Andrologia. 2020;00:e13549. wileyonlinelibrary.com/journal/and | 1 of 10 https://doi.org/10.1111/and.13549 © 2020 Blackwell Verlag GmbH 1 | INTRODUCTION Infertility is a worldwide problem, affecting 15% of all couples try- ing to conceive, with male infertility as the sole cause in 20%–30% of cases (Agarwal, Mulgund, Hamada, & Chyatte, 2015; Vaidya, Ahmed, Brunckhorst, Yap, & Shabbir, 2018). Several lifestyle factors may influence the spermatic quality, although this is not unanimous in the literature. The health benefits of exercising are yet difficult to evaluate. Current literature suggests that recreational physical activity has either a positive or a neutral effect on semen parameters (Eisenberg et al., 2014; Mínguez-Alarcón, Chavarro, Mendiola, Gaskins, & Torres-Cantero, 2014; Vaamonde, Silva-Grigoletto, Garcia-Manso, Barrera, & Vaamonde-Lemos, 2012). This happens because physi- cal exercise prevents underweight and overweight, and regulates hormone levels (Gomes, Freitas, & Fardilha, 2015). On the other Received: 29 June 2019 | Revised: 23 October 2019 | Accepted: 27 January 2020 DOI: 10.1111/and.13549 ORIGINAL ARTICLE Association of lifestyle factors with semen quality: A pilot study conducted in men from the Portuguese Trás-os-Montes and Alto Douro region followed in fertility support consultations Patrícia Pinto-Pinho 1,2 | Joana Matos 1 | Regina Arantes-Rodrigues 1,3 | Zélia Gomes 4 | Miguel Brito 4 | Osvaldo Moutinho 4 | Bruno Colaço 3 | Rosário Pinto-Leite 1 1 Genetics/Andrology Laboratory, Hospital Centre of Trás-os-Montes and Alto Douro (CHTMAD), Vila Real, Portugal 2 Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal 3 Centre for the Research and Technology of Agro-environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal 4 Department of Obstetrics and Gynecology, Hospital Centre of Trás-os-Montes and Alto Douro (CHTMAD), Vila Real, Portugal Correspondence Rosário Pinto-Leite, Laboratório de Genética, Centro Hospitalar de Trás-os- Montes e Alto Douro, Av. da Noruega, 5000-508 Vila Real, Portugal. Email: mlleite@chtmad.min-saude.pt Funding information Fundação para a Ciência e a Tecnologia, Grant/Award Number: UID/ AGR/04033/2019; Hospital Centre of Trás- os-Montes and Alto Douro Abstract A cross-sectional pilot study was conducted in men followed in fertility consulta- tions, from the portuguese Trás-os-Montes and Alto Douro region, in order to asso- ciate several lifestyle factors with the spermatic parameters. Of a total of 522 men, 373 were compared based on the occupational exposure to harmful factors, smoking habits and practice of physical exercise per week, and the other 149 men according to their body mass index (normal weight vs. overweight vs. obesity). In the absence of harmful occupational factors, physical exercise seems to be associated with sperm quality improvement, whether individuals smoke or not. When exposed to harmful environments, non-smokers that practice physical exercise more than two times per week tended to present the best vitality, normal morphology and sperm concentra- tion ( p > .05). However, if they smoke, physical exercise seems not enough to en- hance the spermatic parameters. The BMI correlated negatively with the spermatic quality, especially with sperm concentration ( p < .05). Concerning men that did not present lifestyle risks associated, the motility, midpiece and tail abnormalities, and teratozoospermia index were significantly worse on obese individuals comparing to overweight men ( p < .05). Thus, patients should also be recommended to control their weight and to have a BMI under 30 kg/m 2 . KEYWORDS body mass index, environmental exposure, physical exercise, semen quality, smoking