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35B - Sperm Counts Are Falling Worldwide

Against

from Section VI - Male-factor Infertility

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

Claims that sperm counts have fallen worldwide are based on meta-analysis of sperm concentration data taken from a variety of published studies that were never designed to answer this question. Since methods of counting sperm in the laboratory over time have changed so markedly, both in terms of the techniques used and in terms of the staff training and quality control methods involved, this debate article argues that it is almost impossible to conclude that the proposed decline is anything other than methodological error. The American cosmologist Carl Sagan said that ‘extraordinary claims require extraordinary evidence’, and at the present time the author of this article argues that the data from these meta-analyses are not extraordinary evidence. To properly answer the question, it is proposed that adequately powered and controlled prospective studies be conducted at various locations around the world. Only then will we truly know whether sperm counts have declined worldwide or not.

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Publisher: Cambridge University Press
Print publication year: 2021

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References

Carlsen, E, Giwercman, A, Keiding, N, Skakkebaek, NE. Evidence for decreasing quality of semen during past 50 years. Br Med J. 1992;305:609–13.CrossRefGoogle ScholarPubMed
Pacey, AA. Are sperm counts declining? Or did we just change of spectacles? Asian J Androl. 2013;15:187–90.CrossRefGoogle ScholarPubMed
Levine, H, Jørgensen, N, Martino-Andrade, A, et al. Temporal trends in sperm count: a systematic review and met-regression analysis. Hum Reprod Update. 2017;23:646–59.CrossRefGoogle Scholar
Björndahl, L, Barratt, CL, Fraser, LR, Kvist, U, Mortimer, D. ESHRE basic semen analysis courses 1995–1999: immediate beneficial effects of standardized training. Hum Reprod. 2002;17:1299–305.CrossRefGoogle ScholarPubMed
Bonde, JP, Ramlau-Hansen, CH, Olsen, J. Trends in sperm counts: the saga continues. Epidemiology. 2011;22:617–19.CrossRefGoogle ScholarPubMed

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