The Role of Exercise to Reduce the Impact of Diabetes in the Seminal Quality: A Systematic Review

Abstract

BackgroundandObjectives: One of the most relevant consequences of diabetes mellitus is the temporal or complete infertility which can happen in young individuals. Therefore, the current systematic review aimed to investigate the effects of exercise to reduce the impact of Type 2 Diabetes Mellitus (T2DM) in seminal quality and related parameters. MaterialsandMethods: A systematic search was conducted in Pubmed and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA). The inclusion criteria were: (1) the study included at least one experimental and one comparison group, (2) the sample of the study was comprised of humans or animals with diabetes mellitus, (3) an intervention based on physical exercise was conducted, and (4) the study reported variables related to the seminal quality. Results: A total of 115 articles were identified. However, only six accomplished the inclusion and exclusion criteria. This systematic review includes a sample size of 260 participants (180 rats and 80 humans). Intervention ranged from 6 to 14 weeks, with 3–6 days per week. All interventions performed endurance training (50–70% VO2max or maximum heart rate). Physical exercise increased sperm count, motility, and morphology, as well as improved testosterone, Luteinizing Hormone (LH), and Follicle Stimulating Hormone (FSH) levels. Moreover, physical exercise intervention reduced the percentages of sperms with negative Tubular Differentiation Index (TDI) and Spermiogenesis Index (SPI), DNA fragmentation, and also ameliorated the diabetes-induced apoptosis and improved sperm apoptosis index. Conclusions: Physical exercise could ameliorate diabetic pathological effects on sperm quality and related parameters that cause infertility or subfertility conditions. However, further homogeneous studies are needed to confirm these findings.

Type 2 diabetes mellitus and the risk of abnormal spermatozoa: A Mendelian randomization study

“…Although they summarize the effects including T1DM and T2DM, our findings may still contradict this. T2DM, accounting for approximately 85-95% of diagnosed DM cases, is the main type of DM ( 20 ), and has negative effects on multiple physiological systems, including the reproductive system. Currently, the incidence of T2DM is increasing rapidly among adolescents, especially men, which will lead to a significant increase in their prevalence of reproductive dysfunction ( 38 )..…”

“…Not surprisingly, the reproductive organs of those patients with DM can also be injured ( 13 , 19 ). Type 2 diabetes mellitus (T2DM) is the main type of DM cases diagnosed, accounting for about 85-95% ( 20 ). Numerous studies have revealed that temporary or complete infertility may occur in young adults of childbearing age with T2DM ( 21 ) T2DM can impair fertility in male animals at multiple levels, including dysregulation of endocrine control of spermatogenesis or impairing penile erection and ejaculation ( 22 , 23 ).…”

“…Numerous studies have revealed that temporary or complete infertility may occur in young adults of childbearing age with T2DM ( 21 ) T2DM can impair fertility in male animals at multiple levels, including dysregulation of endocrine control of spermatogenesis or impairing penile erection and ejaculation ( 22 , 23 ). Furthermore, the low fertility rate of DM patients is well known in humans although the pathophysiological mechanisms of damage are different in T1DM and T2DM ( 20 ). There is evidence of accelerated loss of β-cell function in in younger patients with T2DM, with a prevalence estimated at 31% T2DM has increased in 10-19 years ( 24 ).…”

Influence of physical activity on male fertility

“…Moreover, the results showed an increment in the level of semen total antioxidant capacity (TAC) and GPx (Rosety‐Rodriguez et al, 2014). In corroboration with these findings, a recently conducted systematic review in 2021, demonstrated positive impacts of endurance training on the hormonal level, sperm parameters, spermatogenesis and DNA fragmentation in type 2 diabetes‐induced condition (Lavín‐Pérez et al, 2021).…”

Type 2 diabetes mellitus and the risk of male infertility: a Mendelian randomization study

“…Type 2 diabetes mellitus (T2DM) is a heterogeneous disease caused by the interaction of genetic, environmental and other factors. It is the main type of diagnosed DM cases ( 5 , 6 ), accounting for about 90%-95% ( 7 ). In recent years, the incidence of T2DM has been increasing worldwide ( 8 ), and T2DM and its complications including ED have become a huge burden on global public health ( 9 ).…”