Obesity has been shown to adversely affect male fertility, by reducing spermatogenesis. There are several aetiological theories including endocrine abnormalities, genetic, sexual dysfunction and testicular hyperthermia. Of these, endocrine abnormalities are likely to be the most important, involving increased oestrogen and increased insulin resistance, reduced androgens and reduced inhibin B levels. Possible management options include weight reduction by dieting or surgery and medical treatment to correct specific endocrine abnormalities, but as yet none has been proven to be effective.
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