GLP-1 receptor agonists versus testosterone in male reproductive health: a critical perspective

Abstract

Obesity and hypogonadism share a complex relationship, with obesity-related comorbidities such as type 2 diabetes (T2D), obstructive sleep apnoea (OSA) and cardiovascular disease contributing to hypogonadism. Obesity is associated with impaired androgen secretion, bioavailability and metabolism. The studies have demonstrated an inverse correlation between fat mass and total, free testosterone and sex hormone-binding globulin levels. In addition, recent reports suggest a decline in sperm quality in men from regions with a high obesity prevalence, such as Europe and the United States. The low baseline sperm quality observed in Gregoric et al.'s trial, as stated by the authors, supports this association.