner in a situation where conception may not be possible simply because age has become a contributing factor to the infertility.

Weight-Loss Surgery and Increased Fertility

Because we know that weight-loss surgery is a clinically-proven option in significantly reducing BMI for countless patients who were once severely obese, it can’t be overlooked as a potential option for men who wish to increase their fertility and father children. Particularly for couples who wish to conceive, weight-loss surgery can offer an effective and more timely treatment option than traditional methods. If you or someone you know is facing a fertility struggle and you suspect that their body weight may be a major contributing cause, please make an appointment with a qualified physician to discuss treatment options. You can also learn about our weight loss surgery options here: /bariatric-weight-loss-orange-county/.

Over the course of more than 20 years in practice, I have had the great honor to be introduced to many children of weight-loss surgery patients who, due to their BMI and overall poor health, never thought that parenthood would be possible for them. Proving to them that the seemingly-impossible really is possible continues to be one of my greatest joys as a surgeon.