THE WEIGHT OF FERTILITY: A COMPREHENSIVE STUDY ON THE IMPACT OF OVERWEIGHT AND OBESITY ON MALE RE-PRODUCTIVE HORMONES AND SPERM QUALITY
Main Article Content
Keywords
overweight, obesity, male fertility, sperm counts, reproductive hormones, sperm DNA integrity, systematic review, meta-analysis, etc
Abstract
This research paper investigates the relationship between overweight and obesity and male fertility parameters, including sperm counts, reproductive hormone levels, sperm DNA integrity, and various biochemical markers of metabolic health. We examine the associations between obesity-related factors and male fertility outcomes, including lipid profile (total cholesterol, LDL, HDL, triglycerides), glucose metabolism (fasting glucose, insulin sensitivity), inflammatory markers (CRP, IL-6), hormones (TSH, FT4, FT3, prolactin, inhibin B), and oxidative stress markers (MDA, TAC). Our findings suggest that excess body weight is associated with alterations in these biochemical parameters, which may contribute to the decline in male fertility outcomes. The results of this study provide a comprehensive understanding of the impact of overweight and obesity on male reproductive health and may inform clinical practice and public health interventions aimed at addressing fertility issues in overweight and obese men.
References
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5. Thomas RL, Halim S, Gurudas S, Sivaprasad S, Owens DR. IDF Diabetes Atlas: A review of studies utilising retinal photography on the global prevalence of diabetes related retinopathy between 2015 and 2018. Diab Res Clin Practice. 2019;157:107840.
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8. Taha EA, Sayed SK, Gaber HD, Abdel Hafez HK, Ghandour N, Zahran A, Mostafa T. Does being overweight affect seminal variables in fertile men? Reprod Biomed Online. 2016;33(6):703–8.
9. Keskin MZ, Budak S, Zeyrek T, Çelik O, Mertoglu O, Yoldas M, Ilbey Y. The relationship between serum hormone levels (follicle-stimulating hormone, luteinizing hormone, total tes-tosterone) and semen parameters. Arch Ital Urol Androl. 2015;87(3):194–7.
10. Salgado L, Lavoie HB, Godbout A. Successful pregnancies after spermatogenesis induction with letrozole in men with obesity-related hypogonadotropic hypogonadism. Endocrine Rev. 2015;36:9.
11. Rybar R, Kopecka V, Prinosilova P, Markova P, Rubes J. Male obesity and age in relationship to semen parameters and sperm chromatin integrity. Andrologia. 2011;43(4):286–91.
12. Baccetti B, La Marca A, Piomboni P, Capitani S, Bruni E, Petraglia F, De Leo V. Insulin-dependent diabetes in men is associated with hypothalamo-pituitary derangement and with impairment in semen quality. Hum Reprod. 2002;17(10):2673–7.
13. Keskin MZ, Budak S, Aksoy EE, Yücel C, Karamazak S, Ilbey YO, Kozacıoğlu Z. Investiga-tion of the effect of body mass index (BMI) on semen parameters and male reproductive sys-tem hormones. Arch Ital Urol Androl. 2017;89(3):219–21.
14. Ghasemi H, Karimi J, Goodarzi MT, Khodadadi I, Tavilani H, Moridi H, Kheiripour N. Semi-nal plasma zinc and magnesium levels and their relation to spermatozoa parameters in semen of diabetic men. Int J Diab Devel Ctries. 2016;36(1):34–9.
15. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.
16. Crujeiras AB, Casanueva FF. Obesity and the reproductive system disorders: epigenetics as a potential bridge. Hum Reprod Update. 2015;21(2):249–61.
17. Engin-Ustun Y, Yılmaz N, Akgun N, Aktulay A, Tuzluoğlu AD, Bakırarar B. Body Mass In-dex Effects Kruger’s Criteria in Infertile Men. Int J Fertility Sterility. 2018;11(4):258–62.
18. de Castro Barbosa T, Ingerslev LR, Alm PS, Versteyhe S, Massart J, Rasmussen M, Donkin I, Sjögren R, Mudry JM, Vetterli L, et al. High-fat diet reprograms the epigenome of rat sperma-tozoa and transgenerationally affects metabolism of the offspring. Mol Metab. 2015;5(3):184–97.
