The global obesity epidemic parallels a decrease in male fertility. Yet, the association between body mass index (BMI) and sperm parameters remains controversial. A negative correlation between BMI and sperm concentration or total sperm count (TSC) was shown by several reports,, but not documented by others., The purpose of this report was to update the level of evidence on the association between body mass index (BMI) and sperm count through a systematic review and meta-analysis.