Rumors of Declining Sperm Count Focus Attention on Male Reproductive Health

Reports of declining sperm counts worldwide can be attributed to geography, not physiology, according to one researcher.

“The issue of declining sperm counts is a hot issue that has been discussed widely in the media,” stated Harry Fisch, Columbia Presbyterian Medical Center, Columbia University, New York. “In reality there is no evidence of a worldwide decline in sperm counts.”

So reported Fisch at the annual meeting of the American Urological Association, held June 2-7, 2001, in Anaheim, California. According to Fisch, what was reported as a worldwide decline in sperm counts was really nothing more than a geographic variability.

“What I mean by that is that sperm counts are higher in different regions,” he explained. “We found this in [the U.S.]. For example, in New York sperm counts are higher than in California and Minnesota. So we went back and looked at the original data that suggested a worldwide decline and what we found is that the areas where sperm counts were very high were in New York only. When we removed New York from the data, we found no evidence in a decline of sperm counts worldwide.”

Besides statistical sampling, disease screening and other means of epidemiologic data collecting have played a role in sperm count data.

For example, Fisch and colleagues have found that the incidence of testicular cancer has increased in the United States and worldwide. “Interestingly, in the United States, the increase is only in whites,” he stated. “In black individuals, the incidence of testicular cancer has not gone up and this indicates obviously that there is a racial difference. There is evidence of some other external factors influencing the incidence of testicular cancer.”

He also reported that men are contracting testicular cancer at a younger age today than in years past. “We think it might be related in part to maternal and paternal age,” stated Fisch. “For example, the incidence of hypospadias, the congenital abnormality where the tip of the penis is not in the right place: we found that as men and women get older, they run a greater risk of having children with this disorder.”

So what do physicians tell their patients? “Do we tell them about declining sperm counts in another country?” he asked. “Certainly not. But what we can talk to them about is personal environmental factors.”

No pun intended, Katz said, but weight is a big issue. Men who have a higher percentage of body fat have lower testosterone levels and libido. These lower testosterone levels equate to lower sperm counts.

“We tell patients not to drink alcohol,” he continued. “Drinking alcohol is very detrimental, especially in patients with varicoceles. In situations where there is excessive drinking and liver abnormalities, we absolutely find a deterioration in health and sperm counts.”

He added that physicians should tell patients with fertility problems to avoid hot tubs and excessive heat because excessive heat can reduce sperm counts. Patients should be counseled not to smoke, and not to use marijuana or recreational drugs. Data have shown that these drugs really do cause decreases in sperm counts. Patients should also be counseled to be careful of what health foods they purchase as some may contain hormonal derivatives. “Hormones derived from external sources can reduce a man’s ability to produce these hormones on his own which can cause his sperm count to plummet,” Katz explained.

“These are all issues we can discuss with individual patients,” he continued. “It is also important to note that as men age, they are developing more problems. Many men are developing problems with the prostate, such as prostatitis. In our practice we have found that antibiotics are the one drug that can help improve pregnancy rates for our patients.

“The nice implications about all the research I have been doing is all the attention that it is bringing to male reproductive health,” he concluded. “Infertility is not just a woman’s problem. Infertility is associated with a male problem in 30%-55% of cases. Many women are subjected to tests and procedures that may be completely unnecessary. What I’m trying to suggest to physicians is that all couples coming in with infertility problems need to have the man evaluated also. It is as simple as a semen analysis being sent to a urologist who is familiar with problems in male infertility.”

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