Akalewold M, Yohannes GW, Abdo ZA. Magnitude of infertility and associated factors among women attending selected public hospitals in Addis Ababa, Ethiopia: a cross-sectional study. BMC Womens Health. 2022;22(1):11.

Article  PubMed  PubMed Central  Google Scholar 

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9945):766–81.

Article  PubMed  PubMed Central  Google Scholar 

Wang L, Zhou B, Zhao Z, Yang L, Zhang M, Jiang Y, et al. Body-mass index and obesity in urban and rural China: findings from consecutive nationally representative surveys during 2004-18. Lancet. 2021;398(10294):53–63.

Article  PubMed  Google Scholar 

Sermondade N, Dupont C, Faure C, Boubaya M, Cedrin-Durnerin I, Chavatte-Palmer P, Sifer C, Levy R. Body mass index is not associated with sperm-zona pellucida binding ability in subfertile males. Asian J Androl. 2013;15(5):626–9.

Article  PubMed  PubMed Central  Google Scholar 

Jensen TK, Andersson AM, Jorgensen N, Andersen AG, Carlsen E, Petersen JH, Skakkebaek NE. Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. Fertil Steril. 2004;82(4):863–70.

Article  CAS  PubMed  Google Scholar 

Kahn BE, Brannigan RE. Obesity and male infertility. Curr Opin Urol. 2017;27(5):441–5.

Article  PubMed  Google Scholar 

Mir J, Franken D, Andrabi SW, Ashraf M, Rao K. Impact of weight loss on sperm DNA integrity in obese men. Andrologia. 2018;50:e12957. https://doi.org/10.1111/and.12957

Leisegang K, Sengupta P, Agarwal A, Henkel R. Obesity and male infertility: mechanisms and management. Andrologia. 2021;53(1):e13617.

Article  PubMed  Google Scholar 

Leisegang K, Henkel R, Agarwal A. Obesity and metabolic syndrome associated with systemic inflammation and the impact on the male reproductive system. Am J Reprod Immunol. 2019;82(5):e13178.

Article  CAS  PubMed  Google Scholar 

Miyamoto J, Igarashi M, Watanabe K, Karaki SI, Mukouyama H, Kishino S. Gut microbiota confers host resistance to obesity by metabolizing dietary polyunsaturated fatty acids. Nat Commun. 2019;10(1):4007.

Article  PubMed  PubMed Central  Google Scholar 

Liu H, Huang L, Pei X. Effects of sorghum rice and black rice on genes associated with cholesterol metabolism in hypercholesterolemic mice liver and intestine. Food Sci Nutr. 2021;9(1):217–29.

Article  CAS  PubMed  Google Scholar 

Nyangale EP, Mottram DS, Gibson GR. Gut microbial activity, implications for health and disease: the potential role of metabolite analysis. J Proteome Res. 2012;11(12):5573–85.

Article  CAS  PubMed  Google Scholar 

Hu L, Zhao Y, Liu S, Zhang J, Yuan H, Xu H. High-fat diet in mice led to increased severity of spermatogenesis impairment by lead exposure: perspective from gut microbiota and the efficacy of probiotics. J Sci Food Agric. 2023;103(5):2653–63.

Article  CAS  PubMed  Google Scholar 

Ding N, Zhang X, Zhang XD, Jing J, Liu SS, Mu YP, Peng LL. Impairment of spermatogenesis and sperm motility by the high-fat diet-induced dysbiosis of gut microbes. Gut. 2020;69(9):1608–19.

Article  CAS  PubMed  Google Scholar 

Abbasi B, Abbasi H, Niroumand H. Synbiotic (FamiLact) administration in idiopathic male infertility enhances sperm quality, DNA integrity, and chromatin status: a triple-blinded randomized clinical trial. Int J Reproductive Biomed. 2021;19(3):235–44.

CAS  Google Scholar 

Valcarce DG, Genoves S, Riesco MF, Martorell P, Herraez MP, Ramon D, Robles V. Probiotic administration improves sperm quality in asthenozoospermic human donors. Beneficial Microbes. 2017;8(2):193–206.

Article  CAS  PubMed  Google Scholar 

Sun Z, Li H, Li Y, Qiao J. Lactobacillus salivarius, a potential probiotic to improve the health of LPS-Challenged Piglet intestine by alleviating inflammation as well as oxidative stress in a dose-dependent manner during weaning transition. Front Veterinary Sci. 2020;7:547425.

