INS and obesity due to melanocortin 4 receptor deficiency: In the case of males, the complications of obesity include erectile dysfunction, poor semen quality and subclinical prostatitis; therefore, obesity is known to disrupt male fertility and the reproduction potential, particularly through alteration in the hypothalamic-pituitary-gonadal axis, disruption of testicular steroidogenesis and metabolic dysregulation, including insulin, cytokines and adipokines [17].