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Semen quality of young men in Switzerland: a nationwide cross-sectional population-based study.

ABSTRACT: BACKGROUND:Sperm counts have been steadily decreasing over the past five decades with regional differences in the Western world. The reasons behind these trends are complex, but numerous insights indicate that environmental and lifestyle factors are important players. OBJECTIVE:To evaluate semen quality and male reproductive health in Switzerland. MATERIALS AND METHODS:A nationwide cross-sectional study was conducted on 2523 young men coming from all regions of Switzerland, recruited during military conscription. Semen volume, sperm concentration, motility, and morphology were analyzed. Anatomy of the genital area and testicular volume was recorded. Testicular cancer incidence rates in the general population were retrieved from Swiss regional registries. RESULTS:Median sperm concentration adjusted for period of sexual abstinence was 48 million/mL. Comparing with the 5th percentile of the WHO reference values for fertile men, 17% of men had sperm concentration below 15 million/mL, 25% had less than 40% motile spermatozoa, and 43% had less than 4% normal forms. Disparities in semen quality among geographic regions, urbanization rates, and linguistic areas were limited. A larger proportion of men with poor semen quality had been exposed in utero to maternal smoking. Furthermore, testicular cancer incidence rates in the Swiss general population increased significantly between 1980 and 2014. DISCUSSION:For the first time, a systematic sampling among young men has confirmed that semen quality is affected on a national level. The median sperm concentration measured is among the lowest observed in Europe. No specific geographical differences could be identified. Further studies are needed to determine to what extent the fertility of Swiss men is compromised and to evaluate the impact of environmental and lifestyle factors. CONCLUSION:A significant proportion of Swiss young men display suboptimal semen quality with only 38% having sperm concentration, motility, and morphology values that met WHO semen reference criteria.

SUBMITTER: Rahban R

PROVIDER: S-EPMC6790593 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Semen quality of young men in Switzerland: a nationwide cross-sectional population-based study.

Rahban R R Priskorn L L Senn A A Stettler E E Galli F F Galli F F Vargas J J Van den Bergh M M Fusconi A A Garlantezec R R Jensen T K TK Multigner L L Skakkebaek N E NE Germond M M Jørgensen N N Nef S S

Andrology 20190521 6

<h4>Background</h4>Sperm counts have been steadily decreasing over the past five decades with regional differences in the Western world. The reasons behind these trends are complex, but numerous insights indicate that environmental and lifestyle factors are important players.<h4>Objective</h4>To evaluate semen quality and male reproductive health in Switzerland.<h4>Materials and methods</h4>A nationwide cross-sectional study was conducted on 2523 young men coming from all regions of Switzerland, ...[more]

PMID: 31115178

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Project description:ObjectivesConsiderable interest and controversy over a possible decline in semen quality during the 20th century raised concern that semen quality could have reached a critically low level where it might affect human reproduction. The authors therefore initiated a study to assess reproductive health in men from the general population and to monitor changes in semen quality over time.DesignCross-sectional study of men from the general Danish population. Inclusion criteria were place of residence in the Copenhagen area, and both the man and his mother being born and raised in Denmark. Men with severe or chronic diseases were not included.SettingDanish one-centre study.Participants4867 men, median age 19 years, included from 1996 to 2010.Outcome measuresSemen volume, sperm concentration, total sperm count, sperm motility and sperm morphology.ResultsOnly 23% of participants had optimal sperm concentration and sperm morphology. Comparing with historic data of men attending a Copenhagen infertility clinic in the 1940s and men who recently became fathers, these two groups had significantly better semen quality than our study group from the general population. Over the 15 years, median sperm concentration increased from 43 to 48 million/ml (p=0.02) and total sperm count from 132 to 151 million (p=0.001). The median percentage of motile spermatozoa and abnormal spermatozoa were 68% and 93%, and did not change during the study period.ConclusionsThis large prospective study of semen quality among young men of the general population showed an increasing trend in sperm concentration and total sperm count. However, only one in four men had optimal semen quality. In addition, one in four will most likely face a prolonged waiting time to pregnancy if they in the future want to father a child and another 15% are at risk of the need of fertility treatment. Thus, reduced semen quality seems so frequent that it may impair the fertility rates and further increase the demand for assisted reproduction.

Project description:ObjectiveStudy associations between three measures of alcohol consumption (recent, typical/habitual, binging), semen quality and serum reproductive hormones.DesignCross-sectional population based study.Setting and participants1221 young Danish men, aged 18-28?years were recruited when they attended a compulsory medical examination to determine their fitness for military service from 2008 to 2012. Total alcohol consumption: (1) in the week preceding (habitual/typical) the visit (recent alcohol intake), (2) in a typical week and (3) frequency of 'binge drinking' (consuming more than 5 units/day)) in the past 30?days was estimated.Main outcome measuresSemen quality (volume, sperm concentration, total sperm count, and percentages of motile and morphologically normal spermatozoa) and serum concentration of reproductive hormones (follicle-stimulating hormone, luteinising hormone, testosterone, sex hormone binding globulin, oestradiol, free testosterone and inhibin B).ResultsSperm concentration, total sperm count and percentage of spermatozoa with normal morphology were negatively associated with increasing habitual alcohol intake. This association was observed in men reporting at least 5 units in a typical week but was most pronounced for men with a typical intake of more than 25 units/week. Men with a typical weekly intake above 40 units had a 33% (95% CI 11% to 59%) reduction in sperm concentration compared to men with an intake of 1-5 units/week. A significant increase in serum free testosterone with increasing alcohol consumption the week preceding the visit was found. Binging was not independently associated with semen quality.ConclusionsOur study suggests that even modest habitual alcohol consumption of more than 5 units per week had adverse effects on semen quality although most pronounced associations were seen in men who consumed more than 25 units per week. Alcohol consumption was also linked to changes in testosterone and SHBG levels. Young men should be advised to avoid habitual alcohol intake.

