Journal of Research in Ecology ISSN No: Print: 2319 –1546; Online: 2319– 1554

An International Scientific Research Journal

Original Research

Study of the relationship between anthropometric indices and the status of

sperm in infertile men referred to IVF center of Fatemieh hospital,
Hamedan
Authors: ABSTRACT:
Journal of Research in Ecology

Zahra Seif1, Infertility is one of the most common problems in the present day society
Houshang Babolhavaeji2, that the stress arising from it reduces confidence, increases anxiety and, finally,
Alireza Bahmanabadi3 and decreases erectile dysfunction. Furthermore, having experienced the grief of not
Reza Goodarzi4 having children cause families to suffer from various physical and mental problems so
that the psychological pressures and nervous tensions associated with infertility is
Institution: devastating. Considering the importance of this issue, this study aimed to investigate
1. MSc in Nutrition,
the relationship between the anthropometric indices and the status of sperm in
Alimoradian Hospital of
Nahavand, Hamedan infertile men. 350 infertile men were participated in this cross-sectional study.
University of Medical Ensuring the absence of any other disease, demographic and anthropometric data
Sciences and Health (weight, height), body fat percentage, and sperm parameters were collected. In this
Services, Hamadan, Iran study, SPSS.16.5 software was used for statistical analysis. In order to compare
quantitative traits the Pearson correlation test was used. To compare quantitative
2. MD, PhD, Infertility traits, such as sperm, at different levels of BMI and/or body fat percentage, the
Center, Fatemieh Hospital, analysis of variance (ANOVA) and T- test were also used. In this study, no statistically
Hamadan University of significant relationship was observed between BMI and sperm parameters, but there
Medical Sciences and Health found relation between fat mass percentage and sperm count. It is necessary to
Services, Hamadan, Iran encourage them to do physical activity and use proper nutrition.

3. Agricultural Center for Keywords:

Information Science and Anthropometric, Body Mass Index (BMI), Sperm, Infertility
Technology, Tehran, Iran

4. MSc in nutrition, Imam

Hospital of Borujerd,
Lorestan University of
Medical Sciences and Health
Services, Borujerd, Iran

Corresponding author: Article Citation:

Reza Goodarzi Zahra Seif, Houshang Babolhavaeji, Alireza Bahmanabadi and Reza Goodarzi
Study of the relationship between anthropometric indices and the status of sperm in
infertile men referred to IVF center of Fatemieh hospital, Hamedan
Email ID: Journal of Research in Ecology (2017) 5(1):726-733

