Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.
Front Public Health. 2022 Nov 3;10:1029469. doi: 10.3389/fpubh.2022.1029469. eCollection 2022.
Subfertility is a common problem for couples in modern society. Many studies have confirmed that lifestyle factors can affect fertility although there are conflicting conclusions relating to the effects of physical activity and sleep duration on fertility. In this study, we aimed to summarize and analyze the available evidence.
PubMed, Web of Science, Cochrane, and Embase databases (as of October 14, 2022) were systematically searched for eligible prospective cohort studies. Data were extracted and effect values were combined. We also performed methodological quality and bias risk assessments for all the included studies.
A total of 10 eligible articles were included in our analysis; seven investigated the relationship between physical activity and fertility, and three investigated the effect of sleep duration on fertility. Compared with the lowest level of physical activity, high intensity physical activity (the highest levels of physical activity) was negatively correlated with fertility [odds ratio (OR) = 0.84; 95% confidence interval (CI): 0.70, 1.00, = 64%]. However, we did not find an association between moderate intensity physical activity and fertility (OR = 1.09; 95% CI: 0.98, 1.22, = 60%). We observed an inverse association between limited sleep duration (≤ 7 h) and fertility (OR = 0.92; 95% CI: 0.84, 1.00, = 0%) compared with 8 h of sleep. The relationship between long sleep duration (≥9 h) and fertility was not statistically significant (OR = 0.85; 95% CI: 0.60, 1.21, = 83%). According to the Newcastle-Ottawa Scale score, the overall quality of the research articles included was ranked as medium to high (6-9). Through GRADE system, the quality of evidence for the impact of high intensity physical activity and limited sleep duration on fertility was moderate, while the quality of evidence for the impact of moderate intensity physical activity and long sleep duration on fertility was low.
The current evidence shows that high intensity physical activity and limited sleep time are negatively related to fertility. But there was great heterogeneity among studies, and the quality of research evidence was low to median. Thus, further high-quality research is needed to confirm this conclusion.
CRD42022298137.
生育能力低下是现代社会夫妇常见的问题。许多研究已经证实，生活方式因素会影响生育能力，尽管关于体力活动和睡眠时间对生育能力的影响存在相互矛盾的结论。在这项研究中，我们旨在总结和分析现有证据。
系统检索了 PubMed、Web of Science、Cochrane 和 Embase 数据库（截至 2022 年 10 月 14 日），以获取合格的前瞻性队列研究。提取数据并合并效应值。我们还对所有纳入研究进行了方法学质量和偏倚风险评估。
共有 10 篇符合条件的文章纳入我们的分析；7 项研究了体力活动与生育能力的关系，3 项研究了睡眠时间对生育能力的影响。与最低水平的体力活动相比，高强度体力活动（最高水平的体力活动）与生育能力呈负相关[比值比（OR）=0.84；95%置信区间（CI）：0.70，1.00， = 64%]。然而，我们没有发现中等强度体力活动与生育能力之间存在关联（OR=1.09；95%CI：0.98，1.22， = 60%）。与 8 小时睡眠相比，睡眠时间较短（≤7 小时）与生育能力呈负相关（OR=0.92；95%CI：0.84，1.00， = 0%）。睡眠时间较长（≥9 小时）与生育能力之间的关系无统计学意义（OR=0.85；95%CI：0.60，1.21， = 83%）。根据 Newcastle-Ottawa 量表评分，纳入研究文章的总体质量为中等到高（6-9 分）。通过 GRADE 系统，高强度体力活动和睡眠时间较短对生育能力影响的证据质量为中等，而中等强度体力活动和睡眠时间较长对生育能力影响的证据质量为低。
目前的证据表明，高强度体力活动和睡眠时间较短与生育能力呈负相关。但是研究之间存在很大的异质性，研究证据的质量为低到中。因此，需要进一步开展高质量的研究来证实这一结论。
PROSPERO 注册号：CRD42022298137。