Project description:BackgroundThis is the first large-scale Russian study describing semen quality and reproductive hormone levels among young men.ObjectivesThe aim of the study was to compare semen quality and reproductive hormone levels in young men of four cities and three ethnic groups living in the Siberian region of Russia and to find out ethnic or environmental reasons for regional differences.Materials and methodsThe study population consisted of 1291 young men from Novosibirsk, Kemerovo, Ulan-Ude, and Yakutsk, including 1013 men of three most numerous ethnic groups: Slavs, Buryats, and Yakuts. Each participant provided one sperm and blood sample, information about lifestyle and ethnicity. Anthropometric parameters, semen quality and reproductive hormone levels, were evaluated.ResultsSignificant regional and ethnic differences were detected for semen and reproductive hormone parameters. Median sperm concentrations in Novosibirsk, Kemerovo, Ulan-Ude, and Yakutsk were 54.6, 39.9, 34.7, 33.1 × 106 /ml; total sperm counts-202.5, 138.7, 97.9, 93.4 × 106 ; percentages of morphologically normal spermatozoa-7.8%, 6.5%, 6.3%, 5.0%, respectively. Median sperm concentrations in Slavs, Buryats, and Yakuts were 43.7, 37.0, 30.6 × 106 /ml; total sperm counts-150.0, 102.3 and 74.8 × 106 ; percentages of morphologically normal spermatozoa-6.8%, 6.8%, 4.8%, respectively.DiscussionThe young men in Novosibirsk and Kemerovo, populated by Slavs, had a higher semen quality compared to Ulan-Ude and Yakutsk, populated by Buryats and Yakuts, apparently due to the higher testicular function in Slavic compared to Asian ethnicity. Impaired spermatogenesis in young men in Kemerovo compared to Novosibirsk, located in the same climatic zone and having a socio-cultural and ethnic identity, may be due to the influence of a polluted environment.ConclusionThe findings suggest that ethnic composition and environment may be responsible for regional differences in semen and reproductive hormone parameters.

Project description:Study questionIs anogenital distance (AGD) associated with semen quality and reproductive hormones in men from the general population?Summary answerShort AGD measured from the anus to the base of scrotum (AGDAS) was associated with reduced sperm counts and morphology but not with sperm motility or reproductive hormones.What is known alreadyAGD is longer in males than in females. In rodents, AGD is a well-established and sensitive marker of disruption during the masculinization programming window in utero and it has been suggested to be so in humans as well. Therefore, the average AGD would be expected to be shorter in men with poor semen quality, which some studies have confirmed while others have not.Study design, size, durationThis cross-sectional population-based study was of 1106 men included between 2012 and 2016.Participants/materials, setting, methodsMen from the general Danish population (median age 19 years), unselected with regard to fertility status and semen quality, delivered a semen sample, had a blood sample drawn, which was analyzed for concentrations of reproductive hormones, and answered a comprehensive questionnaire. They also had a physical examination performed including determination of AGD measured as the distance between anus and scrotum (AGDAS) and penis (AGDAP). Odds ratios (OR) and 95% CI were estimated for a man having abnormal semen parameters according to the World Health Organization's reference values or a low/high concentration of reproductive hormones (defined as the lowest or highest 10%) depending on AGD. AGD was categorized in four strata: ≤10th percentile, 10th-30th percentile, 30th-50th percentile and >50th percentile.Main results and the role of chanceMen with the 10% shortest AGDAS had a more than doubled risk (OR: 2.19, 95% CI: 1.40-3.42) of being in the subfertile range for either sperm concentration (<15 million/mL) or sperm morphology (<4%) compared to men with AGDAS above the median (reference). Men in the 10th-30th percentile also had an increased OR of 1.48 (95% CI: 1.06-2.08) but not men in the 30th-50th percentile (OR: 1.14, 95% CI: 0.81-1.62). AGDAP was only weakly related to semen quality. AGD was not associated with testicular volume or any of the reproductive hormones.Limitations, reasons for cautionLimitations include the potential non-differential misclassification of reproductive outcomes based on a single semen and blood sample and some between-examiner differences in AGD measurements which introduces noise and may result in an underestimation of observed associations.Wider implications of the findingsOur study of men from the general population confirmed associations between AGD and semen quality, supporting the hypothesis that AGD in humans could be a marker of fetal testicular development. This suggests that the low semen quality in Danish men may partly be explained by prenatal factors.Study funding/competing interest(s)The study has received financial support from the ReproUnion (L.P.); the Research fund of Rigshospitalet, Copenhagen University Hospital (N.J.); Grants R01ES016863-04 and R01ES016863-02S4; National Institute of Environmental Health Sciences (NIEHS) and National Institute of Environmental Health Sciences grant (P30ES023515) (S.S.); the European Union (Contract numbers BMH4-CT96-0314, QLK4-CT-1999-01422, QLK4-CT-2002-00603, FP7/2007-2013, DEER Grant agreement no. 212844); the Danish Ministry of Health; the Danish Environmental Protection Agency; A.P. Møller and wife Chastine McKinney Møllers foundation; and Svend Andersens Foundation. None of the funders had any role in the study design, collection, analysis or interpretation of data, writing of the paper or publication decisions. The authors have nothing to declare.Trial registration numberN/A.

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Semen quality of young men in Switzerland: a nationwide cross-sectional population-based study.

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Semen quality of young men in Switzerland: a nationwide cross-sectional population-based study.

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