GESTIÓN EN SALUD PÚBLICA: BioEdge: Declining sperm count could lead to ‘extinction’ | Saturday, July 29, 2017

sábado, 29 de julio de 2017

BioEdge: Declining sperm count could lead to ‘extinction’ | Saturday, July 29, 2017 | BioEdge

BioEdge: Declining sperm count could lead to ‘extinction’

Declining sperm count could lead to ‘extinction’

by Michael Cook | 29 Jul 2017 |

In the first systematic review of trends in sperm count, researchers this week reported in the journalHuman Reproduction Update a significant decline in sperm concentration and total sperm count among men from Western countries.

They found a 52.4 percent decline in sperm concentration, and a 59.3 percent decline in total sperm count among men from North America, Europe, Australia and New Zealand who were not selected based on their fertility status. In contrast, no significant decline was seen in South America, Asia and Africa, although far fewer studies have been conducted there.

The study also indicates the rate of decline among Western men is not decreasing: the slope was steep and significant even when analysis was restricted to studies with sample collection between 1996 and 2011.

Dr Hagai Levine, of Hebrew University, in Jerusalem, the lead author, told the BBC that if the trend continued humanity was in deep trouble. "If we will not change the ways that we are living and the environment and the chemicals that we are exposed to, I am very worried about what will happen in the future. Eventually we may have a problem, and with reproduction in general, and it may be the extinction of the human species."

While declines in sperm count have been reported since 1992, the question has remained controversial because of limitations in past studies. However, the current study uses a broader scope and rigorous meta-regression methods, conservatively addresses the reliability of study estimates, and controls for factors that might help explain the decline such as age, abstinence time, and selection of the study population.

"Given the importance of sperm counts for male fertility and human health, this study is an urgent wake-up call for researchers and health authorities around the world to investigate the causes of the sharp ongoing drop in sperm count, with the goal of prevention," said Dr Levine.

The findings have important public health implications. First, these data demonstrate that the proportion of men with sperm counts below the threshold for subfertility or infertility is increasing. Moreover, given the findings from recent studies that reduced sperm count is related to increased morbidity and mortality, the ongoing decline points to serious risks to male fertility and health.

While the current study did not examine causes of the observed declines, sperm count has previously been plausibly associated with environmental and lifestyle influences, including prenatal chemical exposure, adult pesticide exposure, smoking, stress and obesity. Therefore, sperm count may sensitively reflect the impact of the modern environment on male health across the lifespan and serve as a "canary in the coal mine" signalling broader risks to male health.

| Saturday, July 29, 2017 | BioEdge

We're back! And although the northern hemisphere summer is normally a slow-news season, bioethics has been on the front page of world newspapers.

The drama of the dying British baby Charlie Gard, his loving parents, the doctors at Great Ormond Street hospital in central London, and the English law has captured the imagination of people everywhere.

To be honest, I am not sure whose "side" I should be on. Parents should normally make healthcare decisions for their children.

But there are cases in which their choices are plainly wrong -- as a Swedish doctor suggests below in his version of the mysterious resdignation syndrome among refugee children -- and the advice of doctors should be heeded.

Which was the case here? We'd love to hear from you.