Dates:
Received: 19 Nov 2016 Accepted: 30 Nov 2016 Published: 02 Jun 2017

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Seif et al., 2017
INTRODUCTION In many studies, obese samples or those with
Infertility is one of the individual and social problems weight gain were reported as having normal semen
that can lead to the loss of stability of the family. Over quality. However, one must take into account that
the last decade, researchers found that at least one-third nutritional factors and lifestyle are associated with
of infertility problems are related to men and in 20% of obesity or weight gain. It is also noteworthy that the
the cases, the cause of infertility involves both male and reduction of normal morphology of sperm in men with a
female (Meybodi and Aflatounian, 1996). higher body mass index has also been observed
In 1998, a study was conducted to evaluate the (Magnusdottir et al., 2005; Macdonald et al., 2013;
primary infertility in Tehran. The general fertility rate MacDonald et al., 2010; Feldman et al., 2000). The
was reported to be 21.9% (Barooti, 1999). Another relationship between obesity and erectile dysfunction
study in 1999 was conducted on 1174 women in the has been frequently discussed. Accordingly, among
Western parts of Tehran, among which 12.7 of the par- those diagnosed and experiencing symptoms of erectile
ticipants were infertile patients. This study also revealed dysfunction, 79% were obese or had weight gain.
that 98 women (8.3%) had experienced primary infertil- The relationship between obesity and erectile
ity and 43 (3.7%) of them were experiencing secondary dysfunction is expressed, to some extent, by the
infertility (Nojoumi et al., 2002). The estimated infertil- increased levels of several pro-inflammatory cytokines
ity rate has been reported to be 9 - 22% in Iran (Rojouei, in obese people. Such markers of inflammation are
1997). positively associated with endothelial dysfunction,
In those suffering from infertility problems, the which acts directly with erectile dysfunction through
grief associated with not having a child leads to various nitric oxide (Sullivan et al., 1999). It is well known that
physical and mental problems. Thereby, the erectile dysfunction is associated with infertility. In one
psychological pressure and nervous tensions, as a result study, 27% of infertile men are reported as experiencing
of infertility, may have the similar effect as of chronic erectile dysfunction compared to 11% of the fertile
diseases such as cancer, heart attack, high blood pres- controls (O’BRIEN et al., 2005). In one Health Study,
sure and chronic pain (Moein, 2001). The stress associ- obesity was associated with a 1.3 relative risk of erectile
ated with infertility can contribute to the reduced self- dysfunction (Bacon et al., 2003). Among other genetic
esteem, increased anxiety and eventually cause erectile factors contributing to obesity and male infertility, one
dysfunction (Seibel, 1997). can name the Bardet-Biedl and Laurence-Moon
In vitro fertilization and intrauterine insemina- syndromes, which are associated with fatal obesity
tion and other advanced techniques to treat infertility (Mohsin, 2003). The physical and chemical factors in
has opened a new gate of hope for infertile couples the environment also impact the fertility in males, as
(Küchenhoff, 1999). Although infertility treatment is well (Oliva et al., 2001).
physically stressful, lack of infertility treatment is fol-
lowed by anxiety, more than any other type of disease, MATERIALS AND METHODS
and threats the mental health of infertile couples are This cross - sectional study included all infertile
affected. Although obesity is a known risk factor for men (N = 350) in year 2007 referring to the Infertility
infertility in women (Pasquali et al., 2003), the effect of Center of Fatemieh Hospital- Hamadan. None of these
obesity on sperm count still remains an issue of wide- people had a history of specific diseases and all were
spread debate in males (Jensen et al., 2004). satisfied to enter into the study. Male infertility was
727 Journal of Research in Ecology (2017) 5(1):726–733
 Seif et al., 2017
Table 2. Comparison of the sperm count means according to the BMI of infertile men
BMI Number Mean Std F P-Value
Underweight 42 106×96.28 106×11.55 0.58
Normal 127 106×85.66 106×42.54 8.11
6 0.62
Overweight 142 10 ×91.72 106×16.61 8.11
6 6
Obese 39 10 ×90.33 10 ×41.28 0.58

defined as the inability to conceive a pregnancy after a respectively. As it can be seen in table 1, the mean,
year of intercourse without contraception (Meybodi and body mass index was 25.2 kg/m2, and minimum and
Aflatounian, 1996). For the observation of ethical prin- maximum body mass indices were 14.7 kg/m2 and 48
ciples, the participant was given written consent after kg/m2, respectively.
providing them required explanations. In terms of body mass index, 12% of subjects
Since the age and duration of infertility are not were underweight (BMI <20) 36.3% were normal
factors involved in male infertility (Khalili et al., 2001), weight (BMI =20-24 .9), and 6/40% were overweight
therefore people of different ages were selected in this (BMI =25-29. 9). Additionally, 11.1% were obese
study. Demographic factors were collected using a ques- (BMI> 30) in which the majority (51.7%) normal
tionnaire; anthropometric parameters were measured by weight (Table 1).
standard means as well, and semen analysis was also According to table 2, no statistically significant
done by hand. Also, Body Mass Index was calculated relationship was observed between BMI and sperm
according to the formula BMI = (Weight in Kilograms / count, sperm motility, mean, semen volume, semen con-
(Height in Meters x Height in Meters) (Eisenberg et al., centration and the morphology of sperm in infertile
2014). men.
The body fat percentage was measured using the The results represented in table 2 indicate that,
Bioelectrical Impedance (BI) method by means of when significance level is set at .05, it seems that mean
Omron’s body composition monitor (Raustorp et al., count of sperms for four mentioned subgroups are statis-
2006). tically equal. That is because the P-value (0.62) is high-
SPSS 16.0 software was used for statistical anal- er than the significance level (0.05).
ysis. The Pearson correlation test was used to determine The results represented in table 3 indicate that,
the correlation between quantitative traits. The t-test and when significance level is set at .05, it seems that mean
analysis of variance (ANOVA) were used to compare mobility of sperms for four mentioned subgroups are
body fat percentages and quantitative traits such as statistically equal. That is because the P-value (0.374) is
sperm counts at higher than the significance level (0.05).
different BMI levels. The results represented in table 4 indicate that,
RESULTS when significance level is set at .05, it seems that mean
The average age of participants was 32.6 years. semen volume for four mentioned subgroups are statisti-
The minimum and maximum ages were 17 and 75 years cally equal. That is because the P-value (0.253) is high-
Table 3. Comparison of the sperm motility
Table 1. Distribution of BMI among infertile men Mea P-
BMI n Std F
BMI category Number Percent n Value
Underweight<20 BMI 42 12 Underweight 42 29.28 15.14
Normal weight BMI(20-24/9) 127 26.2 Normal 127 33.3 17.52
10.42 0.374
Overweight BMI(25-29/9) 142 40.6 Overweight 142 34.35 16.99
Obese BMI>30 39 11.1 Obese 39 31.76 17.61