19. Hart RJ, Doherty DA, McLachlan RI, Walls ML, Keelan JA, Dickinson JE, Skakkebaek NE, Norman RJ, Handelsman DJ. Testicular function in a birth cohort of young men. Hum Reprod. 2015;30(12):2713–24.
20. Fui MN, Dupuis P, Grossmann M. Lowered testosterone in male obesity: mechanisms, morbid-ity and management. Asian J Androl. 2014;16(2):223–31.
21. Yaeram J, Setchell BP, Maddocks S. Effect of heat stress on the fertility of male mice in vivo and in vitro. Reprod Fertil Dev. 2006;18(6):647–53.
22. Abbasihormozi SH, Babapour V, Kouhkan A, Niasari Naslji A, Afraz K, Zolfaghary Z, Shah-verdi AH. Stress hormone and oxidative stress biomarkers link obesity and diabetes with re-duced fertility potential. Cell J. 2019;21(3):307–13.
23. Sexton WJ, Jarow JP. Effect of diabetes mellitus upon male reproductive function. Urology. 1997;49(4):508–13.
24. Schlatt S, Weinbauer GF. Immunohistochemical localization of proliferating cell nuclear an-tigen as a tool to study cell proliferation in rodent and primate testes. Int J Androl. 1994;17(4):214–22.
25. Salama M, Tsuji M, Tamura M, Kagawa S. Impact of aging and diabetes mellitus on the ex-pression of the proliferating cell nuclear antigen in rat testicular tissue. Arch Androl. 1998;40(2):95–107.
26. Cameron DF, Rountree J, Schultz RE, Repetta D, Murray FT. Sustained hyperglycemia results in testicular dysfunction and reduced fertility potential in BBWOR diabetic rats. Am J Phys-iol.
27. Murray FT, Cameron DF, Orth JM. Gonadal dysfunction in the spontaneously diabetic BB rat. Metab Clin Exp. 1983;32(7 Suppl 1):141–7.
28. Handelsman DJ, Conway AJ, Boylan LM. Testicular function and glycemic control in diabetic men. A controlled study. Andrologia. 1985;17(5):488–96.
29. Pergialiotis V, Prodromidou A, Frountzas M, Korou LM, Vlachos GD, Perrea D. Diabetes mellitus and functional sperm characteristics: A meta-analysis of observational studies. J Dia-betes Complicat. 2016;30(6):1167–76.
30. Sermondade N, Faure C, Fezeu L, Shayeb AG, Bonde JP, Jensen TK, Van Wely M, Cao J, Martini AC, Eskandar M, et al. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Human Reprod update. 2013;19(3):221–31.
31. Wang S, Sun J, Wang J, Ping Z, Liu L. Does obesity based on body mass index affect semen quality?-A meta-analysis and systematic review from the general population rather than the infertile population. Andrologia. 2021;53(7):e14099.
32. Salas-Huetos A, James ER, Broberg DS, Aston KI, Carrell DT, Jenkins TG. The combined ef-fect of obesity and aging on human sperm DNA methylation signatures: inclusion of BMI in the paternal germ line age prediction model. Sci Rep. 2020;10(1):15409.
33. Pini T, Parks J, Russ J, Dzieciatkowska M, Hansen KC, Schoolcraft WB, Katz-Jaffe M. Obesi-ty significantly alters the human sperm proteome, with potential implications for fertility. J Assist Reprod Genet. 2020;37(4):777–87.
34. Chen YA, Chang HC, Liao CH. The impact of obesity on serum testosterone levels and semen quality in a population of infertile men. Urol Sci. 2019;30(3):118–23.
35. Taha EA, Algahny Algahlan HA, Zidan M, Abdelhafez A, Farag FF. Scrotal ultrasonographic findings in obese infertile patients and their correlations to semen and hormonal profile. Turk-ish J Urol. 2019;45(1):7–11.
36. Ferigolo PC, Ribeiro de Andrade MB, Camargo M, Carvalho VM, Cardozo KHM, Bertolla RP, Fraietta R. Sperm functional aspects and enriched proteomic pathways of seminal plasma of adult men with obesity. Andrology. 2019;7(3):341–9.
