A world authority on human reproductive health is calling for a global response to an alarming decline in male fertility with an estimated one in 20 young men today having sperm counts low enough to impede conception.
Christopher Barratt, Professor of Reproductive Medicine at the University of Dundee in Scotland, said the world had not “woken up” to the impending crisis of male infertility and its longer-term economic and societal consequences.
He will highlight the need for a concerted global response to this issue as a keynote speaker at the 9th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2019) in Hong Kong this week.
Professor Barratt, formerly Director of the World Health Organisation’s Male Fertility Expert Working Group, said assisted reproductive technology was a highly newsworthy, multi-billion dollar enterprise to assist the one in six couples struggling to achieve their dream of having a baby.
He said success rates from procedures such as IVF, often including Intra Cytoplasmic Sperm Injection (ICSI) – where a single sperm is injected into an egg to assist fertilisation – had captured the attention of the general public.
“The perception from the outside is that all is well in the world of male reproduction, but this is an illusion,” he said. “Lack of knowledge and data about male infertility and how to treat it means that boosting a couple’s chances of having a baby will usually involve costly and invasive intervention for the female partner.
“In a world in which we claim to be addressing inequalities between men and women, the fact that the female partner often has to bear the burden of male infertility is an infringement of basic human rights and dignity.”
Professor Barratt said sperm counts had been declining steadily for the past 40 years and, while environmental factors may be the cause, the specific reason for this disturbing trend was only “educated guesswork.”
In some countries, including Scandinavia, there has been extensive research in this area, however in other parts of the world, including Africa, Asia and South America, there is little definitive data on male infertility.
Professor Barratt praised the Australian Government for a recent announcement that it was investing millions of dollars in a national men’s health strategy, including research into the causes and prevention of male infertility.
“Australia has grasped the nettle on this issue,” he said. “It is a shining light example that needs to be replicated around the world.”
Professor Barratt said the ASPIRE Congress in Hong Kong provided a powerful platform to promote awareness of male infertility in the Asia Pacific region of four billion people, representing about 60 per cent of the global population.
“We must engage medical professionals to develop the drive and energy to deal with this global health issue,” he explained. “Now is the time for an urgent wake-up call. The first step is to galvanise the professions into action and also to get a groundswell from patients pushing for this to be done.
“This should involve in part better promotion of positive lifestyle issues to help men make more informed choices about their reproductive health.
“Little progress has been made in developing new diagnostic tools or medical management strategies for male infertility beyond the advent of ICSI. Quality semen analysis could be part of the strategy of action as we now know for sure that semen samples analysed in different laboratories give different results, hence diagnostic and prognostic information.”
As sperm counts decline, the chances of achieving conception are less. Many men and women are also now delaying having children beyond prime reproductive age and in some parts of the world, including the European Union, family sizes are below population replacement level.
“The combined impacts of these factors equate to a very negative outlook,” Professor Barratt said.
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