Exercise & Training

Exercise intervention improves fertility outcomes in females and males: an umbrella review of meta-analyses.

TL;DR

Exercise is associated with improved fertility and reproductive health outcomes in both females and males, supporting its potential role as an adjunctive, low-cost, noninvasive component of fertility management, though certainty of evidence ranged from high to very low across outcomes with most evidence rated as low or very low certainty.

Key Findings

Exercise showed positive effects on reproductive hormonal profiles in females, including sex hormone-binding globulin (SHBG) and anti-Müllerian hormone (AMH).

  • The umbrella review covered 13 meta-analyses including 24,470 females and 8,068 males.
  • Positive hormonal effects were observed specifically for SHBG and AMH in female participants.
  • Six databases were searched from inception to 24 November 2025: PubMed, Cochrane Library, Web of Science, Scopus, EBSCOhost, and Google Scholar.
  • Eligible studies were restricted to systematic reviews with meta-analyses of randomised controlled trials.

Exercise in females was associated with higher ovulation rate, pregnancy rate, and clinical pregnancy rate.

  • These outcomes were identified across the 13 included meta-analyses covering female participants.
  • Methodological quality, risk of bias, and certainty of evidence were assessed using AMSTAR 2, ROBIS, and GRADE respectively.
  • The certainty of evidence ranged from high to very low across outcomes, with most evidence rated as low or very low certainty.
  • Overlap among reviews was managed using citation matrices to avoid double-counting evidence.

Exercise in males was linked to improvements in sperm quality, including sperm concentration, morphology, count, and semen volume.

  • Male participants numbered 8,068 across the included meta-analyses.
  • Four specific sperm quality parameters showed improvement: concentration, morphology, count, and semen volume.
  • All included studies were meta-analyses of randomised controlled trials.
  • Heterogeneity across populations and exercise intervention components limited confidence in the findings.

Exercise in male participants was associated with higher pregnancy rates in their female partners.

  • This finding links male exercise behavior to a downstream reproductive outcome in female partners.
  • The evidence was drawn from meta-analyses of randomised controlled trials included in the umbrella review.
  • The certainty of evidence for most outcomes was rated as low or very low by GRADE assessment.
  • The review protocol was registered with PROSPERO (CRD42025638675).

The certainty of evidence across fertility-related exercise outcomes ranged from high to very low, with most outcomes rated as low or very low certainty.

  • Certainty was assessed using the GRADE framework.
  • Heterogeneity across populations and exercise intervention components (type, intensity, duration, frequency) limited confidence.
  • Thirteen meta-analyses were included in total, representing a broad but variable evidence base.
  • The authors called for further high-quality trials to clarify optimal exercise prescriptions and strengthen certainty of evidence.

The umbrella review identified exercise as a potential adjunctive, low-cost, noninvasive component of fertility management for both females and males.

  • The review covered a combined sample of 24,470 females and 8,068 males across 13 meta-analyses.
  • Exercise was described as 'low cost and biologically plausible' as a lifestyle strategy for improving reproductive outcomes.
  • The review noted that scalable lifestyle strategies to improve reproductive outcomes remain limited in the context of infertility as 'a major global health burden.'
  • The authors concluded that further trials are needed to clarify optimal exercise prescriptions.

What This Means

This research pooled results from 13 separate scientific analyses covering over 24,000 women and 8,000 men to examine whether exercise can improve fertility outcomes. The study found that physically active women tended to have better hormonal profiles related to reproduction—specifically higher levels of SHBG and AMH—as well as higher rates of ovulation, pregnancy, and clinical pregnancy. In men, exercise was linked to better sperm quality across multiple measures including count, concentration, shape, and semen volume, and men who exercised were more likely to have partners who became pregnant. The findings suggest that exercise may be a practical, affordable tool to support reproductive health for people trying to conceive, regardless of sex. Unlike many fertility treatments, exercise requires no medical procedure and carries few risks, making it a potentially accessible option to complement conventional fertility care. However, the researchers caution that the quality of the underlying evidence was mostly rated as 'low' or 'very low' certainty, meaning these results should be interpreted carefully. This research suggests that while exercise appears promising for improving fertility-related outcomes, scientists do not yet have enough high-quality evidence to say exactly what type, intensity, or duration of exercise works best. More rigorously designed clinical trials are needed before firm recommendations can be made. In the meantime, the findings add to growing evidence that general physical activity may have benefits beyond cardiovascular and metabolic health, extending into reproductive health for both women and men.

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Citation

Lam L, Alemu B, Davenport M, Wang C, Chan Y, Wang Y. (2026). Exercise intervention improves fertility outcomes in females and males: an umbrella review of meta-analyses.. Journal of global health. https://doi.org/10.7189/jogh-16-04282