There’s been a lot of controversy and speculation surrounding the recently reported decline in sperm counts over the last 50 plus years. What the heck is going on? Are men really getting that unhealthy? Is it something in our environment?
Read on to find out what the current research is saying and protect yourself from becoming part of this dubious statistic.
How the Sperm Count Crisis Began…
The Elisabeth Carlsen Study
All the concern about lowering sperm counts began right around the time a study was released by Elisabeth Carlsen and associates in 1992. The purpose of this study was to determine whether there was a significant change in sperm quality over the previous 50 years.
Carlsen’s study examined and analyzed 61 research papers published on the subject from 1938 to 1991 to look for growing trends and possible correlations.
These 61 investigations looked at the sperm production of almost 15,000 men.
The results indicated that male sperm production decreased substantially over this 50-year period. Findings revealed that both sperm count and semen volume declined drastically, with sperm counts receding by a whopping 50% (1).
Not only did the research show significant decreases in sperm production, but the findings also supported the increased prevalence of male reproductive disorders, such as:
- Testicular cancer
- Cryptorchidism – one or both testicles fail to descend
- Hypospadias – the opening of the urethra is located on the underside of the penis instead of the tip
There is no question that bold claims were made in Carlsen’s findings; however, they were met by a lot of skepticism and resistance.
Some of the researchers who reviewed the work of Carlsen et al. felt the results needed a second look and may not have accurately represented the entire male population.
The Harry Fisch Review
Harry Fisch and associates performed a review of the findings presented by Carlsen a few years later in 1996.
Fisch found the following issues in Carlsen’s research:
- Only 20 of the 61 studies included more than 100 subjects
- The men included in these 20 studies represented 91% of the total subjects (2)
- Between 1938 and 1970 there were only 5 studies with 100 or more subjects
- All 5 studies were done in the US and 4 of those were conducted in New York city (2)
- The other 15 of the 20 studies including 100 or more participants were carried out after 1970
- Only 3 of these were done in the US with 1 in New York city (2)
- 5 of the 7 studies with lowest sperm counts were conducted in third world countries (2)
As you can see, these findings done by Fisch’s team cast some doubt on the legitimacy of the findings presented by Carlsen.
It’s not accurate to claim continuity of sperm count decline when the studies to substantiate this claim are from a variety of different locations.
Fisch’s findings served to raise more questions such as; “Is geographical location a contributing factor to declining sperm quality?”. An important consideration for sure.
Numbers Not Reflecting the Decline?
Another good point which was raised about Carlsen’s findings was from hormone and infertility specialist Dr. Brad Anawalt.
A typical average sperm count sits at around 60 to 70 million sperm per millilitre of semen. This has been the reported average or norm for decades.
So, if sperm production really has declined by 50%, shouldn’t the average male sperm count now sit at roughly 30 to 35 million sperm per ml?
Dr. Anawalt claims that this drop off in average sperm count is not happening. He is looking at male infertility and assessing sperm quality on a daily basis and has seen no evidence to support a 50% reduction in sperm count for the average male.
However, Anawalt’s conclusions are from a small sample of males in one geographic location.
Even though there is some contention about just how serious the decline is. Most experts will still agree that there is a notable decrease in sperm counts and an increase in male infertility.
The Hagai Levine Study
Similar to the study done by Elisabeth Carlsen and her group, another long-term research analysis was carried out by Hagai Levine and associates. The analysis examined 185 sperm count studies based on semen samples provide by almost 43,000 men between 1973 and 2011 (3).
The findings of this research were similar to that of Carlsen’s team, reporting a 52% reduction in sperm concentration and 59% decrease in total sperm count.
These numbers were based on men from North America, Europe, and Oceania.
Extracting exact meaning from these numbers may be challenging, but it seems like it’s pretty safe to say that sperm counts are on the decline in many western countries.
Researchers involved in this study questioned whether these findings could be an indication of a much larger problem in male health.
What About Sperm Quality?
Most of the older studies on male infertility assessed only sperm count, concentration, and semen volume, but did not look at sperm quality.
Sperm quality is generally appraised based on sperm motility (mobility) and sperm morphology (shape).
Recent studies indicate that along with sperm counts, sperm motility is also on the decline.
ASRM Study
One study presented at the 2018 ASRM (American Society for Reproductive Medicine) summit supported this assertion (4).
The study included 120,000 men with infertility problems. The results showed that Total Motile Sperm Count (TMSC) decreased by more than 5% from 2002 to 2017. Perhaps not the most impressive decline on the surface but note the shorter time frame compared to the other studies mentioned above. Five percent in just 15 years is certainly significant.
