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Licensed Unlicensed Requires Authentication Published by De Gruyter November 13, 2020

Adverse effects of metabolic disorders in childhood on adult reproductive function and fertility in the male

Isabel Viola Wagner ORCID logo, Elizabeth Oliver, Jörg Dötsch and Olle Söder

Abstract

Over the last 50 years, there has been a steady decline in fertility rates in humans, which has occurred in parallel with an increasing incidence of obesity and metabolic disorders. The potential impact of these disorders and plausible mechanisms by which they negatively influence male reproduction are only partly understood and published data are often controversial. Obesity is one of the most important health challenges worldwide and is becoming more prevalent in children and adolescents. Obesity, the metabolic syndrome and related co-morbidities can lead to impaired male reproductive function, including adverse effects on spermatogenesis and steroidogenesis as illustrated by reduced sperm number and quality, decreased testosterone levels and elevated inflammatory markers. The incidence of diabetes mellitus type I is also dramatically increasing and may negatively impact spermatogenesis and testicular function, resulting in decreased serum testosterone and epididymal weight. In this review, we summarize and discuss the effects of metabolic diseases that typically develop during childhood and adolescence on later reproductive function and fertility. While impact on reproductive health is likely observed in both sexes, we have chosen to focus on the male in the current review. Specifically, we illustrate adverse effects of obesity, type 1 diabetes, the metabolic syndrome and insulin resistance on sperm function and testosterone metabolism. Identification of pathophysiological mechanisms during childhood may open up new avenues for early prevention and treatment resulting in better reproductive outcomes and improved fertility rates during adulthood.


Corresponding author: Isabel Viola Wagner, MD, Karolinska Institutet, Department of Women’s and Children’s Health, Pediatric Endocrinology Unit, Stockholm, Sweden; Department of Pediatrics, Medical Faculty, University of Cologne, Pediatric Endocrinology Unit, Cologne, Germany; and Division of Pediatric Endocrinology and Diabetes, Department of Paediatrics, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany, Phone: +49 (0) 451/50042827, E-mail:

Acknowledgments

The authors wishes to thank all the children, adolescents and families and adults who participated in the cited studies.

  1. Research funding: We did not get financial support or funding for writing this review.

  2. Author Contributions: All four authors contributed in writing and revising the review.

  3. Competing interests: The authors have no conflicts of interest to the preparation or content of the manuscript.

  4. Ethical approval: The authors have no ethical conflicts to disclose.

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Received: 2020-05-15
Accepted: 2020-09-21
Published Online: 2020-11-13
Published in Print: 2021-01-27

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