Trends in Sperm Count
Reporter and Curator: Dr. Sudipta Saha, Ph.D.
There has been a genuine decline in semen quality over the past 50 years. There is lot of controversy about this as there are limitations in studies that have attempted to address it. Sperm count is of considerable public health importance for several reasons. First, sperm count is closely linked to male fecundity and is a crucial component of semen analysis, the first step to identify male factor infertility.
Reduced sperm count is associated with cryptorchidism, hypospadias and testicular cancer. It may be associated with multiple environmental influences, including endocrine disrupting chemicals, pesticides, heat and lifestyle factors, including diet, stress, smoking and BMI. Therefore, sperm count may sensitively reflect the impacts of the modern environment on male health throughout the life span.
This study provided a systematic review and meta-regression analysis of recent trends in sperm counts as measured by sperm concentration (SC) and total sperm count (TSC), and their modification by fertility and geographic group. Analyzing trends by birth cohorts instead of year of sample collection may aid in assessing the causes of the decline (prenatal or in adult life) but was not feasible owing to lack of information.
This rigorous and comprehensive analysis found that SC declined 52.4% between 1973 and 2011 among unselected men from western countries, with no evidence of a ‘leveling off’ in recent years. Declining mean SC implies that an increasing proportion of men have sperm counts below any given threshold for sub-fertility or infertility. The high proportion of men from western countries with concentration below 40 million/ml is particularly concerning given the evidence that SC below this threshold is associated with a decreased monthly probability of conception.
Declines in sperm count have implications beyond fertility and reproduction. The decline reported in this study is consistent with reported trends in other male reproductive health indicators, such as testicular germ cell tumors, cryptorchidism, onset of male puberty and total testosterone levels. The public health implications are even wider. Recent studies have shown that poor sperm count is associated with overall morbidity and mortality. While the current study is not designed to provide direct information on the causes of the observed declines, sperm count has been plausibly associated with multiple environmental (including unwanted chemical exposure in alarming levels) and lifestyle influences, both prenatally and in adult life. In particular, endocrine disruption from chemical exposures or maternal smoking during critical windows of male reproductive development may play a role in prenatal life, while lifestyle changes and exposure to pesticides may play a role in adult life.
These findings strongly suggest a significant decline in male reproductive health, which has serious implications beyond fertility concerns. Research on causes and implications of this decline is urgently needed.
REFERENCES
Temporal trends in sperm count: a systematic review and meta-regression analysis
Hagai Levine, Niels Jørgensen, Anderson Martino‐Andrade, Jaime Mendiola, Dan Weksler-Derri, Irina Mindlis, Rachel Pinotti, Shanna H Swan. Human Reproduction Update, July 25, 2017, doi:10.1093/humupd/dmx022.
Link: https://academic.oup.com/humupd/article-lookup/doi/10.1093/humupd/dmx022.
Sperm Counts Are Declining Among Western Men – Interview with Dr. Hagai Levine
A critical method of evaluating tests for male infertility.
https://www.ncbi.nlm.nih.gov/pubmed/6688444
Estimating fertility potential via semen analysis data.
https://www.ncbi.nlm.nih.gov/pubmed/8458929
Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners.
https://www.ncbi.nlm.nih.gov/pubmed/9777833
World Health Organization reference values for human semen characteristics.
https://www.ncbi.nlm.nih.gov/pubmed/19934213
Intake of Fruits and Vegetables with Low-to-Moderate Pesticide Residues Is Positively Associated with Semen-Quality Parameters among Young Healthy Men.
https://www.ncbi.nlm.nih.gov/pubmed/27075904
Semen quality of Indian welders occupationally exposed to nickel and chromium.
https://www.ncbi.nlm.nih.gov/pubmed/12849857
Semen analyses in 1,283 men from the United States over a 25-year period: no decline in quality.
https://www.ncbi.nlm.nih.gov/pubmed/8612826
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