Cited by 730Sperm and Testicular FunctionMale Reproductive Health StudiesHypothalamic control of reproductive hormones

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Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries

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Levine, Hagai, Jørgensen, Niels, Martino-Andrade, Anderson, Mendiola, Jaime, Weksler-Derri, Dan, Jolles, Maya, Pinotti, Rachel, Swan, Shanna H·2023·Human Reproduction Update

DOI 10.1093/humupd/dmac035

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Abstract

BACKGROUND: Numerous studies have reported declines in semen quality and other markers of male reproductive health. Our previous meta-analysis reported a significant decrease in sperm concentration (SC) and total sperm count (TSC) among men from North America–Europe–Australia (NEA) based on studies published during 1981–2013. At that time, there were too few studies with data from South/Central America–Asia–Africa (SAA) to reliably estimate trends among men from these continents. OBJECTIVE AND RATIONALE: The aim of this study was to examine trends in sperm count among men from all continents. The broader implications of a global decline in sperm count, the knowledge gaps left unfilled by our prior analysis and the controversies surrounding this issue warranted an up-to-date meta-analysis. SEARCH METHODS: We searched PubMed/MEDLINE and EMBASE to identify studies of human SC and TSC published during 2014–2019. After review of 2936 abstracts and 868 full articles, 44 estimates of SC and TSC from 38 studies met the protocol criteria. Data were extracted on semen parameters (SC, TSC, semen volume), collection year and covariates. Combining these new data with data from our previous meta-analysis, the current meta-analysis includes results from 223 studies, yielding 288 estimates based on semen samples collected 1973–2018. Slopes of SC and TSC were estimated as functions of sample collection year using simple linear regression as well as weighted meta-regression. The latter models were adjusted for predetermined covariates and examined for modification by fertility status (unselected by fertility versus fertile), and by two groups of continents: NEA and SAA. These analyses were repeated for data collected post-2000. Multiple sensitivity analyses were conducted to examine assumptions, including linearity. OUTCOMES: Overall, SC declined appreciably between 1973 and 2018 (slope in the simple linear model: –0.87 million/ml/year, 95% CI: –0.89 to –0.86; P < 0.001). In an adjusted meta-regression model, which included two interaction terms [time × fertility group (P = 0.012) and time × continents (P = 0.058)], declines were seen among unselected men from NEA (–1.27; –1.78 to –0.77; P < 0.001) and unselected men from SAA (–0.65; –1.29 to –0.01; P = 0.045) and fertile men from NEA (–0.50; –1.00 to –0.01; P = 0.046). Among unselected men from all continents, the mean SC declined by 51.6% between 1973 and 2018 (–1.17: –1.66 to –0.68; P < 0.001). The slope for SC among unselected men was steeper in a model restricted to post-2000 data (–1.73: –3.23 to –0.24; P = 0.024) and the percent decline per year doubled, increasing from 1.16% post-1972 to 2.64% post-2000. Results were similar for TSC, with a 62.3% overall decline among unselected men (–4.70 million/year; –6.56 to –2.83; P < 0.001) in the adjusted meta-regression model. All results changed only minimally in multiple sensitivity analyses. WIDER IMPLICATIONS: This analysis is the first to report a decline in sperm count among unselected men from South/Central America–Asia–Africa, in contrast to our previous meta-analysis that was underpowered to examine those continents. Furthermore, data suggest that this world-wide decline is continuing in the 21st century at an accelerated pace. Research on the causes of this continuing decline and actions to prevent further disruption of male reproductive health are urgently needed.

