Emerging Role of Obstructive Sleep Apnea and Body Mass Index on Semen Parameters of Infertile Men

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  • Department of Physiology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research, Tambaram, Chennai – 600073, Tamil Nadu ,IN
  • Department of Mind Body Medicine and Lifestyle Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai – 600116, Tamil Nadu ,IN
  • Andrology and Reproductive Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam – 603103, Tamil Nadu ,IN




Body Mass Index, Infertility, Obesity, Obstructive Sleep Apnea, Semen


The curiosity on possible association between Obstructive Sleep Apnea and infertility has gained considerable toehold over the recent years. Infertility, obesity and obstructive sleep apnea exhibit a vicious circle and, hence, their interrelationships are being explored incessantly. Our objective is to determine the influence of body mass index and Obstructive Sleep Apnea (OSA) on semen quality of infertile men. This cross-sectional study was conducted on 60 infertile male participants. Individuals were grouped based on their BMI. OSA screening was done with STOPBANG questionnaire, and risk stratification was done according to the scoring system. Semen analysis was done in accordance with WHO 2010 guidelines. Participants with normal BMI were 16 (26.7%) while 27 (45%) participants were overweight and 17 (28.3%) were obese. OSA risk stratification showed that 16.7% were at high risk for OSA, 40% were at moderate risk and 43.3% were at low risk. High OSA risk among infertile men was significantly associated with sperm concentration (p= 0.03) whereas elevated BMI had significant association with semen volume (p= 0.04). Certain seminal characteristics had a conceivable relation with both OSA risk and increased BMI. Hence, screening for OSA and maintaining an ideal body weight might improve the reproductive potential.


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How to Cite

Andiappan, M., Chandrasekar Mathangi, D., & Thanikachalam, P. (2022). Emerging Role of Obstructive Sleep Apnea and Body Mass Index on Semen Parameters of Infertile Men. Journal of Endocrinology and Reproduction, 26(2), 99–105. https://doi.org/10.18311/jer/2022/29114



Original Research



Luhar S, Timæus IM, Jones R, Cunningham S, Patel SA, Kinra S, et al. Forecasting the prevalence of overweight and obesity in India to 2040. PLoS One. 2020; 15(2). https://doi.org/10.1371/journal.pone.0229438 PMid:32092114 PMCid:PMC7039458

Plessis SSD, Cabler S, McAlister D, Sabanegh E. The effect of obesity on sperm disorders and male infertility. Nature Reviews Urology. 2010; 7(3):13-61. https://doi.org/10.1038/nrurol.2010.6 PMid:20157305

Katib A. Mechanisms linking obesity to male infertility. Central European Journal of Urology. 2015; 68(1):79-85. https://doi.org/10.5173/ceju.2015.01.435 PMid:25914843 PMCid:PMC4408383

Leisegang K, Sengupta P, Agarwal A, Henkel R. Obesity and male infertility: Mechanisms and management. Andrologia. 2021; 53(1). https://doi.org/10.1111/and.13617 PMCid:PMC7995002

Noussier HM. Obesity: the major preventable risk factor of obstructive sleep apnea. Journal of Current Medical Research and Practice. 2019; 4(1):1-5. https://doi.org/10.4103/JCMRP.JCMRP_138_18

Ghosh P, Varma NKS, Ajith V, Prabha R, Raj M. Epidemiological study on prevalent risk factors and craniofacial skeletal patterns in obstructive sleep apnea among South Indian population. Indian Journal of Dental Research. 2020; 31(5):784-90. https://doi.org/10.4103/ijdr.IJDR_224_19 PMid:33433520

Jhuang Y-H, Chung C-H, Wang I-D, Peng C-K, Meng E, Chien W-C. Association of Obstructive Sleep Apnea with the Risk of Male Infertility in Taiwan. Journal of the American Medical Association. 2021; 4(1). https://doi.org/10.1001/jamanetworkopen.2020.31846 PMid:33475753 PMCid:PMC7821032

World Health Organization. WHO laboratory manual for the examination of human semen and semen-cervical mucus interaction; 2010.

Katole A, Saoji A. Prevalence of primary infertility and its associated risk factors in urban population of central India: A community- based cross-sectional study. Indian Journal of Community Medicine. 2019; 44(4):337-41. https://doi.org/10.4103/ijcm. IJCM_7_19 PMid:31802796 PMCid:PMC6881900

Chavarro JE, Toth TL, Wright DL, et al. Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic. Fertility and Sterility. 2010; 93(7):2222-31. https://doi.org/10.1016/j.fertnstert.2009.01.100 PMid:19261274 PMCid:PMC2864498

Guo D, Wu W, Tang Q, et al. The impact of BMI on sperm parameters and the metabolite changes of seminal plasma concomitantly. Oncotarget. 2017; 8(30):48619-34. https://doi.org/10.18632/oncotarget.14950 PMid:28159940 PMCid:PMC5564712