37. Calderón B, Huerta L, Casado ME, González-Casbas JM, Botella-Carretero JI, Martín-Hidalgo A. Morbid obesity–related changes in the expression of lipid receptors, transporters, and HSL in human sperm. J Assist Reprod Genet. 2019;36(4):777–86.
38. Qi YN, Ma J, Han RY, Liu WJ, Wang SS. [Correlation of the levels of seminal plasma homo-cysteine, folate and cobalamin with semen parameters in obese men]. Zhonghua Nan Ke Xue. 2018;24(10):883–6.
39. Ramaraju GA, Teppala S, Prathigudupu K, Kalagara M, Thota S, Kota M, Cheemakurthi R. Association between obesity and sperm quality. Andrologia. 2018;50:3.
40. Oliveira JBA, Petersen CG, Mauri AL, Vagnini LD, Renzi A, Oliveira-Pelegrin GR, Nicoletti A, Cavagna M, Dieamant F, Baruffi RLR, et al. Association between body mass index (BMI) and sperm quality or sperm DNA integrity. A large population study. Hum Reprod. 2017;31:i79–80.
41. Wang EY, Huang Y, Du QY, Yao GD, Sun YP. Body mass index effects sperm quality: a ret-rospective study in Northern China. Asian J Androl. 2017;19(2):234–7.
42. Luque EM, Tissera A, Gaggino MP, Molina RI, Mangeaud A, Vincenti LM, Beltramone F, Larcher JS, Estofán D, Cuneo M, et al. Body mass index and human sperm quality: neither one extreme nor the other. Reprod Fertility Develop. 2017;29(4):731–9.
43. Alshahrani S, Ahmed AF, Gabr AH, Abalhassan M, Ahmad G. The impact of body mass index on semen parameters in infertile men. Andrologia. 2016;48(10):1125–9.
44. Garolla A, Torino M, Miola P, Caretta N, Pizzol D, Menegazzo M, Bertoldo A, Foresta C. Twenty-four-hour monitoring of scrotal temperature in obese men and men with a varicocele as a
45. Samavat J, Natali I, Degl’Innocenti S, Filimberti E, Cantini G, Di Franco A, Danza G, Seghie-ri G, Lucchese M, Baldi E, et al. Acrosome reaction is impaired in spermatozoa of obese men: a preliminary study. Fertil Steril. 2014;102(5):1274–81.e1272.
46. Shuangyong B, Jiansong W, Qinghua Z. Correlation of body mass index, free fatty acid and inhibin B in seminal plasma with seminal parameter of infertile male. Chin J Androl. 2014;28(8):22–6.
47. Leisegang K, Bouic PJ, Menkveld R, Henkel RR. Obesity is associated with increased seminal insulin and leptin alongside reduced fertility parameters in a controlled male cohort. Reprod Biol Endocrinol. 2014;12:34.
48. Belloc S, Cohen-Bacrie M, Amar E, Izard V, Benkhalifa M, Dalléac A, de Mouzon J. High body mass index has a deleterious effect on semen parameters except morphology: results from a large cohort study. Fertil Steril. 2014;102(5):1268–73.
49. La Vignera S, Condorelli RA, Vicari E, Calogero AE. Negative effect of increased body weight on sperm conventional and nonconventional flow cytometric sperm parameters. J An-drol. 2012;33(1):53–8.
50. Fariello RM, Pariz JR, Spaine DM, Cedenho AP, Bertolla RP, Fraietta R. Association between obesity and alteration of sperm DNA integrity and mitochondrial activity. BJU Int. 2012;110(6):863–7.
2. Oztekin U, Caniklioglu M, Sari S, Gurel A, Selmi V, Isikay L. The impact of body mass index on reproductive hormones, testosterone/estradiol ratio and semen parameters. Central Eur J Urol. 2020;73(2):226–30.
3. Liu Y, Ding Z. Obesity, a serious etiologic factor for male subfertility in modern society. Re-production. 2017;154(4):R123-r131.
4. Agbaje IM, Rogers DA, McVicar CM, McClure N, Atkinson AB, Mallidis C, Lewis SE. Insu-lin dependant diabetes mellitus: implications for male reproductive function. Hum Reprod. 2007;22(7):1871–7.
