Male fertility concerns

Urgent action must be taken over the decline in male fertility in the Western world, an expert says today.

Professor Niels Skakkebaek, of the University of Copenhagen, Denmark, writes in today’s (11 October) BMJ that a recent meta-analysis showing significant declines in sperm counts among men in the Western world caught considerable media attention.

"Should we be concerned?" he asks. "Is male reproductive health really at risk?"

He highlights a parallel rise in male reproductive health problems which are linked to the risk of poor semen quality, such as trends in testicular germ cell cancer which has risen substantially over the past few decades, particularly in young men.

Professor Skakkebaek writes that one hypothesis is that these male reproductive disorders may be linked through a testicular dysgenesis syndrome affecting the function of testosterone production. "Testosterone levels among healthy men in the US, Denmark, and Finland have shown noteworthy falls over recent decades," he writes.

He adds that we do not know what could be causing these disturbing trends, but there is "little doubt that we should look into environmental causes including lifestyle effects" which include "food, water, skin, and work and home environments".

"Both wildlife research and experimental studies suggest that modern lifestyles are associated with increased exposure to various endocrine disrupting chemicals such as pesticides that together may be harmful to wildlife and humans, even though exposure to individual chemicals is low," he writes.

"However, little has been done to explore their potential effects on semen quality and testicular cancer."

He concludes: "In order to help future generations we must act now to prioritise new basic and clinical research programmes in reproductive medicine."

Skakkebaek, N. E. Sperm counts, testicular cancers, and the environment. BMJ 11 October 2017; doi: 10.1136/bmj.j4517 [abstract]

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