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Changes in total sperm count after gastric bypass and sleeve gastrectomy: the BARIASPERM prospective study

Claire Carette 1, 2 Rachel Lévy 3, 4 Florence Eustache 5 Gabriel Baron 6, 7, 8 Muriel Coupaye 9, 10 Simon Msika 9 Christophe Barrat 11, 9 Régis Cohen 12 Jean-Marc Catheline 12 Florence Brugnon 13, 14 Karem Slim 15 Charles Barsamian 1, 2 Jean-Marc Chevallier 16 Marion Bretault 17, 18 Jean-Luc Bouillot 19 Jean-Philippe Antignac 20 Claire Rives-Lange 1, 2 Philippe Ravaud 6, 7, 8 Sébastien Czernichow 1, 2, 6, 7, 8 
Abstract : Background: The massive weight loss induced by bariatric surgery is associated with major benefits, but the effect on semen variables is still uncertain. Objectives: To explore semen modifications with gastric bypass and sleeve gastrectomy. Setting: Five French University Hospitals. Methods: Male candidates for bariatric surgery with no history of infertility were recruited in this controlled prospective study. Sperm characteristics were collected before surgery and then 6 months and up to 12 months after surgery. Results: Forty-six adult men who underwent gastric bypass (n = 20) or sleeve gastrectomy (n = 26) were included. Total sperm count tended to be lower at 6 months and showed a significant decrease at 12 months in both surgery groups, at -69.5 million (-96.8 to -42.2 million; P = 0.0021). Total sperm count at 12 months relative to baseline was -41.4 million (P = .0391) after gastric bypass and -91.1 million (P = .0080) after sleeve gastrectomy. This was counterbalanced by an associated resolution of hypogonadism and decrease of DNA fragmentation in most patients with time after surgery. Conclusion: Improvement in some semen variables after bariatric surgery observed in 3 previous studies is in contrast to the lower mean total sperm count found in this study at 1 year. The possible reversibility of this effect in the long term and the impact of surgery on fertility both remain unknown.
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Claire Carette, Rachel Lévy, Florence Eustache, Gabriel Baron, Muriel Coupaye, et al.. Changes in total sperm count after gastric bypass and sleeve gastrectomy: the BARIASPERM prospective study. Surgery for Obesity and Related Diseases, Elsevier, 2019, 15 (8), pp.1271-1279. ⟨10.1016/j.soard.2019.04.019⟩. ⟨hal-03040814⟩

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