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Since the 1960s, the ketogenic diet has been demonstrated to have significant effects in terms of weight loss ( In vitro study has ever demonstrated that ketone bodies being utilized as an energy source for sperm movement ( Our recent study observed the effects of metformin on metabolic imbalance, antioxidant capacity, apoptosis, and reproductive function in male mice with high-fat and high-cholesterol diet-induced obesity, and demonstrated that it protected against the disrupted testicular histology and semen quality by increasing the testosterone concentration and enhancing anti-oxidative enzymes in the testes ( Methods Headings This study was approved by the Institutional Animal Care and Use Committee of the Taipei Medical University (IACUC