Effects of physical exercises on semen quality and reproductive outcomes in male infertility: A protocol for systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Infertility has troubled the world's 186 million people, and male infertility accounts for more than half. The literature of physical exercise related to semen quality has shown inconsistent results, and there is currently no systematic review to evaluate the effects of exercise on reproductive outcomes in male infertility patients. This study aims to assessing the effects of exercise interventions based on randomized controlled trials (RCTs) on semen quality and reproductive outcomes in male infertility. METHODS: English and Chinese literature about physical exercise treatment for male infertility published before July 31, 2019 will be systematic searched in PubMed, Embase, Web of Science, Cochrane Library, Open Grey, Clinicaltrials.gov, Chinese Clinical Trial Registry, WANFANG, VIP Chinese Science and Technology Journal Database, CNKI, Chinese biomedical document service system (SinoMed). Only RCTs of patients with male infertility will be included. Literature screening, data extraction, and the assessment of risk of bias will be independently conducted by 2 reviewers, and the 3rd reviewer will be consulted if any different opinions existed. Live-birth rate, pregnancy rate, adverse events (including miscarriage), sperm concentration, progressive motility, sperm morphology, and sperm DNA fragmentation will be evaluated. Systematic review and meta-analysis will be produced by RevMan 5.3 and Stata 14.0. This protocol reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION: We will assess the efficacy and safety of physical exercise on semen quality and reproductive outcomes in infertile men. The findings will be published in a peer-reviewed journal to provide evidence-based medical evidence for clinical decision making and the patient's lifestyle guidance. REGISTRATION INFORMATION: PROSPERO CRD42019140294