Concerns about the potential impact of mobile phones on health are growing due to the increased use of the mobile phones, tablets, and other devices over the past few years. Mobile phones, wireless telephones, mobile base stations, and power lines are some of the main sources of our daily exposure to radiofrequency electromagnetic fields (RF-EMFs). There are more than 2 billion mobile phones in use worldwide [1-3].

Exposure to RF energy depends on the frequency of the mobile phone used. The most common frequency of phones used in the United States is 900 to 1900 MHz, while in many parts of the world, phones work at frequencies from 850 to 1800 MHz. The higher the frequency, the higher the energy. Radiant energy is absorbed by 3 main mechanisms in the human body: (1) Aural effect; the body receives and absorbs the RF signal depending on the size of the body part and the signal wavelength; (2) RF signal binds with tissue; and (3) absorption intensification [4,5].

The effects of electromagnetic radiation (EMR) can be divided into two main categories: thermal properties and nonthermal properties. Thermal properties are caused by the increase in temperature due to the energy absorption of oscillating electric fields. This can lead to heat in the exposed parts of the body. Thermal effects are calculated in terms of specific absorption rate. The specific absorption rate depends largely on the antenna, location, and frequency settings [6]. Some studies show that human exposure to RF waves can cause cognitive and behavioral impairments and decreased learning and memory. Significant thermal effects may be associated with adverse health effects such as problems with sleep, hearing, reproduction, impairment of the nervous system and increased cancer risk [7].

Infertility is defined as the inability to get pregnant after one year of intercourse without the use of contraceptive methods, and it affects 15% of couples worldwide. Male infertility is the cause of 30-50% of infertility, of which 30-40% of the causes are referred to as sperm disorders [8]. The influence of mobile phone exposure on male fertility has been studied in recent years [9]. In normal physiological conditions, spermatogenesis is a balanced process of maturation, cell division, and storage, which is particularly susceptible to environmental stimuli and chemicals. The mechanism is unclear, but its hypothesized that the component involved is the cytoskeleton which consists of charged proteins. The cytoskeleton is a structural and functional part of the cell that plays a main role in motility of the sperm and actively participates in the morphological alterations that happen during mammalian spermatogenesis [9,10].

A study of the effect of EMFs on female rats using transmission electron microscopy showed the increased existence of numerous drops of lipid in patches and luteal cells, as well as an increase in the number of autophilic antibodies and macrophages in some granulosa cells [11]. Other researchers showed that EMFs increase macrophages in the corpus luteum and growing follicles, and they believe that EMFs increase apoptosis in mice ovaries. In addition, most researchers showed that EMFs damage stromal cells in the uterus and uterine tubes through apoptosis of the glandular epithelium, ovarian cortex, and luminal epithelium [12,13].

It is necessary for future research to explore the safety criteria of RF-EMR. As electronic devices that emit RF-EMR are used very close to the body, RF shielding could be used in electronic devices to block RF-EMF waves and increase distance from them. Systematic review papers are a type of review that analyze the findings of other studies and provide the best evidence for a decision about a health approach [14]. Some studies demonstrated the potential harmful effects of RF on various sperm parameters, such as sperm motility, due to mobile phone usage [15]. Due to conflicting results among published research and since no systematic review has been performed to analyze the effects of RF-EMF exposure from other electronic devices on the fertility system in recent years, this evidence-based study is necessary.

The aims of this study are to clarify the best evidence associated with the influence of RF-EMFs on the fertility system and to make observations that could provide insight on a potential mechanism. The other objective of this study is to determine the effect of an RF-EMF on primary or secondary infertility.

This is a protocol for a systematic review, so the results are not presented. The results of this study will be submitted to a peer-reviewed journal for publication and also presented at PROSPERO (international prospective register of systematic reviews). The PROSPERO registration number is CRD42017072462.

The purpose of systematic reviews is to present a comprehensive summary of articles related to a study question and to provide solutions to disagreeing results between studies. While the greatest source of evidence for informed decisions is provided by systematic reviews and meta-analyses, to the best of our knowledge, this will be the first systematic review evaluating the radiofrequency electromagnetic field on fertility. This systematic review will provide evidence-based data on the effect of radiofrequency electromagnetic waves on fertility system. This article will also classify the harmful effect of RF waves on primary and secondary infertility and will validate the use of radiofrequency electromagnetic devices during reproductive period. This study could be useful for decreasing infertility. This is important due to the growing rate of infertility, which has negative outcomes for couples and health care system. The absence of studies evaluating the effects of radiofrequency electromagnetic waves on the fertility system will be a limitation of this study.