Mount Sinai Study
A similar study was done in the US to measure the TMSC of sperm donors with no reported infertility issues.
2586 donors spread out over 5 US cities provided sperm samples between 2007 and 2017. The results showed declines in total sperm count, sperm concentration, and total motile sperm count everywhere except New York city…must be the pizza.
Research continues to show sperm production and quality are trending downwards.
What is Causing the Decline?
If we can agree that there is some marked level of decline in sperm production, the next thing to look at is why? What could possibly be causing these declines?
This can spark another debate about whether sperm quality declines due to lifestyle and environment, or if men are born with these deficiencies. Or perhaps it’s a combination of the two?
Maybe He’s Born With It?
Is the significant drop off in sperm count the result of changing male genetics?
Some theories about declining male fertility are based on biological and genetic factors rather than environmental or behavioural causes.
For example, it is hypothesized that reduced sperm production may be caused by factors such as:
- Lower testosterone levels
- Cryptorchidism
- Hypospadias
- Testicular cancer
- Male AGD reduction
Low Testosterone Levels
Low testosterone levels (aka low T), has been linked to reduced sperm production and male infertility (5).
Low T can occur through a number of different ways. However, in some cases, low testosterone levels are thought by some to begin in utero.
For example, the Leydig cells found in the testes are responsible for hormone production. These cells begin to form and develop in utero and if underdeveloped, are thought to be a cause of low T and decreased sperm production.
Cryptorchidism
Cryptorchidism occurs when one or both testicles fail to drop into the scrotum. The testes should drop before the age of nine months. Cryptorchidism has also been associated with increased risk of infertility and reduced sperm production (7).
Hypospadias
Hypospadias is another reproductive abnormality where the opening of the urethra is located on the underside of the penis instead of at the tip where it should be.
This condition is not necessarily indicative of infertility issues, but it is another example of male reproductive disorders appearing at birth (8).
Testicular Cancer
Testicular cancer has also been linked with abnormalities in semen production and lowered sperm counts (9).
Cryptorchidism (see above) can be a risk factor for developing testicular cancer.
Male AGD
AGD refers to anogenital distance, which means the distance from the genitals to anus.
Some research indicates that a shorter AGD in males may contribute to lower sperm production (10,11).
However, there is not enough evidence to establish a causal link.
Lifestyle and Sperm Production
The other side of the coin talks about lifestyle and environmental factors as the major factors that contribute to lower sperm counts and concentrations.
Some of these factors may include:
- Diet
- Environment
- Exercise
- Underwear
- Cell phones
- Bad habits
Diet
Diet is almost always considered when determining causal factors for a variety of health problems, and male infertility is no exception.
Research indicates that diets that are high in nutrients and low in fats and sugars may have a positive role in sperm production and overall health.
For example, plant-based diets that are high in antioxidants can help boost sperm counts and sperm quality (12). Avoiding processed foods is always recommended for better sperm health.
For a list of foods that are killing your sperm – click here
Environment
Research has been done on the effect that chemicals like phthalates can have on a developing fetus. One study showed how phthalates may affect testosterone production, compromising testicular function (6).
Common sources of phthalates include plastics, personal care products and polyvinyl chloride (PVC).
Want to go phthalate free? Check out this website
Bisphenol A (BPA) is a common environmental chemical in plastics which has also shown to be correlated to a decline in sperm health. (17) Commonly thought of as an endocrine disrupter, it can affect both female and male hormones and may reduce fertility.
Exercise
A sedentary lifestyle has also been linked to lower sperm production, and obesity can negatively impact sperm quality (13). This should come as no surprise to anyone. It would be hard to deny the connection between our sedentary jobs and lives to declining sperm counts.
Increased daily exercise can help boost testosterone, resulting in improved sperm health.
Underwear
It has been reported that tight-fitting underwear, namely briefs (aka tightie whities), can contribute to lower sperm production.
This issue is most likely due to increased heat in the scrotum that is caused by the scrotum being closer to the body.
Cell Phones
The heat, along with the electromagnetic waves, given off by cell phones are thought to have a detrimental effect on sperm production (14).
For a more in-depth look at how cell phones may affecting your sperm counts – click here.
Poor Lifestyle Choices
There are several studies that indicate a correlation between low sperm counts and poor lifestyle choices, like:
- Excess alcohol and drug consumption
- Smoking
- Eating processed food (see dietary info above)
- Inactive lifestyle (see exercise info above)
Solutions for Healthy Sperm Production
If you are dealing with male infertility issues caused by low sperm count or impaired sperm quality, there are several things you can do to try to correct the issue.
