Male Infertility: Sperm Counts Continue To Decline Globally

Sperm count is not only an indicator of male fertility; it is also a gauge of men’s health. Alarmingly, however, sperm counts are continuing to decline rapidly across the globe, in what researchers have called a global crisis, which has broad implications for the survival of the human species.

In this article, we share the findings of an international team of researchers and the impact on fertility, and provide advice for those who are concerned about their sperm count.

Recently published research has shown declining sperm counts among men from South and Central America, Asia and Africa, and also shows that the decline in sperm counts in North America, Europe, and Australia – reported by the same team in 2017-has continued and even accelerated in the 21st century.

The research was published by an international team led by Professor Hagai Levine of Hebrew University of Jerusalem’s Hadassah Braun School of Public Health, with Prof. Shanna Swan at the Icahn School of Medicine, Mount Sinai, New York, along with researchers in Denmark, Brazil, Spain, Israel and the USA.

As Levine summarized these results: “Overall, we’re seeing a significant worldwide decline in sperm counts of over 50% in the past 46 years, a decline that has accelerated in recent years”.

Impact on fertility

The authors say that links between sperm count and infertility are well-recognized, and that the decline in sperm counts reflects a global crisis related to our modern environment and lifestyle, with broad implications for the survival of the human species.

Already approximately 30% to 40% of all infertility cases are due to a male factor, and in the vast majority of cases, male infertility is due to problems with the sperm.

Time is running out, cautioned Levine. “Our findings serve as a canary in a coal mine. We have a serious problem on our hands that, if not mitigated, could threaten mankind’s survival. We urgently call for global action to promote healthier environments for all species and reduce exposures and behaviours that threaten our reproductive health.”

Impact beyond fertility

However, sperm count is not only an indicator of human fertility; it also is an indicator of men’s health, with low levels being associated with increased risk of chronic disease, testicular cancer and a decreased lifespan.

Swan explained: “Low sperm counts do not only affect men’s fertility, but have serious ramifications for men’s health more generally, and are linked with other adverse trends, termed together as testicular dysgenesis syndrome. The troubling declines in men’s sperm concentration and total sperm counts at over 1% each year as reported in our paper are consistent with adverse trends in other men’s health outcomes, such as testicular cancer, hormonal disruption, and genital birth defects, as well as declines in female reproductive health. This clearly cannot continue unchecked.”

What is causing sperm count declines?

While the study did not examine the causes of sperm count declines, Levine pointed to recent research indicating that disturbances in the development of the reproductive tract during fetal life are linked to lifetime impairment of fertility and other markers of reproductive dysfunction. Additionally, Levine explained that “lifestyle choices and chemicals in the environment are adversely affecting this fetal development.”

The findings

Numerous studies have reported declines in semen quality and other markers of male reproductive health.

Previous research by the same team reported a significant decrease in sperm concentration (SC) and total sperm count (TSC) among men from North America-Europe-Australia (NEA) based on studies published during 1981-2013. In 2017, ‘Temporal Trends in Sperm Count: A Systematic Review and Meta-Regression Analysis’ was published (Levine et al.,2017). That article, which was widely discussed and highly cited, includes all eligible English-language publications in 1981 – 2013 that contained data on sperm count.

At that time, however, there were too few studies with data from South/Central America-Asia-Africa (SAA) to reliably estimate trends among men from these continents.

Published in the journal Human Reproduction Update, the aim of this latest sperm research, with data from 53 countries, was to examine trends in sperm count among men from all continents. It includes an additional seven years of data collection (2011-2018) and focuses on sperm count trends among men in regions not reviewed previously, specifically South America, Asia and Africa.
The data shows, for the first time, that men in those regions share the significant decline in total sperm counts (TSC) and sperm concentration (SC) seen previously in North America, Europe and Australia. Furthermore, this study shows an accelerated post-2000 decline in TSC and SC globally.

This substantial and persistent decline is now recognized as a significant public health concern. In 2018 already, a group of leading clinicians and scientists called for governments to acknowledge decreased male fertility as a major public health problem and to recognize the importance of male reproductive health for the survival of the human (and other) species (Levine et al.,2018).

Male infertility treatment

Fortunately for the millions of men affected by low or no sperm count, there are a range of treatments, procedures and options, thanks to great advances in medical technology.

For example, one of the major break throughs in treatment of male infertility is Intracytoplasmic Sperm Injection (ICSI). As the name ‘Intracytoplasmic Sperm Injection’ suggests, ICSI is used to inject the sperm directly into the egg during IVF (In Vitro Fertilisation) treatment.

ICSI is used in the case of poor semen characteristics. Because only a few normal sperm are needed and because of its rate of fertilisation of around 70%, this treatment gives even men who were previously considered completely sterile an excellent chance to have their own child. It is a revolution in the treatment of men with very severe infertility, making fatherhood possible for the most challenging of cases. To date, tens of thousands of children have been born around the world as the result of ICSI.

In addition to ICSI, Medfem Fertility Clinic also proudly offers a range of other treatments, including hormonal therapy, varicocele repair, vasectomy reversal, surgical sperm retrieval, artificial insemination (AI) or intrauterine insemination (IUI), sperm donations and freezing and storing semen samples for the future.

Where to get sperm count treatment

Treatment for low or no sperm count is available in South Africa at Medfem Fertility Clinic, provided by a team of highly qualified and experienced fertility experts and embryologists; and trained, qualified theatre staff, nurse practitioners, clinical psychologists and specialist pharmacists in state-of-the-art facilities equipped with advanced technologies to maintain a leading pregnancy success rate.

At Medfem we believe in helping you reach your family dream through:

* World-Class Fertility for Everyone – we believe in making world-class fertility treatments available for everyone

* A Positive Fertility Journey – It is our joy and commitment to give you a positive outcome to your fertility journey

* Delivered With Empathy & Caring – So you may have a fond memory, of a feeling of empathy, caring and being part of the Medfem family

If you would like to meet one of our fertility specialists at Medfem Fertility Clinic, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

Our Fertility Specialists can also meet with You During a Virtual Consultation Via Zoom or Skype. Click here to book a virtual consultation now.
We look forward to meeting you at Medfem Fertility Clinic!



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