The intersection of physical exercise, lifestyle, oxidative stress, and male infertility: A scoping review

Male infertility is significantly influenced by modifiable lifestyle factors such as physical inactivity, obesity, and oxidative stress. Precision exercise has emerged as a promising intervention to reduce oxidative stress and improve sperm quality. This scoping review aimed to map the current evidence on the role of precision exercise and targeted lifestyle modifications in improving fertility-related outcomes among infertile men, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) framework. A systematic search was performed in PubMed, ScienceDirect, and Wiley Online Library for studies published between 2020 and 2025. Eligible articles were screened, charted, and thematically analyzed, resulting in the inclusion of nine studies. Key themes were identified: (1) fatty acids and sperm quality, (2) oxidative stress, (3) antioxidants, (4) lifestyle and environmental factors, and (5) preconception care. Moderate physical activity and antioxidant-rich interventions were consistently associated with improvements in sperm motility, concentration, and morphology. In contrast, sedentary behaviour, heat exposure, obesity, and smoking were associated with a reduction in semen quality. In general, precision exercise and targeted lifestyle modifications demonstrate the potential to improve male fertility, although more standardized and longitudinal research is needed to support clinical application.