Effects of Exercise Interventions on Fertility-Related Indicators in Young Men: A Systematic Review and Meta-Analysis.

Background: In this paper, a meta-analytical approach was used to test the effect of exercise on the relevant indicators of fertility in young men, with a view to providing a scientifically sound exercise intervention program for male fertility.

Method: We systematically searched PubMed, MEDLINE, PsycINFO, SportDiscus, Web of Science, CNKI (China National Knowledge Infrastructure), and Wanfang Database for randomized controlled trials and quasi-experimental studies examining the relationship between exercise and male fertility, with the search conducted up to July 31, 2025. Primary outcomes were semen concentration and sperm motility; secondary outcomes included testosterone, pregnancy rate, and live birth rate. Review Manager 5.3 was used for risk of bias assessment, heterogeneity testing, subgroup/effect size analysis, and sensitivity analysis.

Results: (1) A total of 10 studies were included (n = 1511). (2) Exercise was effective in improving semen concentration (SMD=0.35, 95% CI (0.16, 0.54), P < 0.001), sperm motility (SMD = 0.79, 95% CI (0.31, 1.28), P < 0.01), testosterone (SMD = 1.21, 95% CI (0.84, 1.58), P < 0.001), pregnancy rate in young men (RR, 12.60; 95% CI (2.43, 65.35); P < 0.01), live birth rate (RR, 1.90; 95% CI (1.04, 3.46); P < 0.05), and other fertility-related indicators. (3) Three to four times/week (SMD = 0.51, 95% CI (0.12, 0.90), P < 0.05), 30-60 min per intervention (SMD=0.34, 95%(0.14, 0.54), P < 0.001), and duration of 2-8 weeks (SMD = 0.70, 95% CI (0.14, 1.26), P < 0.05), moderate-intensity (SMD = 0.36, 95% CI (0.06, 0.67), P < 0.05) exercise was more effective as an intervention for semen concentration in young men. (4) Three to four times/week (SMD = 1.01, 95% CI (0.60, 1.42), P < 0.001), with a duration of 30-60 min per intervention (SMD = 0.76, 95% CI (0.19, 1.33), P < 0.05), and lasting 9-16 weeks (SMD = 0.66, 95% CI (0.16, 1.15), P < 0.01), moderate-intensity (SMD = 0.82, 95% CI (0.16, 1.48), P < 0.05) exercise was optimal for sperm motility intervention in young men.

Conclusion: Moderate exercise can increase semen concentration, sperm motility, and testosterone levels in men, increasing pregnancy rates and the number of live births. The ideal exercise intervention program to improve men's reproductive health consists of moderate exercise for 3-4 sessions per week, lasting 30-60 min each, over a total of 2-8 weeks.