Impact of insulin resistance on sperm parameters and serum osteocalcin levels: A prospective cross-sectional comparative study

This prospective cross-sectional comparative study aimed to elucidate the effects of insulin resistance and the role of osteocalcin protein in male infertility. A cohort of 171 infertile men aged 25-55 was examined at an assisted reproduction clinic. Hormone profiles, glucose/insulin levels, osteocalcin concentrations, lipid profiles, and semen parameters were assessed. Using the HOMA index, patients were classified as insulin-resistant (n=87) or insulin-sensitive (n=84). Insulin-resistant patients had significantly lower total testosterone (p<0.001), free androgen index (p<0.001), and carboxylated osteocalcin levels (p=0.039) compared to insulin-sensitive patients. Linear regression analysis revealed a negative correlation between HOMA-IR and both total testosterone levels (p=0.022) and sperm motility (p=0.037). No association was found between HOMA-IR and osteocalcin levels (p=0.417). These findings suggest that insulin resistance negatively impacts male reproductive function, particularly testosterone levels and sperm motility. Larger studies are needed to confirm the role of osteocalcin in male infertility and its potential as a therapeutic target.