OBJECTIVE: To synthesise existing literature on exercise-induced alterations in semen parameters and to assess the clinical impact on male fertility.
METHODS: Studies reporting on the association between semen parameters and endurance exercise in healthy men were eligible. Men attending fertility clinics were excluded. We searched MEDLINE (PubMed), Embase, SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and International Clinical Trials Registry Platform (ICTRP) from their inception to May 28th 2022. JBI Critical Appraisal Tool was used to assess the potential risk of bias.
RESULTS: Thirteen studies met inclusion criteria, reporting on 280 subjects. Eight articles reported on endurance runners, three on cyclists and four on triathletes. Four studies did not find any statistically significant sperm alterations. Five reported significant changes in semen parameters, but these were not clinically relevant, as semen parameters remained well above World Health Organisation (WHO) thresholds. Four articles reported a decrease in semen quality with potential clinical consequences as they found a reduced number of sperm cells exhibiting normal morphology in cyclists and triathletes and a greater amount of DNA fragmentation in triathletes.
CONCLUSIONS: Endurance exercise can have a negative effect on semen quality, although rarely with a clinically relevant impact on male fertility. Evidence is however limited, with poor quality of the included studies.
BACKGROUND: PROSPERO International prospective register of systematic reviews (CRD42022336753).
目的:综合现有关于运动诱发精液参数改变的文献,并评估其对男性生育力的临床影响。
方法:关于健康男性精液参数与耐力运动之间关联的研究报告是合格的。参加生育诊所的男性被排除在外。我们搜索了MEDLINE(PubMed),Embase,SPORTDiscus,Cochrane中央对照试验登记册(中央),ClinicalTrials.gov和国际临床试验注册平台(ICTRP)从成立到2022年5月28日。JBI关键评估工具用于评估潜在的偏差风险。
结果:13项研究符合纳入标准,报告280个主题。八篇文章报道了耐力跑运动员,三个骑自行车的人和四个铁人三项运动员。四项研究没有发现任何统计学上显著的精子改变。五个报告了精液参数的显著变化,但这些与临床无关,由于精液参数仍远高于世界卫生组织(WHO)的阈值。四篇文章报道了精液质量的下降,并带来潜在的临床后果,因为他们发现自行车运动员和铁人三项运动员中表现出正常形态的精子细胞数量减少,而铁人三项运动员中DNA片段数量增加。
结论:耐力运动会对精液质量产生负面影响,尽管很少对男性生育能力有临床相关影响。然而证据有限,纳入研究的质量较差。
背景:PROSPERO国际前瞻性系统评价注册(CRD4202236753)。