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Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Meta-analysis of Observational Studies in Epidemiology<SUBTITLE>A Proposal for Reporting</SUBTITLE>
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623
The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648
Introduction to Meta‐Analysis
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009) · doi:10.1002/9780470743386 · Cited by 14,225
Evidence for decreasing quality of semen during past 50 years.
Carlsen, E., Giwercman, A., Keiding, N., & Skakkebæk, N. E. (1992) · BMJ · doi:10.1136/bmj.305.6854.609 · Cited by 2,768
Temporal trends in sperm count: a systematic review and meta-regression analysis
Levine, H., Jørgensen, N., Martino-Andrade, A., Mendiola, J., Weksler-Derri, D., Mindlis, I., Pinotti, R., & Swan, S. H. (2017) · Human Reproduction Update · doi:10.1093/humupd/dmx022 · Cited by 1,374
Self-citation
Sperm Morphology, Motility, and Concentration in Fertile and Infertile Men
Guzick, D. S., Overstreet, J. W., Factor-Litvak, P., Brazil, C. K., Nakajima, S. T., Coutifaris, C., Carson, S. A., Cisneros, P., Steinkampf, M. P., Hill, J. A., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa003005 · Cited by 1,336
Decline in Semen Quality among Fertile Men in Paris during the Past 20 Years
Auger, J., Kunstmann, J. M., Czyglik, F., & Jouannet, P. (1995) · New England Journal of Medicine · doi:10.1056/nejm199502023320501 · Cited by 1,131
Male Reproductive Disorders and Fertility Trends: Influences of Environment and Genetic Susceptibility
Skakkebæk, N. E., Meyts, E. R., Louis, G. M. B., Toppari, J., Andersson, A., Eisenberg, M. L., Jensen, T. K., Jørgensen, N., Swan, S. H., Sapra, K. J., et al. (2015) · Physiological Reviews · doi:10.1152/physrev.00017.2015 · Cited by 1,030
Self-citation
Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners
Bonde, J. P. E., Ernst, E., Jensen, T. K., Hjollund, N. H. I., Kolstad, H., Scheike, T., Giwercman, A., Skakkebæk, N. E., Henriksen, T. B., & Olsen, J. (1998) · The Lancet · doi:10.1016/s0140-6736(97)10514-1 · Cited by 791

Show all 245 references

Research works printed but not linked: 5

Ahmed, 2019, Effect of BMI on semen parameters in male infertility in tertiary care hospital of Karachi, Natl Editor Advis Board, 30, 104
Azad, 2018, Evaluation of PAWP and PLCζ expression in infertile men with previous ICSI fertilization failure, Urol J, 15, 38
Kumar, 2011, DAZL 260A > G and MTHFR 677C > T variants in sperm DNA of infertile Indian men, Indian J Biochem Biophys, 48, 422
Lee, 2001, Fertility after bilateral cryptorchidism. Evaluation by paternity, hormone, and semen data, Horm Res, 55, 28
National Toxicology Program, 2015, Handbook for Conducting a Literature-Based Health Assessment Using OHAT Approach for Systematic Review and Evidence Integration

