Dr. Ahmed
Mounjaro, Victoza, Ozempic and Fertility in Men:
GLP-1 agonists, such as Ozempic and Mounjaro, are known for inducing significant weight loss, which is crucial for addressing infertility in both men and women.
Approximately 45% of obese men suffer from hypogonadism, which can be alleviated by reducing body fat, leading to increased testosterone levels due to decreased activation of female hormones like estradiol in adipose tissue.
These GLP-1 agonists may therefore have a beneficial impact on male impotency. Liraglutide, specifically, has been shown to enhance libido, sexual function, performance, and glycemic control [Ref].
Moreover, GLP-1 agonists regulate gonadotropin-releasing hormone (GnRH), including luteinizing hormone (LH) and follicle-stimulating hormone (FSH), through their receptors in the hypothalamus and thalamus.
In women, GLP-1 use has also been linked to improvements in menstrual flow, timing, and symptoms associated with polycystic ovary syndrome (PCOS) [Ref].
In a recent study, it was observed that GLP-1 agonists may improve fertility rates in obese men.
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Ozempic and Fertility in Men: Key points:
- Male fertility is negatively impacted by obesity because of hormonal abnormalities. Because of its ability to cause weight reduction, GLP-1 receptor agonists are being studied for their effects on male reproductive health.
- GLP-1 receptors may also have an impact on energy metabolism and glucose homeostasis, both of which are essential for spermatogenesis.
- GLP-1 receptor agonists are effective in aiding weight loss in clinical trials. More recently studies have shown benefits in sperm parameters, including motility, count, and concentration.
- GLP-1 receptor agonists may improve insulin secretion and sperm metabolism, which may have a beneficial effect on male fertility.
- GLP-1 Receptor agonists have potential as a treatment for idiopathic infertility in obese males; however, additional studies and follow-up times are required to verify their effectiveness and long-term consequences.
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Obesity and Hypogonadism:
Infertility is a term used to describe a couple unable to conceive after engaging in frequent, unprotected sexual activity for one year.
In men, infertility is defined as the incapacity of a man to impregnate a woman after a year of consistent, unprotected sexual activity if the woman is free of gynecological issues.
According to estimates from the World Health Organization in 1991, 8-12% of couples globally suffered infertility at some point in their reproductive lives, impacting 50 to 80 million couples.
Now there is a need to take some preventive measures and to provide some assisted techniques to help those with irreversible cases.
From the past two decades, some emerging reports also concluded the change in human semen quality along with the development of congenital malformation of male reproductive organs or tract and also an increasing trend to develop testicular cancers.
There is limited treatment. Most therapies are directed towards the underlying cause of infertility. Where no identifiable cause is found, clomiphene citrate, androgens, and supplements like vitamin E and selenium are used.
Clomiphene citrate improves sperm concentration while anastrozole is used to treat hypogonadism.
The recent study concluded “the potential role of GLP-1 analogs in improving male infertility” but more work is still required.
Findings: GLP-1 and Fertility:
This review looks at how GLP-1 RAs affect male fertility and suggests that obese men who are idiopathically infertile may benefit from using them.
While spermatogenesis and hormonal impacts are explored. Additional trials including obese infertile men are required for validation.[ref]
GLP-1 and Fertility: Methodology and Analysis:
A review was conducted with a thorough search of PubMed, Google Scholar, and Science Direct using keywords such as “GLP-1 receptor agonists”, “male infertility”, “BMI and male infertility”, “GLP-1 RAs and weight loss”, and “GLP-1 RA and male reproductive system”.
Recent clinical trials with a focus on male fertility, GLP-1 RAs, and weight loss were given priority during the screening process.
Thorough coverage of relevant studies was guaranteed by an extensive study of the literature.
The goal of this strategy was to compile the most recent data on the possible effects of GLP-1 RAs on male reproductive health, specifically about treating male infertility caused by obesity.
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Factors contributing towards reproductive health disorders in Males:
It is yet unknown what is causing these noted alterations in male reproductive health.
Lifestyle choices like employment, smoking, attire, and even, time spent commuting may be relevant.
Other environmental toxicants, herbicides, insecticides, and heavy metals also contribute. However, the theory that has attracted the greatest interest pertains to developmental exposure to environmental xenoestrogens.
The Danish Environmental Protection Agency (EPA) conducted an assessment of this vast and intricate field.
Each Sertoli cell supports the formation of a specific number of germ cells, and they are crucial in controlling the environment inside the seminiferous tubules.
Any disruption to the reproductive system’s development that results in fewer Sertoli cells would ultimately lower the person’s ability to produce sperm in later life.[ref]
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Nutritional models that increase infertility risks:
The Western diet has recently come to be recognized as the primary nutritional model for both industrialized and developing nations.
Simple carbohydrates, trans and saturated fats, high consumption of animal protein, low levels of dietary fiber, and necessary low unsaturated fatty acids are the characteristics of the Western diet.
The introduction of such a modern diet has exacerbated the issue affecting semen quality.
Deficient semen parameters and low fertility are caused by processed meats, or red meat as mentioned in several sources, fatty dairy products, alcohol, sweets and drinks, coffee, potatoes, lack of whole grain products, fruits vegetables, fish and seafood, nuts, poultry, and skim dairy products [ref].
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Relation of oxidative stress and genomics with male infertility:
Oxidative stress:
Men’s infertility has been linked in large part to oxidative stress. It is a condition that leads to an imbalance in antioxidant and oxidant levels, which destroys the biological system.
The oxidative equilibrium will be disturbed, due to the oxidative stress, liquid peroxidation, and the production of reactive oxygen species (ROS), if the rate at which free radicals are formed and eliminated inside the cell is not equal.
It is well-recognized that antioxidants counteract these effects, reducing the likelihood of infertility.
In infertile men, there is a substantial rise in reactive oxygen species (ROS) levels together with a decline in antioxidant capacity in comparison to the fertile group
Genomics:
Researchers also concluded that increased human spermatozoa ROS generation in mitochondria is under the exposure of radiofrequency electromagnetic exposure.
Mobile phone-generated ROS contributes to genomic instability by triggering apoptosis and altering gene expression, including genes like Bax, cytochrome c, and caspase 3.
It disrupts protein folding, impairs essential protein functions, and activates stress proteins like p38 MAP kinase, which phosphorylates heat shock proteins like hsp27, affecting sperm motility. Furthermore, it significantly reduces testosterone levels (p < 0.05) [ref].
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In Summary:
GLP-1 analogs such as Liraglutide, Dulaglutide, and Semaglutide may improve fertility rates in men by increasing testosterone levels and sperm counts.
However, more studies need to be done to elucidate their role in male infertility.
