Prevalence of poor semen parameters in men with metabolic syndrome
Dr Sathya Balasubramanyam
Senior Consultant, Institute of Reproductive
Medicine and Women’s Health,
Madras Medical Mission, Chennai , India
declining trend in semen parameters
among fertile men in the last 20 years has
been described.(Jouannet et al N Engl J Med
Whether male infertility is actually
increasing has still not been clearly
changes have been associated with
male infertility- eg. smoking, sedentary
population-based studies suggest an
elevated risk for subfertility among couples
in which the male partner is obese and an
increased likelihood of abnormal semen
parameters among heavier men.
Steril. Hammoud et.al Oct 2008.
metabolic syndrome is a cluster of the
most dangerous heart attack risk factors:
diabetes and prediabetes, abdominal obesity,
high cholesterol and high blood pressure.
A quarter of the world’s adults have
People with metabolic syndrome are twice as
likely to die from, and three times as likely
to have a heart attack or stroke compared
with people without the syndrome.
with metabolic syndrome have a fivefold greater risk of developing type 2
puts metabolic syndrome and diabetes
way ahead of HIV/AIDS in morbidity and
mortality terms yet the problem is not as
to assess the prevalence of metabolic
syndrome in men with normal and abnormal
Setting: Institute of Reproductive Medicine.
Materials and Methods: 748 men underwent
semen analysis in the infertility clinic from
Aug 2009 till March 2010.
We have complete data to diagnose
Metabolic syndrome in 526 men.
The men were assessed for the following
parameters to diagnose metabolic syndrome
Fasting Blood Sugar,
HDL and Triglycerides.
All of them underwent a Semen analysis in
the same andrology lab.
concentration, total motility and
morphology were assessed –
age of men in our study was 34.3±3.4
Proportion of abnormal semen parameters
in men attending our infertility clinic was
Number of men with metabolic syndrome
was 136 (26.5 %).
Prevalence of Metabolic syndrome in men in
Sample size based on prevalence-248
of men with metabolic syndrome and
normal sperm parameters-79/285(27.7%)
Number of men with metabolic syndrome and
abnormal sperm parameters-57/241(23.2%)
Chi square test showed that the difference
was not statistically significant P=0.16
of men with BMI>30 was
42/84 had abnormal semen parameters
Proportion of non obese men with abnormal
semen parameters 199/442(45.02%)
Chi square test P=0.36
of men with BMI>35=13, all 13 had
abnormal semen parameters.
men had high abnormal waist circumference
(15%). Population prevalence 20.8%.
46/241had waist >102cm and abnormal sperm
32/285 had waist>102 cm and normal sperm
men had high fasting blood sugars (15.6%).
Population prevalence 18.2%.
men had high fasting sugars and abnormal sperm
men had high fasting sugars and normal sperm
men had abnormal triglyceride levels
(47.3%). Population prevalence 32%.
105 men with high triglycerides had abnormal
144 men with high triglycerides had normal sperm
men had low HDL levels
(70.9%).Population prevalence is 54.9%.
men had low HDL levels and abnormal
men had low HDL levels and normal
BP>130/85(26.2%).Population prevalence 35%
men with high blood pressure had
abnormal semen analysis 29.4%.
men had high blood pressure and normal
sperm parameters 23.5%
was found to be unrelated to sperm
concentration, motility and morphology by
Chavarro et al in their study on 483 male
partners of subfertile couples.(May 2010
Jensen et al found no dose response
relationship between BMI and sperm
concentration in their study 1158 young
Danish military recruits(Fertil Steril 2004;
et al found a statistically
significant negative correlation between
increasing BMI and sperm concentration in
men with normal sperm concentration(Hum
are conflicting reports on the effect of
BMI on sperm motility.
is no evidence currently of an effect of
increasing BMI and abnormal sperm
morphology.(Hammoud et al FertilSteril Oct
could not find any studies assessing the
effect of metabolic syndrome on sperm
parameters.( according to the latest WHO
our study, 26% of men had metabolic
syndrome was found to be higher than that in
the general population 18%.
prevalence of Metabolic syndrome was
not significantly different in those with
normal or abnormal semen parameters.
syndrome by itself does not appear
to increase the chances of a man having
abnormal sperm parameters.
in women, metabolic syndrome does
not appear to have a major effect on
fertility at least in the early stages.
studies are needed to see if
semen parameters tend to deteriorate over
time in men with metabolic syndrome.
not identified earlier on, morbid obesity
could lead on to abnormalities in the semen
Population based studies would give a more
accurate information on the effect of
metabolic syndrome in men with respect to
duration to conception.