Treatment of male infertility secondary to morbid obesity

Nat Clin Pract Endocrinol Metab. 2008 Jul;4(7):415-9. doi: 10.1038/ncpendmet0844. Epub 2008 Jun 3.


Background: A 29-year-old man presented to a clinic with infertility and hypogonadism in the setting of morbid obesity. On presentation, he had notable gynecomastia and a low testicular volume. The patient's weight was 154 kg and his height was 168 cm (BMI 54.5 kg/m(2)). Before referral to the clinic, the patient had been treated with testosterone therapy for 4 months for hypogonadism. This treatment had caused his initially low sperm concentration to fall to undetectable levels.

Investigations: Measurement of reproductive hormone levels, pituitary MRI, and semen analysis.

Diagnosis: Infertility secondary to hypogonadotropic hypogonadism and an elevated estrogen:testosterone ratio.

Management: Treatment with an aromatase inhibitor, anastrozole, led to normalization of the patient's testosterone, luteinizing hormone and follicle-stimulating hormone levels, suppression of serum estradiol levels, and to normalization of spermatogenesis and fertility.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anastrozole
  • Aromatase Inhibitors / therapeutic use*
  • Follicle Stimulating Hormone / blood
  • Humans
  • Hypogonadism / blood
  • Hypogonadism / complications*
  • Hypogonadism / drug therapy
  • Infertility, Male / blood
  • Infertility, Male / complications*
  • Infertility, Male / drug therapy*
  • Luteinizing Hormone / blood
  • Male
  • Nitriles / therapeutic use*
  • Obesity, Morbid / blood
  • Obesity, Morbid / complications*
  • Spermatogenesis / drug effects
  • Spermatogenesis / physiology
  • Testosterone / blood
  • Triazoles / therapeutic use*


  • Aromatase Inhibitors
  • Nitriles
  • Triazoles
  • Anastrozole
  • Testosterone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone