Sexual and Reproductive Outcomes in Obese Fertile Men with Functional Hypogonadism after Treatment with Liraglutide: Preliminary Results
Abstract
:1. Introduction
2. Materials and Methods
- Moderate and/or severe obesity (body mass index (BMI) of between 30 and 39.99);
- Waist circumference >94 cm;
- Severe erectile dysfunction ((ED)—International Index of Erectile Function 5 Items (IIEF-5) score below 7) that is unresponsive to conventional treatment with PDE5i during the last 3 months, according to a previously published procedure [10];
- TT < 12 nmol/L according to the Italian Society of Endocrinology guidelines [11];
- Normal–low gonadotropin levels (lowest quartiles of the reference range);
- Levels of sex hormone-binding globulin (SHBG) that are reduced compared to the reference range (confirmed data);
- Homeostasis Model Assessment Index (HOMA) > 2.5 [12].
- Group A (n = 35): Patients with an active desire for fatherhood. They were prescribed conventional treatment for fertility using urofollitropin 150 IU subcutaneously (three times a week) associated with hCG 2000 IU subcutaneously (twice a week) for 4 months;
- Group B (n = 35): Patients with no active desire for fatherhood. They were prescribed liraglutide 0.6 mg subcutaneously every day for the first week, then 1.2 mg (second week), 1.8 mg (third week), 2.4 mg (fourth week), and 3.0 mg (from the fifth week for another three months);
- Group C (n = 40): Patients who had already fathered a child and were not seeking fertility. They were prescribed transdermal testosterone gel (2%) at 60 mg every day for 4 months.
- Patients with primary testicular disease: cryptorchidism, testicular tumor, varicocele (all grades) or previous varicocelectomy, previous orchitis, or previous testicular torsion;
- Patients with increased levels of prolactin or TSH;
- Patients with hypothalamic-pituitary lesions described via magnetic resonance imaging;
- Patients with arterial hypertension, dyslipidemia, impaired fasting blood glucose, or diabetes mellitus.
- Weight, height, BMI, and waist circumference;
- HOMA index, TT, LH, FSH, SHBG, total PSA, and hematocrit;
- Semen analysis (except for group C patients);
- IIEF-5 and the frequency of PDE5i use, as needed, for sexual activity.
2.1. Hormone Measurements
2.2. Semen Analysis
2.3. Statistical Analysis
2.4. Ethical Approval
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameters | Group A | Group B | Group C |
---|---|---|---|
Weight (kg) | 114 ± 6 | 116 ± 10 | 111 ± 5 |
BMI (kg/m2) | 35 ± 3 | 36 ± 3 | 33 ± 2 |
Waist circumference (cm) | 106 ± 5 | 108 ± 6 | 108 ± 4 |
Total testosterone (ng/mL) | 1.6 ± 0.2 | 1.4 ± 0.6 | 1.8 ± 0.4 |
Follicle-stimulating hormone (IU/L) | 1.8 ± 0.2 | 1.6 ± 0.3 | 1.2 ± 0.4 |
Luteinizing hormone (IU/L) | 2.2 ± 0.2 | 2.0 ± 0.3 | 1.8 ± 0.4 |
Sex hormone-binding globulin (nmol/L) | 11.5 ± 3.0 | 14.0 ± 3.0 | 16 ± 6.0 |
Prostate-specific antigen (ng/mL) | 0.8 ± 0.2 | 0.6 ± 0.3 | 0.7 ± 0.1 |
Hematocrit (%) | 40 ± 4 | 38 ± 6 | 42 ± 4 |
HOMA index | 6.0 ± 1.2 | 6.5 ± 1.9 | 5.6 ± 1.6 |
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La Vignera, S.; Condorelli, R.A.; Calogero, A.E.; Cannarella, R.; Aversa, A. Sexual and Reproductive Outcomes in Obese Fertile Men with Functional Hypogonadism after Treatment with Liraglutide: Preliminary Results. J. Clin. Med. 2023, 12, 672. https://doi.org/10.3390/jcm12020672
La Vignera S, Condorelli RA, Calogero AE, Cannarella R, Aversa A. Sexual and Reproductive Outcomes in Obese Fertile Men with Functional Hypogonadism after Treatment with Liraglutide: Preliminary Results. Journal of Clinical Medicine. 2023; 12(2):672. https://doi.org/10.3390/jcm12020672
Chicago/Turabian StyleLa Vignera, Sandro, Rosita A. Condorelli, Aldo E. Calogero, Rossella Cannarella, and Antonio Aversa. 2023. "Sexual and Reproductive Outcomes in Obese Fertile Men with Functional Hypogonadism after Treatment with Liraglutide: Preliminary Results" Journal of Clinical Medicine 12, no. 2: 672. https://doi.org/10.3390/jcm12020672
APA StyleLa Vignera, S., Condorelli, R. A., Calogero, A. E., Cannarella, R., & Aversa, A. (2023). Sexual and Reproductive Outcomes in Obese Fertile Men with Functional Hypogonadism after Treatment with Liraglutide: Preliminary Results. Journal of Clinical Medicine, 12(2), 672. https://doi.org/10.3390/jcm12020672