Pw Kenny · Environment international 2024 · systematic review with dose-response meta-analysis of observational studies · n=9 studies

The effects of radiofrequency exposure on male fertility: A systematic review of human observational studies with dose-response meta-analysis.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of human observational studies

PubMed 38880061 · doi:10.1016/j.envint.2024.108817 · record verified 2026-08-26

What was done

As part of World Health Organization (WHO) exposure guideline development, authors systematically reviewed human observational studies on the effects of radiofrequency electromagnetic field (RF-EMF) exposure on male fertility endpoints (sperm concentration, morphology, total and progressive motility, total sperm count, and time to pregnancy). Databases including MEDLINE, Embase, Web of Science, and EMF Portal were searched. Risk of bias was appraised with the OHAT tool, evidence certainty graded via OHAT GRADE, and dose-response meta-analyses conducted where appropriate.

What was found

Nine studies were identified (7 general public, 2 occupational). Meta-analyses on daily mobile phone use duration found no statistically significant effects across semen parameters, all graded as very low certainty: - Sperm concentration: mean difference (MD) per hour of daily use 1.6 × 10⁶/mL (95% CI -1.7 to 4.9; 3 studies). - Sperm morphology: MD 0.15 percentage points deviation of normal forms per hour (95% CI -0.21 to 0.51; 3 studies). - Sperm progressive motility: MD -0.46 percentage points per hour (95% CI -1.04 to 0.13; 2 studies). - Total sperm count: MD -0.44 × 10⁶/ejaculate per hour (95% CI -2.59 to 1.7; 2 studies). For carrying a phone in a front pocket, qualitative synthesis indicated little or no effect on sperm parameters or time to pregnancy (1 of 3 studies found a significant effect on total motility/motile count). Occupational studies could not be pooled due to high heterogeneity and high risk of bias across domains.

Why it matters

This WHO-commissioned systematic review demonstrates that currently available observational evidence provides very low certainty regarding any adverse impact of mobile phone or occupational RF-EMF exposure on male reproductive health.

Limits

Only nine studies met inclusion criteria, with at most three contributing to any single meta-analysis. Most included studies had high risk of exposure characterization bias (often relying on self-reported phone use), selection bias, outcome assessment bias, and uncontrolled confounding. Total participant counts across studies were not reported in the abstract.

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