Abstract
BACKGROUND: Male infertility is an increasingly recognized contributor to the global infertility burden, occurring alongside reported declines in semen quality and a rising prevalence of obesity, particularly central obesity, in many populations. Although adiposity and body fat distribution have been implicated in male reproductive health, existing evidence remains inconsistent and often relies solely on body mass index. OBJECTIVE: To evaluate the association between general and central anthropometric measures of obesity and semen parameters in male partners of infertile couples without identifiable clinical risk factors for infertility other than adiposity. METHODS: This hospital-based cross-sectional analytical study included 100 male partners of infertile couples aged 21-50 years. Anthropometric assessment comprised body mass index, waist circumference, waist-hip ratio, and waist-height ratio using population-appropriate cut-offs. Semen analysis was performed in accordance with World Health Organization 2010 guidelines. Group comparisons were conducted using non-parametric methods, and associations were assessed using Spearman's rank correlation, with adjustment for multiple comparisons. Results: Higher levels of general and central adiposity were associated with poorer semen quality parameters. Men with elevated body mass index demonstrated lower sperm concentration, total sperm count, total motility, and progressive motility compared with those with normal body mass index, while semen volume showed minimal variation. Measures of central obesity exhibited more moderate inverse associations with semen parameters than body mass index alone. Across all anthropometric indices, progressive sperm motility showed the most pronounced inverse association, whereas semen volume remained largely unaffected. CONCLUSIONS: Both general and, more prominently, central adiposity are associated with adverse semen quality profiles, particularly with respect to sperm motility. Incorporation of waist-based anthropometric indices alongside body mass index may enhance risk characterization among male partners of infertile couples. Prospective and interventional studies are required to clarify causality and to determine whether modification of central adiposity is associated with improvements in semen quality and reproductive outcomes.