The role of testicular microcirculatory disorders in spermatogenic dysfunction in obese men

Abstract

Abstract Background: Obesity is a recognized risk factor for systemic microcirculatory disorders. The association between obesity-related microcirculatory disorders and spermatogenesis has been difficult to investigate and has not been reported in the literature until now. The aim of this study was to study the role of testicular microcirculatory disorders in spermatogenic dysfunction in obese men. Subjects: 576 participants were enrolled in this prospective observational study. Methods: Angio PLUSTM Planwave Ultrasensitive Imaging of the testicular microcirculation was performed and the number of vessels was counted and recorded as the ultrasonic microvascular density (UMVD). Results: Participants were divided into Group I (normozoospermia), Group II (asthenozoospermia, teratozoospermia and asthenoteratozoospermia) and Group III (oligozoospermia and NOA) based on semen results. There were no differences in BMI and UMVD between semen groups (p>0.05). Participants were then divided into normal weight, overweight and obese subgroups based on body mass index. In the obese subgroup, UMVD tended to decrease with decreasing sperm concentration, with significant differences in groups I, II and III (p<0.01). ROC curve for UMVD was established for differential diagnosis between Groups I, II and Group III in the obese subgroup. UMVD had a high diagnostic value with a cut-off value of 19.25 /cm2, AUC of 0.829, sensitivity of 0.773 and specificity of 0.737 (95% CI: 0.740-0.917). Conclusions: Our findings suggest that microcirculatory disorders play an essential role in the development of spermatogenic dysfunction in obese men. Obese participants with oligozoospermia and NOA had a significantly lower UMVD. Testicular UMVD below 19.25 /cm2 was highly suggestive of spermatogenic dysfunction. Angio PLUSTM Planwave Ultrasensitive Imaging should be used routinely to screen testicular microcirculation in obese men and to identify those who may benefit from microcirculation improvement therapy.