Article  Google Scholar 

Desilets AR, Dhakal-Karki S, Dunican KC. Role of metformin for weight management in patients without type 2 diabetes. Annals Pharmacotherapy. 2008;42(6):817–26.

Article  CAS  Google Scholar 

Song S, Andrikopoulos S, Filippis C, Thorburn AW, Khan D, Proietto J. Mechanism of fat-induced hepatic gluconeogenesis: effect of metformin. Am J Physiol Endocrinol Metabolism. 2001;281(2):E275–282.

Article  CAS  Google Scholar 

Faure M, Bertoldo MJ, Khoueiry R, Bongrani A, Brion F, Giulivi C, Dupont J, Froment P. Metformin in reproductive biology. Front Endocrinol. 2018;9:675.

Article  Google Scholar 

Zhu R, Wei J, Liu H, Liu C, Wang L, Chen B, et al. Lycopene attenuates body weight gain through induction of browning via regulation of peroxisome proliferator-activated receptor gamma in high-fat diet-induced obese mice. J Nutr Biochem. 2020;78:108335.

Article  CAS  PubMed  Google Scholar 

Wu T, Sun M, Liu R, Sui W, Zhang J, Yin J, et al. Bifidobacterium longum subsp. Longum Remodeled Roseburia and phosphatidylserine levels and ameliorated intestinal disorders and liver metabolic abnormalities Induced by high-fat diet. J Agric Food Chem. 2020;68(16):4632–40.

Article  CAS  PubMed  Google Scholar 

Hou M, Venier N, Sugar L, Musquera M, Pollak M, Kiss A, et al. Protective effect of metformin in CD1 mice placed on a high carbohydrate-high fat diet.Biochem. Biophys Res Commun. 2010;397(3):537–42.

Article  CAS  Google Scholar 

Pandey A, Verma S, Kumar VL. Metformin maintains mucosal integrity in experimental model of colitis by inhibiting oxidative stress and pro-inflammatory signaling. Biomed Pharmacother. 2017;94:1121–8.

Article  CAS  PubMed  Google Scholar 

Richburg JH. The relevance of spontaneous- and chemically-induced alterations in testicular germ cell apoptosis to toxicology. Toxicol Lett. 2000;112–113:79–86.

Article  PubMed  Google Scholar 

Guo Y, Du X, Bian Y, Wang S. Chronic unpredictable stress-induced reproductive deficits were prevented by probiotics. Reprod Biol. 2020;20(2):175–83.

Article  PubMed  Google Scholar 

Kerr JB, Millar M, Maddocks S, Sharpe RM. Stage-dependent changes in spermatogenesis and sertoli cells in relation to the onset of spermatogenic failure following withdrawal of testosterone. Anat Rec. 1993;235(4):547–59.

Article  CAS  PubMed  Google Scholar 

Niu S, Chen J, Duan F, Song Q, Qin M, Wang Z, Liu J. Possible mechanism underlying the effect of Heshouwuyin, a tonifying kidney herb, on sperm quality in aging rats. BMC Complement Altern Med. 2014;14:250.

Article  PubMed  PubMed Central  Google Scholar 

Moretti E, Figura N, Campagna MS, Gonnelli S, Iacoponi F, Collodel G. Sperm parameters and semen levels of inflammatory cytokines in Helicobacter pylori-infected men. Urology. 2015;86(1):41–6.

Article  PubMed  Google Scholar 

American Diabetes Association. 9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S90-S102. https://doi.org/10.2337/dc19-S009

Napolitano A, Miller S, Nicholls AW, Baker D, Van Horn S, Thomas E, et al. Novel gut-based pharmacology of metformin in patients with type 2 diabetes mellitus. PLoS ONE. 2014;9(7):e100778.

Article  PubMed  PubMed Central  Google Scholar 

Zhou Q, Qu Z, Wang N, Liu H, Yang H, Wang H. Miao sour soup influences serum lipid via regulation of high-fat diet-induced intestinal flora in obese rats. Food Sci Nutr. 2023;11(5):2232–42.

Article  CAS  PubMed  Google Scholar 

Wang B, Kong Q, Li X, Zhao J, Zhang H, Chen W, Wang G. A high-fat diet increases gut microbiota biodiversity and energy expenditure due to nutrient difference. Nutrients. 2020;12(10):3197.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hales DB. Testicular macrophage modulation of Leydig cell steroidogenesis. J Reprod Immunol. 2002;57(1–2):3–18.

Article