Jaffar M, Ashraf M. Does weight loss improve fertility with respect to semen parameters-results from a large cohort study. International Journal of Infertility & Fetal Medicine. 2017; 8(1):12-17. https://doi.org/10.5005/jp-journals-10016-1141

Alahmar AT, Ali Z, Muhsin Z, Qasim H. The impact of obesity on seminal fluid in men with infertility. Middle East Fertility Society Journal. 2018; 23(4):346-9. https://doi.org/10.1016/j.mefs.2018.04.010

Virtanen HE, Jørgensen N, Toppari J. Semen quality in the 21st century. Nature Reviews Urology. 2017; 14(2):120-30. https://doi.org/10.1038/nrurol.2016.261 PMid:28050014

MacDonald AA, Herbison GP, Showell M, Farquhar CM. The impact of body mass index on semen parameters and reproductive hormones in human males: A systematic review with meta-analysis. Human Reproduction Update. 2009; 16(3):293-311. https://doi.org/10.1093/humupd/dmp047 PMid:19889752

Aggerholm AS, Thulstrup AM, Toft G, Ramlau-Hansen CH, Bonde JP. Is overweight a risk factor for reduced semen quality and altered serum sex hormone profile? Fertility and Sterility. 2008; 90(3):619-26. https://doi.org/10.1016/j.fertnstert.2007.07.1292 PMid:18068160

Duits FH, Van Wely M, Van Der Veen F, Gianotten J. Healthy overweight male partners of subfertile couples should not worry about their semen quality. Fertility and Sterility. 2010; 94(4):1356-59. https://doi.org/10.1016/j.fertnstert.2009.05.075 PMid:19608174

Eisenberg ML, Kim S, Chen Z, Sundaram R, Schisterman EF, Louis GMB. The relationship between male BMI and waist circumference on semen quality: Data from the LIFE study. Human Reproduction. 2014; 29(2):193-200. https://doi.org/10.1093/humrep/det428 PMid:24306102 PMCid:PMC3896223

Macdonald AA, Stewart AW, Farquhar CM. Body mass index in relation to semen quality and reproductive hormones in New Zealand men: A cross-sectional study in fertility clinics. Human Reproduction. 2013; 28(12):3178-87. https://doi.org/10.1093/humrep/det379 PMid:24129611

Jensen TK, Andersson AM, Jørgensen N, Andersen A-G, Carlsen E, Petersen JH. Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. Fertility and Sterility. 2004; 82(4):863-70. https://doi.org/10.1016/j.fertnstert.2004.03.056 PMid:15482761

Maghsoumi-Norouzabad L, Javid AZ, Aiiashi S, Hosseini SA, Dadfar M, Bazyar H. The impact of obesity on various semen parameters and sex hormones in Iranian men with infertility: A cross-sectional study. Research and Reports in Urology. 2020; 12:357-65. https://doi.org/10.2147/RRU.S258617 PMid:32944568 PMCid:PMC7481269

Wang EY, Huang Y, Du QY, Yao GD, Sun YP. Body mass index effects sperm quality: A retrospective study in Northern China. Asian Journal of Andrology. 2017; 19(2):234-7. https://doi.org/10.4103/1008-682X.169996 PMid:26732109 PMCid:PMC5312225

Anand AM, Bharadwaj R, Krishnaswamy NR. Role of facial pattern in patients with obstructive sleep apnea among the South Indian (Chennai) population: A cross-sectional study. Journal of Dental Sleep Medicine. 2020; 7(1). https://doi.org/10.15331/ jdsm.7106

Pattanaik S, Rajagopal R, Mohanty N, Pattanaik S. Prevalence of obstructive sleep apnea in an Indian population: Using stopbang questionnaire. Asian Journal of Pharmaceutical and Clinical Research. 2018; 11(11):100. https://doi.org/10.22159/ajpcr.2018.v11i11.27598

Prabhu G, Selvamuthukumaran S JS. Observational study to determine the pattern of distribution of stop-bang score in predicting OSA and its implication among female health care providers. Int J Med Res Rev. 2019; 7(3). https://doi.org/10.17511/ijmrr.2019.i03.04

Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: Implications for treatment. Chest. 2010; 137(3):711-19. https://doi.org/10.1378/chest.09-0360 PMid:20202954 PMCid:PMC3021364

Nagappa M, Wong J, Singh M, Wong DT, Chung F. An update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine. Current Opinion in Anesthesiology. 2017. https://doi.org/10.1097/ACO.0000000000000426 PMid:27898430 PMCid:PMC5214142

Pallangyo P, Mgopa LR, Mkojera Z, Komba M, Millinga J, Misidai N. Obstructive sleep apnea and associated factors among hypertensive patients attending a tertiary cardiac center in Tanzania: A comparative cross-sectional study. Sleep Science and Practice. 2021; 5(1):1-11. https://doi.org/10.1186/s41606-021-00069-z