Home Medizin Das nächste Ziel von GLP-1: männliche Unfruchtbarkeit?

Das nächste Ziel von GLP-1: männliche Unfruchtbarkeit?

von NFI Redaktion

The rapid interest in glucagon-like peptide-1 receptor agonists (GLP-1-RAs) such as Semaglutide and Tirzepatide has sparked questions about the potential therapeutic effects of this class of medications beyond their current indications for type 2 diabetes and obesity. Recent clinical studies have revealed benefits of GLP-1 agents for the heart, liver, and kidneys, but the current evidence on how these medications may impact male fertility is unclear. Experts suggest that the connection between GLP-1-RAs and improved male fertility is biologically plausible.

Initial data indicates that overweight and obesity are strongly linked to male infertility in various ways. Obesity can disrupt fertility-related hormones, increase the risk of defective sperm, impair sperm quality, and even hinder sexual intercourse due to the association of obesity with erectile dysfunction. Therefore, in theory, GLP-1-RAs should enhance male fertility in men taking the medications for weight loss. Animal studies and a handful of small studies and observational data suggest that GLP-1-RAs may have the potential to improve male fertility in other ways.

A recent narrative review on GLP-1-RAs and male reproductive health published in the journal Medicine in December 2023 explored the potential of these medications for treating male infertility and offered optimism. Dr. Hossein Sadeghi-Nejad, MD, Director of Urology at the NYU Grossman School of Medicine and co-author of the article, stated that understanding the interaction between weight loss and increased testosterone levels was one of the reasons for conducting their analysis.

The review examined the well-known link between obesity and poorer fertility outcomes. Dr. Ranjith Ramasamy, the lead author, highlighted the significant social and economic impact of obesity on overall health and specifically on male infertility. The authors emphasized the negative effects of obesity on assisted reproductive technology outcomes and subfertility, attributing hormonal changes and adverse effects on sperm parameters to excess adipose tissue.

While most evidence on GLP-1-RAs and sperm parameters is derived from preclinical research, a few clinical studies have shown promising results. For example, a study on Liraglutide in men with metabolic hypogonadism found improved sperm concentration, motility, and morphology in participants who were not actively seeking fatherhood. However, the direct impact of GLP-1 agents on male fertility, independent of weight loss, requires further investigation.

Overall, it is crucial to validate the synergistic role of GLP-1 receptor agonists in male fertility through well-designed randomized clinical trials. Understanding the direct and indirect effects of these medications on male reproductive health, including potential impacts on offspring, is essential for optimizing patient care and ensuring long-term safety. Collaborative efforts between researchers, healthcare providers, and regulatory agencies will be vital in advancing our knowledge in this evolving field.

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