Declining Sperm Quality is a Global Health Emergency

A professor of pediatric endocrinology and andrology says that we've already waited two decades too long to address the problem.


New data demonstrating that men are about half as fertile as they were in the 1970s represents proof of a men’s health emergency, according to experts on reproduction and andrology. Niels Skakkebæk, a professor of pediatric endocrinology at the University of Copenhagen, is raising the alarm not only because his lab work shows that men may increasingly struggle to impregnate women, but also because research suggests that declining fertility may be correlated with an increase in testicular cancer and life-threatening illnesses.

“We have already waited too long,” Skakkebæk wrote ominously in the editorial.

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Fatherly spoke with Skakkebæk about what the current data says, and more importantly, how the research is failing to address a problem that’s been decades in the making, and instead has addressed mere symptoms of the problem.

Can you explain why men’s health is at risk, not just their fertility, as a result of this alarming trend?

There has, in the same period, also been an increase in other male reproductive malfunctions, including serum testosterone levels, or testosterone levels in the blood, and testicular cancer. Male reproductive health seems to be at risk. Male infertility also seems to be associated with poorer general health.

What makes this such an emergency, even for people who may not be affected directly by male infertility?

Well, it seems that many industrialized countries cannot sustain their populations. For instance, there are now 50 percent fewer young Germans and Japanese than in the 1960s.

Does this mean men should be as concerned with their cancer risk as they are with their infertility risk?

Yes, particularly men with cryptorchidism and poor semen quality and smaller testes have an increased risk and should do self-palpations regularly.

Cryptorchidism is a pretty common birth defect. How does this figure into the trend of poor male fertility?

Generally, men do not talk much about problems with their genitalia. However, it is well established that cryptorchidism is associated with reduced semen quality and increased risk of testicular cancer.

I believe mothers of babies usually are aware of the problem if it exists. However, infertility and testicular cancer are late symptoms and cryptorchidism does not affect the daily life of the boy and his family. Nowadays it is recommended that cryptorchidism is corrected surgically early in childhood.

What makes scientists suspect that this trend in male reproductive health is not a genetic issue primarily?

The rapid increases in testicular cancer and decreases in sperm counts and testosterone levels over the last few decades can only be explained by environmental factors in a broad sense, including lifestyle. Such rapid changes cannot be due to mutations in the genome. Although environmental factors seem to affect the unborn and newly born child more than adults, we know that adults can also suffer from environmental problems.

So what are the takeaways here? What can be done?

We are now suffering from a neglect over several generations in interest in male reproductive research. So, in most cases, doctors have little to offer. However, it is very important that not only the women is examined if a couple cannot have children. The man should have a full investigation.

It is surprising to see that the reproductive problems and low fertility rate below replacement levels continue now in second generations of industrialized countries like Japan, Singapore, and Germany. Governments in most industrialized countries do not seem to be able to see the writing on the wall that their populations will change drastically within one or two generations if the situation does not change.

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