5. Thomas RL, Halim S, Gurudas S, Sivaprasad S, Owens DR. IDF Diabetes Atlas: A review of studies utilising retinal photography on the global prevalence of diabetes related retinopathy between 2015 and 2018. Diab Res Clin Practice. 2019;157:107840.
6. Williams R, Karuranga S, Malanda B, Saeedi P, Basit A, Besançon S, Bommer C, Esteghama-ti A, Ogurtsova K, Zhang P, et al. Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diab Res Clin Practice. 2020;162:108072.
7. Karimi J, Goodarzi MT, Tavilani H, Khodadadi I, Amiri I. Increased receptor for advanced glycation end products in spermatozoa of diabetic men and its association with sperm nuclear DNA fragmentation. Andrologia. 2012;44(Suppl 1):280–6.
8. Taha EA, Sayed SK, Gaber HD, Abdel Hafez HK, Ghandour N, Zahran A, Mostafa T. Does being overweight affect seminal variables in fertile men? Reprod Biomed Online. 2016;33(6):703–8.
9. Keskin MZ, Budak S, Zeyrek T, Çelik O, Mertoglu O, Yoldas M, Ilbey Y. The relationship between serum hormone levels (follicle-stimulating hormone, luteinizing hormone, total tes-tosterone) and semen parameters. Arch Ital Urol Androl. 2015;87(3):194–7.
10. Salgado L, Lavoie HB, Godbout A. Successful pregnancies after spermatogenesis induction with letrozole in men with obesity-related hypogonadotropic hypogonadism. Endocrine Rev. 2015;36:9.
11. Rybar R, Kopecka V, Prinosilova P, Markova P, Rubes J. Male obesity and age in relationship to semen parameters and sperm chromatin integrity. Andrologia. 2011;43(4):286–91.
12. Baccetti B, La Marca A, Piomboni P, Capitani S, Bruni E, Petraglia F, De Leo V. Insulin-dependent diabetes in men is associated with hypothalamo-pituitary derangement and with impairment in semen quality. Hum Reprod. 2002;17(10):2673–7.
13. Keskin MZ, Budak S, Aksoy EE, Yücel C, Karamazak S, Ilbey YO, Kozacıoğlu Z. Investiga-tion of the effect of body mass index (BMI) on semen parameters and male reproductive sys-tem hormones. Arch Ital Urol Androl. 2017;89(3):219–21.
14. Ghasemi H, Karimi J, Goodarzi MT, Khodadadi I, Tavilani H, Moridi H, Kheiripour N. Semi-nal plasma zinc and magnesium levels and their relation to spermatozoa parameters in semen of diabetic men. Int J Diab Devel Ctries. 2016;36(1):34–9.
15. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.
16. Crujeiras AB, Casanueva FF. Obesity and the reproductive system disorders: epigenetics as a potential bridge. Hum Reprod Update. 2015;21(2):249–61.
17. Engin-Ustun Y, Yılmaz N, Akgun N, Aktulay A, Tuzluoğlu AD, Bakırarar B. Body Mass In-dex Effects Kruger’s Criteria in Infertile Men. Int J Fertility Sterility. 2018;11(4):258–62.
18. de Castro Barbosa T, Ingerslev LR, Alm PS, Versteyhe S, Massart J, Rasmussen M, Donkin I, Sjögren R, Mudry JM, Vetterli L, et al. High-fat diet reprograms the epigenome of rat sperma-tozoa and transgenerationally affects metabolism of the offspring. Mol Metab. 2015;5(3):184–97.
19. Hart RJ, Doherty DA, McLachlan RI, Walls ML, Keelan JA, Dickinson JE, Skakkebaek NE, Norman RJ, Handelsman DJ. Testicular function in a birth cohort of young men. Hum Reprod. 2015;30(12):2713–24.
20. Fui MN, Dupuis P, Grossmann M. Lowered testosterone in male obesity: mechanisms, morbid-ity and management. Asian J Androl. 2014;16(2):223–31.
21. Yaeram J, Setchell BP, Maddocks S. Effect of heat stress on the fertility of male mice in vivo and in vitro. Reprod Fertil Dev. 2006;18(6):647–53.
22. Abbasihormozi SH, Babapour V, Kouhkan A, Niasari Naslji A, Afraz K, Zolfaghary Z, Shah-verdi AH. Stress hormone and oxidative stress biomarkers link obesity and diabetes with re-duced fertility potential. Cell J. 2019;21(3):307–13.