Journal of Research in Ecology (2017) 5(1):726–733 728

Seif et al., 2017
Table 4. Comparison of the Semen volume of infertile Table 7. Classification of the infertile men according
men according to the BMI to BMI
BMI n Mean Std F P-Value Body fat percentage % N
Underweight 42 2.95 0.76 Less than normal 14.9 52
Normal 127 2.88 0.99 1.367 0.253 Normal 52.00 182
Overweight 142 3.11 1.04 Higher than normal 33.1 116
Obese 39 2.97 0.84
Table 9. Comparison of the mean sperm motility ac-
cording to the body fat percentage of infertile men
Table 5. Comparison of the sperm morphology of in-
fertile men according to the BMI Body fat P-
F Std Mean N
BMI n Mean Std F P-Value percentage Value
Underweight 42 17.02 5.11 Less than
17.54 34.82 52
Normal 127 17.74 6.24
normal
0.574 0.632 Normal 0.708 0.345 17.02 32.59 182
Overweight 142 17.64 6.51
Higher than
Obese 39 18.84 7.62 16.99 33.04 116
normal

er than the significance level (0.05). the lower sperm count accordingly
The results represented in table 5 indicate that, No statistically significant correlation was
when significance level is set at .05, it seems that sperm observed between body fat percentage and sperm count,
morphology for four mentioned subgroups are statisti- sperm motility, mean, semen volume, sperm concentra-
cally equal. That is because the P-value (0.632) is high- tion and morphology of sperm among infertile men
er than the significance level (0.05). (Table 7).
The results represented in table 6 indicate that, The results represented in table 8 indicate that,
when significance level is set at .05, it seems that Semen when significance level is set at .05, it seems that mean
concentration of infertile men attending Fatemieh infer- sperm count according to the body fat percentage of
tility center for four mentioned subgroups are statistical- infertile men attending Fatemieh infertility center are
ly equal. That is because the P-value (0.33) is higher statistically equal. That is because the P-value (0.889) is
than the significance level (0.05). higher than the significance level (0.05).
The average body fat of the samples The results represented in table 9 indicate that,
was17.63%. The highest sperm count (90.74×10) was when significance level is set at .05, it seems that mean
observed in people with normal body fat percentage. sperm motility according to the body fat percentage of
Those with body fat percentage of less than normal had infertile men attending Fatemieh infertility center are

Table 6. Comparison of the semen concentration of infertile men

Semen concentration Semen concentration Normal semen
BMI P-Value
(S.W) N (%) (T.H) N (%) concentration N (%)
Underweight 1(2.4%) 41(97.6%)
Normal χ2= 6.89 6(4.7%) 1(0.8%) 121(94.5%)
Overweight df=6 5(3.5%) 137(96.5%)
Obese p= 0.33 36(92.3%)
Total 14(4%) 2(0.6%) 334(95.4%)

Table 8. Comparison of the mean, sperm count according to the body fat percentage of infertile men
Body fat percentage P-Value F Std Mean N
Less than normal 42.52×58 68.88×58 52
Normal 0.889 0.117 51.9×58 90.74×58 182
Higher than normal 52.05×58 89.99×58 116

