None listed
Conditions
Brief summary
Obesity is a global health problem that is reaching epidemic proportions. Since the 1970’s the rates of overweight and obesity in reproductive-age men has nearly tripled such that 70% of Australian adult men (>18 years) are now overweight or obese. Male obesity alters the physical and molecular structure of sperm which both reduces fertility and increases obesity risk of the next generation. There is emerging evidence from work in mice that that these effects might be reversible for example in response to an antioxidant rich high quality diet and diet and exercise but also that some interventions, for example weight loss with a nutritionally insufficient diet, may be deleterious. Bariatric surgery is increasingly used to treat obesity. The 2 most commonly used procedures: sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), differ in regards to the magnitude of weight loss, resolution of co-morbidities and impacts on nutrient intake and absorption. For example RYGB is associated more immediate and more patients with resolution of type II diabetes and control of metabolic syndrome with a greater reduction in triglyceride levels, greater improvements to LDL levels and lower HOMA index compared with SG. Poor diet quality is a common outcome after SG as patients experience difficulties in eating certain foods which may contribute to these reduced outcomes. In terms of fertility, following RYGB, hormone profiles (testosterone, inhibin B, SHBG and estrogens) and erectile dysfunction improve in obese men. However less is known about the effects of SG. The effects of surgical weight loss procedures on sperm structure and function really remain unclear, and it cannot be assumed that these procedures necessarily result in beneficial or even similar effects on reproductive potential and outcomes. Therefore, we aim to determine the effect of these procedures (SG and RYGB) on the structure and function of sperm.
Interventions
Male patients undergoing bariatric surgery (sleeve gastrectomy [SG], Roux-en-Y gastric bypass [RYGB]) will be recruited to be apart of the non-randomized parallel arm within-subject design study. Semen and blood samples will be collected at 4 collection times from each participant over the study procedure;
1) Baseline to establish initial assessment of sperm quality and reproductive characteristics in each participant.
2) Prior to surgery and after heavy caloric restriction.
3) Initial weight lo
Male patients undergoing bariatric surgery (sleeve gastrectomy [SG], Roux-en-Y gastric bypass [RYGB]) will be recruited to be apart of the non-randomized parallel arm within-subject design study. Semen and blood samples will be collected at 4 collection times from each participant over the study procedure; 1) Baseline to establish initial assessment of sperm quality and reproductive characteristics in each participant. 2) Prior to surgery and after heavy caloric restriction. 3) Initial weight loss (6 months post-surgery). 4) Stabilisation of weight loss (12 months post-surgery).
Sponsors
Robinson Research Institute, University of Adelaide
Eligibility
Sex/Gender
Male
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
Inclusion Criteria (1) BMI >30 kg/m2 and a waist circumferences of >102cm. These are the current standard criteria for categorising obesity. A number of studies assessing male obesity and fertility have used waist circumference in conjunction with BMI, as waist circumference in humans has been determined to be a better indicator for cardio metabolic disease risk. (2) Males aged 18-40years. ROS the primary outcome is not altered in this age range. There are also little reported changes to other sperm parameters to be measured in this age range. (3) At recruitment, patient is on a participating clinic’s waiting list to undergo a first-time SG, ABG or RYGB. To ensure participants in the study are not having a revision or conversion which may confound results.
Exclusion criteria
Exclusion Criteria (known con-founders) (1) Males who have had vasectomies or vasectomy reversals. (2) Males with un-descendent testes, suspected pathologies related to fertility (i.e. varicoceles) or known genetic disorders that effect weight and fertility (i.e. Klinefelter's Syndrome, Prader-Willi or Larence-Moon-Bardet-Biedel). (3) Males diagnosed with azoospermia at initial assessment. During the study period any results with implications for future or current fertility or for general wellbeing will be noted, and results will be sent to participant’s general practitioners, with the option for participants to be referred to fertility specialists.
Outcome results
None listed