RESUMO
Aim: Leptin is thought to play a role in the neuroendocrine regulation of reproduction. The aim of this study was to assess the effects of obesity on the level of leptin, gonadotrophic hormones and testosterone [T] and consequently its probable fertility problems in male individuals. Subjects and Fourty obese married men were selected from the andrology clinic of the Damanhour Medical National Institute [DMNI] and were divided into two groups. Group I included 20 infertile patients. Group II included 20 fertile subjects. All men had normal growth of their genitalia and had no evidence of endocrine disease. They were subjected to estimation of body mass index [BMI], percent body fat, waist to hip ratio as indicators of the obesity state. Semen analysis and serum level of leptin, follicle - stimulating hormone [FSH], luteinizing hormone [LH], prolactin [PRL], and testosterone were performed in all subjects. Infertile patients were followed for one year with moderate dietary restriction and exercise. At the end of the study, the previous investigations were repeated with recording of pregnancy occurrence. Mean serum levels of LH and FSH were significantly lower in group I than in group II subjects. Indices of obesity showed a positive significant correlation with the duration of infertility as well as a negative correlation with serum LH in group I and T in group II subjects. Serum leptin showed a significant direct correlation with waist to hip ratio. At the end of the follow up period, obesity indices and mean serum leptin significantly decreased, while sperm density and motility, mean serum FSH, LH, and T significantly increased. The seven subjects who had their first pregnancy during this period had significantly lower body obesity indices with higher sperm density and LH values when compared with those who were still infertile. Conclusions: These results prove that obesity may represent an actual threat to male fertility causing decrease in sperm density, motility and gonadotrophin with hyperleptinemia. These effects are readily reversible and can be corrected with weight reduction