729 Journal of Research in Ecology (2017) 5(1):726–733

 Seif et al., 2017
Table 10. Comparison of the mean semen volume Table 11. Comparison of the mean morphology of
according to the body fat percentage sperm according to the body fat percentage
Body fat Body fat
P-Value F Std Mean N P-Value F Std Mean N
percentage percentage
Less than Less than
0.87 2.94 52 5.63 17.59 52
normal normal
Normal 0.584 0.529 0.96 3.04 182 Normal 0.894 0.112 6.13 17.89 182
Higher than Higher than
1.04 2.93 116 7.11 17.56 116
normal normal
statistically equal. That is because the P-value (0.708) is (28.96×106). Additionally, no statistically significant
higher than the significance level (0.05). correlation was observed between BMI and sperm count
The results represented in table 10 indicate that, in infertile men. By considering this case, our study was
when significance level is set at .05, it seems that mean consistent with a number of previous studies
semen volume according to the body fat percentage of (Magnusdottir et al., 2005; Macdonald et al., 2013;
infertile men attending Fatemieh infertility center are MacDonald et al., 2010; Feldman et al., 2000). Howev-
statistically equal. That is because the P-value (0.584) is er, it did not comply with some other studies (Tsao et
higher than the significance level (0.05). al., 2015; Eisenberg et al., 2014; Sermondade et al.,
The results represented in table 11 indicate that, 2012).
when significance level is set at 0.05, it seems that mean The highest percentage of normal morphology
morphology of sperm according to the body fat of sperm according to the body mass index was ob-
percentage of infertile men attending Fatemieh infertili- served in obese patients (18/84), and the lowest amount
ty center are statistically equal. That is because the P- was observed in underweight individuals (17/02). As
value (0.894) is higher than the significance level well, no significant relationship was observed between
(0.05). BMI and normal morphology of sperm, which is con-
The results represented in table 12 indicate that, sistent with the study of Jeansen (Jensen, 2004).
when significance level is set at .05, it seems that mean However, this is in contrary to the findings of
semen concentration according to the body fat percent- Tsao et al. (2015). In the few studies,
age of infertile men attending Fatemieh infertility center the relationship between body fat percentage and factors
are statistically equal. That is because the P-value (0.36) affecting semen quality has been investigated.
is higher than the significance level (0.05). The highest sperm count was reported in
individuals with normal body fat mass percentage, (10 ×
DISCUSSION 74.90), and the lowest amount was observed in those
In the evaluation of sperm counts, according to with lower fat mass percentage (10 × 88.68).
body mass index, the lowest amount was observed in In comparison of the semen volume, according
normal weight individuals (66. 85×106), and the highest to fat mass percentage, the highest volume was ob-
amount was reported in underweight individuals served in the group with normal body fat percentage

Table 12. Comparison of the mean semen concentration according to the body fat percentage of infertile men
Semen concentration Semen concentration Normal semen
BMI P-Value
(S.W) N (%) (T.H) N (%) concentration N (%)
Less than normal χ2=4.3 2(3.8%) 1(1.9%) 49(94.2%)
Normal df=4 5(2.7%) 1(0.5%) 176(96.7)
Higher than normal p= 0.36 7(6.0%) 0 109(94%)
Journal of Research in Ecology (2017) 5(1):767–733 730
Seif et al., 2017
(3.04) and the lowest amount was observed in the group cause frequent studies have revealed symptoms of erec-
with fat content of higher than normal. tile dysfunction among obese men or those having gain
Nonetheless, there was no statistically signifi- weight (Eisenberg, 2014; Feldman, 2000). Therefore,
cant relationship between semen volume and percentage the cause of infertility among some subjects in this
of body fat. The highest percentage of normal morphol- study may be associated with erection dysfunction.
ogy of sperm, according to the body fat percentage was Among infertile men, the highest risk of mortal-
observed in individuals with normal fat (17.89) and the ity was observed in those having abnormal parameters
lowest amount was reported in subjects with body fat of semen were exposed to a higher risk of mortality,
content of more than normal (17.56). No statistically which is suggestive of a common cause of infertility and
significant relationship between these two variables was mortality (Eisenberg, 2014).
observed as well. However, chih-wei Tsao et al. showed Although in many studies, obese or overweight
that the normal morphology of sperm is reduced by in- subjects had normal semen quality (Magnusdottir et al.,
creasing the body fat percentage (Tsao et al., 2015). 2005; Macdonald, 2013; MacDonald, 2010; Feldman,
Since leptin is secreted by adipose tissue, the 2000), but it is important to note that nutritional factors
percentage of body fat may affect fertility through the and lifestyle are associated with obesity, weight gain,
secretion of leptin., Animal studies have also shown that and health of individuals.
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