Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2019
Changes in total sperm count after gastric bypass and sleeve gastrectomy: the BARIASPERM prospective study.
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Carette Claire, Levy Rachel, Eustache Florence, Baron Gabriel, Coupaye Muriel, Msika Simon, Barrat Christophe, Cohen Régis, Catheline Jean-Marc, Brugnon Florence, Slim Karem, Barsamian Charles, Chevallier Jean-Marc, Bretault Marion, Bouillot Jean-Luc, Antignac Jean-Philippe, Rives-Lange Claire, Ravaud Philippe, Czernichow Sébastien
Аннотация
BACKGROUND: The massive weight loss induced by bariatric surgery is associated with major benefits, but the effect on semen variables is still uncertain.
OBJECTIVES: To explore semen modifications with gastric bypass and sleeve gastrectomy.
SETTING: Five French University Hospitals.
METHODS: Male candidates for bariatric surgery with no history of infertility were recruited in this controlled prospective study. Sperm characteristics were collected before surgery and then 6 months and up to 12 months after surgery.
RESULTS: Forty-six adult men who underwent gastric bypass (n = 20) or sleeve gastrectomy (n = 26) were included. Total sperm count tended to be lower at 6 months and showed a significant decrease at 12 months in both surgery groups, at -69.5 million (-96.8 to -42.2 million; P = 0.0021). Total sperm count at 12 months relative to baseline was -41.4 million (P = .0391) after gastric bypass and -91.1 million (P = .0080) after sleeve gastrectomy. This was counterbalanced by an associated resolution of hypogonadism and decrease of DNA fragmentation in most patients with time after surgery.
CONCLUSION: Improvement in some semen variables after bariatric surgery observed in 3 previous studies is in contrast to the lower mean total sperm count found in this study at 1 year. The possible reversibility of this effect in the long term and the impact of surgery on fertility both remain unknown.
OBJECTIVES: To explore semen modifications with gastric bypass and sleeve gastrectomy.
SETTING: Five French University Hospitals.
METHODS: Male candidates for bariatric surgery with no history of infertility were recruited in this controlled prospective study. Sperm characteristics were collected before surgery and then 6 months and up to 12 months after surgery.
RESULTS: Forty-six adult men who underwent gastric bypass (n = 20) or sleeve gastrectomy (n = 26) were included. Total sperm count tended to be lower at 6 months and showed a significant decrease at 12 months in both surgery groups, at -69.5 million (-96.8 to -42.2 million; P = 0.0021). Total sperm count at 12 months relative to baseline was -41.4 million (P = .0391) after gastric bypass and -91.1 million (P = .0080) after sleeve gastrectomy. This was counterbalanced by an associated resolution of hypogonadism and decrease of DNA fragmentation in most patients with time after surgery.
CONCLUSION: Improvement in some semen variables after bariatric surgery observed in 3 previous studies is in contrast to the lower mean total sperm count found in this study at 1 year. The possible reversibility of this effect in the long term and the impact of surgery on fertility both remain unknown.