Impact of the metabolic syndrome on reproductive health in males of infertile couples [Tesi di dottorato]

AIM OF THE THESIS Since Metabolic Syndrome (MetS) is essentially based on increased adiposity and it is associated with male hypogonadism, erectile dysfunction, psychological disturbances, and BPH/LUTS, and all these factors might, in different ways, affect reproductive capacity, we investigated their possible correlations with MetS. Hence, we performed two studies. In the first study (study 1) we evaluated possible associations between MetS, semen and hormonal parameters, as well as clinical characteristics, including sexual, ultrasound and psychological characteristics, in a cohort of men with couple infertility. In the second study (study 2), we systematically investigated the possible associations between MetS and prostate-related symptoms and signs in a cohort of young men in infertile unions and tried to establish whether these associations correlate with fertility. Study 1 conclusions We report that an increasing number of MetS factors are dose-dependently associated with relevant organic (poor sperm quality, hypogonadism, ED) and psychological (depression, somatization) features that might affect reproductive outcomes of men seeking medical care for couple infertility. This might tailor ad hoc therapeutic intervention. Behavioural interventions targeting lifestyle factors, such as dietary practice and physical activity, might ameliorate not only metabolic and psychological parameters but also male infertility, as has been demonstrated for female infertility. Study 2 conclusions This study demonstrates that in a cohort of men with infertility, a component-dependent, stepwise association was observed between an increase in the number of MetS components and the total and transitional zone prostate enlargement and prostate related-inflammatory signs but not symptoms or current infection of the male genital tract, which suggests a sub-clinical inflammation of the prostate. Relative prostate overgrowth may also correlate with MetS-related hyperinsulinaemic state. In addition, MetS but not MetS’s related prostate CDU abnormalities was associated with poor sperm morphology. FINAL CONCLUSIONS In men with couple infertility, MetS is associated with hypogonadism, poor sperm morphology, testis ultrasound inhomogeneity, erectile dysfunction, somatization and depression. In addition, MetS is positively associated with prostate enlargement, biochemical (seminal interleukin 8) and ultrasound-derived signs of prostate inflammation but not with prostate-related symptoms, which suggests that MetS is a trigger for a subclinical, early-onset form of benign prostatic hyperplasia. Recognizing MetS could help patients to improve not only fertility but also sexual and overall health.

diritti: info:eu-repo/semantics/openAccess
In relazione con info:eu-repo/semantics/altIdentifier/hdl/2158/850825
Prof Mario Maggi

Tesi di dottorato. | Lingua: Inglese. | Paese: | BID: TD17038788