Reproductive health is not just a female matter


Published 13 September 2018

World leaders in andrology call on governments to prioritise male reproductive health 'for the health and survival of our species'

A group of leaders in andrology have called on governments worldwide, as well as scientific and medical communities and the public, to make male reproductive health a priority. The campaigners, from Europe, USA, Australia and Japan, say in the Stockholm Male Reproductive Health Statement, that fertility has wrongly been regarded as only a female issue. They are now calling for more funding for research into male reproductive health which they argue has been neglected, partly because of cultural bias.

The statement signed by 27 clinicians, scientists and public health professionals highlights the importance of men’s fertility for ‘the health and survival of our species’. It outlines measures which they wish policy-makers worldwide to adopt.
These include stricter regulations governing the effect of pharmaceuticals on sperm function and the introduction of reproductive health surveillance systems.

Signatories, who include professors Roelof Menkveld and Lars Björndahl, both former co-ordinators of ESHRE's SIG Andrology, also want officials to devise health promotion and education programmes that emphasise the crucial contribution of both sexes to reproductive health.

The campaign comes in response to growing concerns around a decline in human sperm counts.
In July this year, a meta-analysis of 185 studies spanning 40 years found a reduction of more than 50% in sperm concentration and total sperm count.(1) The research was based on data involving nearly 43,000 men from North America, Europe, Australia and New Zealand. The study did not look at factors potentially behind this decline, but the impact of chemical exposures or maternal smoking on endocrine health and life-style are believed to be involved.

The 27 experts now campaigning for change say that semen quality is a strong indicator of a man’s future health and a decrease in fertility should be recognised as ‘a major public health problem’. However, they note that ART is now seen as the ‘remedy’ for almost all causes of male infertility, even severe cases, and add that this has led to a lack of motivation to sustain research in this area, despite little being known about possible long-term consequences.

In their statement, they emphasise that it is critical to continue research to improve clinical technologies, and not to succumb to ‘short-cutting strategies’. The scientific and medical community should collaborate in developing global and local research agendas, which would improve an understanding of the causes and implications of a decline in male reproductive health.

Simone Immler from the University of East Anglia and one of the signatories to the statement, told Focus on Reproduction that knowledge around male fertility ‘lags behind’ that concerning women’s.
She added: 'It’s only more recently that researchers have looked more closely into the role of male sperm and how it can be affected by factors such as environment. The general feeling is that research has focused on female fertility. We’re lagging behind on male reproductive health - it’s high time it was given more prominence.'

The statement can be viewed here as a PDF.

1. Levine H, Jorgensen N, Martino-Andrade A, et al. Temporal trends in sperm count: A systematic review and meta-regression analysis. Hum Reprod Update 2017; 23: 646-659.