Some simple and helpful suggestions for treatments include:
- Dietary changes
- Getting more exercise
- Getting optimal sleep
- Reducing your stress
- Taking supplements
- Consider getting a semen analysis
Dietary Adjustments
This may be the best thing you can do naturally in order to improve sperm quality, as well as your overall health.
Some ways to change your diet are:
- Target foods rich in antioxidants and nutrients (including folate, vitamin C, zinc, vitamin E etc.)
- Avoid foods high in soy or synthetic estrogens
- Cut out unhealthy fats (trans fats – read your labels!)
- Cut out refined sugar
- Reduce consumption of processed foods (deli meats, pastries, boxed foods etc)
More Exercise
Even just 40 minutes a day of moderate exercise can help improve your overall health.
More Sleep
Research indicates that not getting the required amount of sleep can have negative effects on sperm production (15).
Reduce the amount of screen time you do at night – put down the iPad and pick up a book! If that doesn’t work, consider deep breathing and meditation exercises. Melatonin can also be very helpful for those having difficulty sleeping.
Reduce Stress
This one is obviously easier said than done, but reducing daily stress can significantly help boost overall health and sense of well-being.
The relationship between stress and infertility has been deliberated extensively (16).
If you have excess stress in your life, incorporate deep breathing with daily exercise. We can’t “stress” how important and helpful these positive lifestyle choices can be.
Take Supplements
A variety of supplements can be taken to help improve male infertility and boost sperm production.
It is a good idea to talk to a health care professional before taking any supplements.
Not sure which supplements are best for your situation? Book an online consultation with Drew and take only the supplements you really need.
Sperm Averages
Even though average sperm counts have been on the decline, a sperm count is still not considered a serious concern until it goes below 15 million sperm/ml.
However, I am always surprised when men come into my clinic and tell me their sperm count is fine and after reviewing their semen analysis, they are “barely” above normal. Remember, you shouldn’t be happy with just a barely normal sperm count. You should be thinking about optimizing your sperm…making your sperm as healthy as it can possibly be.
Don’t be satisfied with below average numbers when it comes to your sperm. Better sperm make for better embryos which can mean a healthier pregnancy and baby.
Conclusion
Although sperm counts are not quite at an apocalyptic point like some articles would have you believe, it should be a rather large wake up call for men to take better care of themselves for their fertility futures.
If you are a man looking to improve your sperm count or other sperm related issue and you’re not quite sure where to start, contact Drew and book an online consultation today!
References
- Carlsen, E. Et al. Evidence for decreasing quality of semen during past 50 years. PubMed, 1992.
- Fisch, H. Et al. Geographic variations in sperm counts: a potential cause of bias in studies of semen quality. American Society for Reproductive Medicine, 1996.
- Levine, H. Et al. Temporal trends in sperm count: a systematic review and meta-regression analysis. Human Reproduction Update, 2017.
- ASRM. Sperm Count and Motility in Decline in North America and Europe. American Society for Reproductive Medicine’s 2018 Scientific Congress & Expo, 2018.
- Majzoub, A. Et al. Testosterone replacement in the infertile man. PubMed, 2016.
- Chang, H.W. Phthalates might interfere with testicular function by reducing testosterone and insulin-like factor 3 levels. PubMed, 2015.
- Chung, E. Cryptorchidism and its impact on male fertility: a state of art review of current literature. PubMed, 2011.
- Singh, J.C. Et al. Effect of hypospadias on sexual function and reproduction. PubMed, 2008.
- Djaladat, H. Et al. The Association Between Testis Cancer and Semen Abnormalities Before Orchiectomy: A Systematic Review. PubMed, 2014.
- Eisenberg, M. Anogenital distance as a measure of human male fertility. PubMed, 2014.
- Mendiola, J. Et al. Shorter Anogenital Distance Predicts Poorer Semen Quality in Young Men in Rochester, New York. PubMed, 2011.
- Nassan, F.L. Diet and men’s fertility: does diet affect sperm quality? PubMed, 2018.
- Rosety, M.A. Exercise improved semen quality and reproductive hormone levels in sedentary obese adults. PubMed, 2017.
- Gorpinchenko, I. The influence of direct mobile phone radiation on sperm quality. PubMed, 2014.
- Liu, M.M. Et al. Sleep Deprivation and Late Bedtime Impair Sperm Health Through Increasing Antisperm Antibody Production: A Prospective Study of 981 Healthy Men. PubMed, 2017.
- Rooney, K. Et al. The relationship between stress and infertility. PubMed, 2018.
- Song X, Miao M, Zhou X, Li D, Tian Y, Liang H, Li R, Yuan W. Bisphenol A Exposure and Sperm ACHE Hydroxymethylation in Men. Int J Environ Res Public Health. 2019 Jan 8;16(1).
