Received November 17, 2025
Accepted December 05, 2025

Infertility is a global reproductive disorder affecting approximately 45.8 million couples, with male factors implicated in 30–50% of cases. Although psychological stress has been associated with diminished sperm quality, defining it as a direct cause of male infertility remains challenging because study findings are inconsistent. Therefore, this review aimed to evaluate the extent to which psychological stress may adversely affect seminal quality parameters in men. A systematic review was conducted across Embase, PubMed, Scopus, and Web of Science, with included studies undergoing data extraction, risk of bias assessment, and narrative synthesis. Overall, 34 studies were included; three (8.82%) were judged to be at high risk of bias. The studies were published between 1988 and 2023 and comprised a total of 11,141 participants, with sample sizes ranging from 20 to 1,362 participants per study. Psychological stress negatively impacted semen volume in 12.9% of studies, sperm concentration in 52.9%, total sperm count in 56.3%, sperm motility in 63.3%, and sperm morphology in 21.4%. Sources of psychological stress—including academic stress, daily life stress, infertility-related stress, stressful life events, and work-related stress—were correlated with impairment of sperm parameters in 70.6% of included studies. Although evidence was not unanimous and the exact mechanism underlying deterioration of sperm health in stressful situations remained unclear, the findings indicate a complex relationship between psychological stress arising from different aspects of men’s lives and a decline in semen quality.