23. Sexton WJ, Jarow JP. Effect of diabetes mellitus upon male reproductive function. Urology. 1997;49(4):508–13.
24. Schlatt S, Weinbauer GF. Immunohistochemical localization of proliferating cell nuclear an-tigen as a tool to study cell proliferation in rodent and primate testes. Int J Androl. 1994;17(4):214–22.
25. Salama M, Tsuji M, Tamura M, Kagawa S. Impact of aging and diabetes mellitus on the ex-pression of the proliferating cell nuclear antigen in rat testicular tissue. Arch Androl. 1998;40(2):95–107.
26. Cameron DF, Rountree J, Schultz RE, Repetta D, Murray FT. Sustained hyperglycemia results in testicular dysfunction and reduced fertility potential in BBWOR diabetic rats. Am J Phys-iol.
27. Murray FT, Cameron DF, Orth JM. Gonadal dysfunction in the spontaneously diabetic BB rat. Metab Clin Exp. 1983;32(7 Suppl 1):141–7.
28. Handelsman DJ, Conway AJ, Boylan LM. Testicular function and glycemic control in diabetic men. A controlled study. Andrologia. 1985;17(5):488–96.
29. Pergialiotis V, Prodromidou A, Frountzas M, Korou LM, Vlachos GD, Perrea D. Diabetes mellitus and functional sperm characteristics: A meta-analysis of observational studies. J Dia-betes Complicat. 2016;30(6):1167–76.
30. Sermondade N, Faure C, Fezeu L, Shayeb AG, Bonde JP, Jensen TK, Van Wely M, Cao J, Martini AC, Eskandar M, et al. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Human Reprod update. 2013;19(3):221–31.
31. Wang S, Sun J, Wang J, Ping Z, Liu L. Does obesity based on body mass index affect semen quality?-A meta-analysis and systematic review from the general population rather than the infertile population. Andrologia. 2021;53(7):e14099.
32. Salas-Huetos A, James ER, Broberg DS, Aston KI, Carrell DT, Jenkins TG. The combined ef-fect of obesity and aging on human sperm DNA methylation signatures: inclusion of BMI in the paternal germ line age prediction model. Sci Rep. 2020;10(1):15409.
33. Pini T, Parks J, Russ J, Dzieciatkowska M, Hansen KC, Schoolcraft WB, Katz-Jaffe M. Obesi-ty significantly alters the human sperm proteome, with potential implications for fertility. J Assist Reprod Genet. 2020;37(4):777–87.
34. Chen YA, Chang HC, Liao CH. The impact of obesity on serum testosterone levels and semen quality in a population of infertile men. Urol Sci. 2019;30(3):118–23.
35. Taha EA, Algahny Algahlan HA, Zidan M, Abdelhafez A, Farag FF. Scrotal ultrasonographic findings in obese infertile patients and their correlations to semen and hormonal profile. Turk-ish J Urol. 2019;45(1):7–11.
36. Ferigolo PC, Ribeiro de Andrade MB, Camargo M, Carvalho VM, Cardozo KHM, Bertolla RP, Fraietta R. Sperm functional aspects and enriched proteomic pathways of seminal plasma of adult men with obesity. Andrology. 2019;7(3):341–9.
37. Calderón B, Huerta L, Casado ME, González-Casbas JM, Botella-Carretero JI, Martín-Hidalgo A. Morbid obesity–related changes in the expression of lipid receptors, transporters, and HSL in human sperm. J Assist Reprod Genet. 2019;36(4):777–86.
38. Qi YN, Ma J, Han RY, Liu WJ, Wang SS. [Correlation of the levels of seminal plasma homo-cysteine, folate and cobalamin with semen parameters in obese men]. Zhonghua Nan Ke Xue. 2018;24(10):883–6.
39. Ramaraju GA, Teppala S, Prathigudupu K, Kalagara M, Thota S, Kota M, Cheemakurthi R. Association between obesity and sperm quality. Andrologia. 2018;50:3.
