Improvements in Sperm Motility Following Low- or High-Intensity Dietary Interventions in Men With Obesity

Introduction: Obesity increases risks of male infertility, but bariatric surgery does not improve semen quality. Recent uncontrolled studies suggest that a low-energy diet (LED) improves semen quality. Further evaluation within a randomized, controlled setting is warranted. Methods: Men with obesity (18-60 years) with normal sperm concentration (normal count) (n = 24) or oligozoospermia (n = 43) were randomized 1:1 to either 800 kcal/day LED for 16 weeks or control, brief dietary intervention (BDI) with 16 weeks' observation. Semen parameters were compared at baseline and 16 weeks. Results: Mean age of men with normal count was 39.4 +/- 6.4 in BDI and 40.2 +/- 9.6 years in the LED group. Mean age of men with oligozoospermia was 39.5 +/- 7.5 in BDI and 37.7 +/- 6.6 years in the LED group. LED caused more weight loss than BDI in men with normal count (14.4 vs 6.3 kg; P <.001) and men with oligozoospermia (17.6 vs 1.8 kg; P <.001). Compared with baseline, in men with normal count total motility (TM) increased 48 +/- 17% to 60 +/- 10% (P <.05) after LED, and 52 +/- 8% to 61 +/- 6% (P <.0001) after BDI; progressive motility (PM) increased 41 +/- 16% to 53 +/- 10% (P <.05) after LED, and 45 +/- 8% to 54 +/- 65% (P <.001) after BDI. In men with oligozoospermia compared with baseline, TM increased 35% [26] to 52% [16] (P <.05) after LED, and 43% [28] to 50% [23] (P =.0587) after BDI; PM increased 29% [23] to 46% [18] (P <.05) after LED, and 33% [25] to 44% [25] (P <.05) after BDI. No differences in postintervention TM or PM were observed between LED and BDI groups in men with normal count or oligozoospermia. Conclusion: LED or BDI may be sufficient to improve sperm motility in men with obesity. The effects of paternal dietary intervention on fertility outcomes requires investigation.