Myth and Facts of Sperm DNA Fragmentation in Assisted Reproduction

Obesity is seen as a global health issue affecting more than onethirdof the world's population. Cardiovascular disorders, type۲ diabetes, cancer (including pros tate cancer), neurodegeneration,and accelerated aging are complications of obesity. Also,erectile dysfunction, poor sperm quality, and subclinical pros tatitisin males are the other common complications of male obesity.Important mediators of obesity that may alter the male reproductivesys tem include hyperinsulinemia, hyperleptinemia,chronic inflammation, and oxidative s tress while being littleunders tood. Obesity is known to impair male fertility and reproductivepotential, specifically by altering the hypothalamic-pituitary-gonadal axis, disrupting tes ticular s teroidogenesis, andcausing metabolic dysregulation, including insulin, cytokines,and adipokines. Importantly, obesity and its underlying mediatorshave a deleterious effect on sperm concentration, motility,viability, and normal morphology. Furthermore, obesity impairschromatin condensation, DNA fragmentation, and promotes apoptosisand heritable epigenetic alterations. This presentationexamines the effects of obesity on the male reproductive sys temand fertility, as well as the mechanisms involved. In addition,ART outcomes of obese men, s trategies for weight management,changes in lifes tyle, prescription medications, and complementaryand alternative medicine for the treatment of subfertilitycaused by obesity are discussed.