40. Oliveira JBA, Petersen CG, Mauri AL, Vagnini LD, Renzi A, Oliveira-Pelegrin GR, Nicoletti A, Cavagna M, Dieamant F, Baruffi RLR, et al. Association between body mass index (BMI) and sperm quality or sperm DNA integrity. A large population study. Hum Reprod. 2017;31:i79–80.
41. Wang EY, Huang Y, Du QY, Yao GD, Sun YP. Body mass index effects sperm quality: a ret-rospective study in Northern China. Asian J Androl. 2017;19(2):234–7.
42. Luque EM, Tissera A, Gaggino MP, Molina RI, Mangeaud A, Vincenti LM, Beltramone F, Larcher JS, Estofán D, Cuneo M, et al. Body mass index and human sperm quality: neither one extreme nor the other. Reprod Fertility Develop. 2017;29(4):731–9.
43. Alshahrani S, Ahmed AF, Gabr AH, Abalhassan M, Ahmad G. The impact of body mass index on semen parameters in infertile men. Andrologia. 2016;48(10):1125–9.
44. Garolla A, Torino M, Miola P, Caretta N, Pizzol D, Menegazzo M, Bertoldo A, Foresta C. Twenty-four-hour monitoring of scrotal temperature in obese men and men with a varicocele as a
45. Samavat J, Natali I, Degl’Innocenti S, Filimberti E, Cantini G, Di Franco A, Danza G, Seghie-ri G, Lucchese M, Baldi E, et al. Acrosome reaction is impaired in spermatozoa of obese men: a preliminary study. Fertil Steril. 2014;102(5):1274–81.e1272.
46. Shuangyong B, Jiansong W, Qinghua Z. Correlation of body mass index, free fatty acid and inhibin B in seminal plasma with seminal parameter of infertile male. Chin J Androl. 2014;28(8):22–6.
47. Leisegang K, Bouic PJ, Menkveld R, Henkel RR. Obesity is associated with increased seminal insulin and leptin alongside reduced fertility parameters in a controlled male cohort. Reprod Biol Endocrinol. 2014;12:34.
48. Belloc S, Cohen-Bacrie M, Amar E, Izard V, Benkhalifa M, Dalléac A, de Mouzon J. High body mass index has a deleterious effect on semen parameters except morphology: results from a large cohort study. Fertil Steril. 2014;102(5):1268–73.
49. La Vignera S, Condorelli RA, Vicari E, Calogero AE. Negative effect of increased body weight on sperm conventional and nonconventional flow cytometric sperm parameters. J An-drol. 2012;33(1):53–8.
50. Fariello RM, Pariz JR, Spaine DM, Cedenho AP, Bertolla RP, Fraietta R. Association between obesity and alteration of sperm DNA integrity and mitochondrial activity. BJU Int. 2012;110(6):863–7.
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Jun 24, 2024
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Sanjay Yatnale, Dr. Nita Sahi, Pooja Awasthi, & Dr. Pankaj Kaingade. (2024). THE WEIGHT OF FERTILITY: A COMPREHENSIVE STUDY ON THE IMPACT OF OVERWEIGHT AND OBESITY ON MALE RE-PRODUCTIVE HORMONES AND SPERM QUALITY. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 3128-3139. https://doi.org/10.53555/jptcp.v31i6.7291
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Author Biographies
Sanjay Yatnale
Ph.D. Research Scholar, Department of Biochemistry, Pacific Medical College and
Hospital,PMU,Udaipur, Rajasthan, India
Dr. Nita Sahi
Professor and Head of Department of Biochemistry, Pacific Medical College and
Hospital,PMU,Udaipur, Rajasthan, India
Pooja Awasthi
Ph.D. Research Scholar, Department of Biochemistry, Pacific Medical College and
Hospital,PMU,Udaipur, Rajasthan, India
Dr. Pankaj Kaingade
Scientific Director, Department of Research, ReproHelix Labs, Kolhapur, Maharashtra, India
How to Cite
Sanjay Yatnale, Dr. Nita Sahi, Pooja Awasthi, & Dr. Pankaj Kaingade. (2024). THE WEIGHT OF FERTILITY: A COMPREHENSIVE STUDY ON THE IMPACT OF OVERWEIGHT AND OBESITY ON MALE RE-PRODUCTIVE HORMONES AND SPERM QUALITY. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 3128-3139. https://doi.org/10.53555/jptcp.v31i6.7291