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Dietary trends and the decline in male reproductive health
Whittaker, J. (2023) · HORMONES · doi:10.1007/s42000-023-00431-z · Cited by 26
Trends in sperm quality by computer-assisted sperm analysis of 49,189 men during 2015–2021 in a fertility center from China
Li, Y., Lu, T., Wu, Z., Wang, Z., Yu, T., Wang, H., Tang, C., & Zhou, Y. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1194455 · Cited by 25
Ambient fine particulate matter constituents and semen quality among adult men in China
Zhang, Y., Wei, J., Zhao, S., Zeng, Q., Sun, S., & Cao, W. (2023) · Journal of Hazardous Materials · doi:10.1016/j.jhazmat.2023.133313 · Cited by 24
Retracted
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Wang, T., Wang, Q., Fan, Z., Xu, R., Deng, X., Li, Y., Liang, S., Lv, Z., Huang, S., Duan, Y., et al. (2023) · Andrology · doi:10.1111/andr.13471 · Cited by 23
Type 1 diabetes impairs the activity of rat testicular somatic and germ cells through NRF2/NLRP3 pathway-mediated oxidative stress
Venditti, M., Romano, M. Z., Boccella, S., Haddadi, A., Biasi, A., Maione, S., & Minucci, S. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1399256 · Cited by 24
Microplastics are detected in bull epididymal sperm and polystyrene microparticles impair sperm fertilization
Grechi, N., Ferronato, G. A., Devkota, S., & Ferraz, M. D. A. M. M. (2024) · Biology of Reproduction · doi:10.1093/biolre/ioae154 · Cited by 26
The impact, mechanisms and prevention strategies of environmental endocrine disruptors on male reproductive health
Han, X., & Jin, X. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1573526 · Cited by 33
Sperm quality decline associated with gaseous pollutant exposure: Evidence from a large cohort multicenter study
Cai, X., Ni, H., Wang, Q., Dai, T., Wang, L., Song, C., Li, Y., Li, F., Meng, T., Sheng, H., et al. (2023) · Journal of Hazardous Materials · doi:10.1016/j.jhazmat.2023.132330 · Cited by 22
Gut microbiota combined with metabolome dissects long-term nanoplastics exposure-induced disturbed spermatogenesis
Yan, Z., Zhong, X., Chen, L., Gong, L., Luo, L., He, Q., Zhu, L., & Tian, K. (2023) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2023.115626 · Cited by 23
Endocrine disruption and male reproductive disorders: unanswered questions
Sharpe, R. M. (2024) · Human Reproduction · doi:10.1093/humrep/deae143 · Cited by 24
Assessing the impact of sub-chronic polyethylene terephthalate nanoplastic exposure on male reproductive health in mice
Tombul, O. K., Akdağ, A. D., Thomas, P. B., & Kaluç, N. (2025) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2025.117235 · Cited by 21
A new insight of cadmium-induced cellular evidence of autophagic-associated spermiophagy during spermatogenesis
Ali, W., Deng, K., Sun, J. G., Ma, Y., Liu, Z., & Zou, H. (2023) · Environmental Science and Pollution Research · doi:10.1007/s11356-023-29548-9 · Cited by 21
Male Infertility: A Comprehensive Review of Urological Causes and Contemporary Management
Barone, B., Amicuzi, U., Tammaro, S., Olivetta, M., Stizzo, M., Musone, M., Napolitano, L., Luca, L. D., Reccia, P., Capone, F., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15010397 · Cited by 20
Single-cell transcriptomics identifies senescence-associated secretory phenotype (SASP) features of testicular aging in human
He, J., Li, J., Li, Y., Xu, Z., Ma, M., Chen, H., Chen, P., Lv, L., Shang, X., & Liu, G. (2024) · Aging · doi:10.18632/aging.205538 · Cited by 21
Pathophysiological effects of hypoxia on testis function and spermatogenesis
Lord, T. (2025) · Nature Reviews Urology · doi:10.1038/s41585-024-00969-6 · Cited by 23
Chronic Dietary Exposure to Environmental Levels of Glyphosate Increases the Risk of Reproductive Dysfunction in Male Mice
Ren, Y., Li, Z., Chen, K., Zhang, H., Liang, Q., Li, Y., Liu, B., & Wang, L. (2025) · Environmental Science & Technology · doi:10.1021/acs.est.5c03589 · Cited by 21
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Sharma, A., Papanikolaou, N., Sherif, S. A., Dimakopolou, A., Thaventhiran, T., Go, C., Entwistle, O. H., Brown, A. C., Luo, R., Jha, R., et al. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad523 · Cited by 20
Exposure to PM2.5, seminal plasma metabolome, and semen quality among Chinese adult men: Association and potential mediation analyses
Zhang, Y., Shi, W., Zhang, M., Lufei, X., Wu, L., Li, C., Zhang, Z., Cao, W., Zhang, J., Zeng, Q., et al. (2023) · Journal of Hazardous Materials · doi:10.1016/j.jhazmat.2023.132602 · Cited by 19
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Garrido, N., & Juliá, M. G. (2024) · Biology · doi:10.3390/biology13010030 · Cited by 19
Effects of temperature anomaly on sperm quality: A multi-center study of 33,234 men
Xiao, L., Wang, Q., Ni, H., Xu, T. S., Cai, X., Dai, T., Wang, L., Song, C., Li, Y., Li, F., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e26765 · Cited by 19
Gut‐Derived Exosomes Mediate the Microbiota Dysbiosis‐Induced Spermatogenesis Impairment by Targeting Meioc in Mice
Chen, T., Zhang, B., He, G., Wang, N., Cao, M., Shen, C., Chen, X., Chen, L., Liu, K., Luo, Y., et al. (2024) · Advanced Science · doi:10.1002/advs.202310110 · Cited by 18
The microRNA-mediated apoptotic signaling axis in male reproduction: a possible and targetable culprit in male infertility
Yu, P., Zhao, X. Y., Zhou, D., Wang, S., Hu, Z., Lian, K., Zhang, N. Y. X., & Duan, P. (2025) · Cell Biology and Toxicology · doi:10.1007/s10565-025-10006-w · Cited by 19
Environmental toxins and reproductive health: unraveling the effects on Sertoli cells and the blood–testis barrier in animals
Jiang, B., Yang, D., & Peng, H. (2024) · Biology of Reproduction · doi:10.1093/biolre/ioae126 · Cited by 20
Microplastics and impaired male reproductive health—exploring biological pathways of harm: a narrative review
Kumar, N., & Mangla, M. (2025) · Biology of Reproduction · doi:10.1093/biolre/ioaf054 · Cited by 21
What Does Intracytoplasmic Sperm Injection Change in Embryonic Development? The Spermatozoon Contribution
Chamayou, S., Giacone, F., Cannarella, R., & Guglielmino, A. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12020671 · Cited by 19
Adult Organophosphate and Carbamate Insecticide Exposure and Sperm Concentration: A Systematic Review and Meta-Analysis of the Epidemiological Evidence
Ellis, L. B., Molina, K., Robbins, C., Freisthler, M. S., Sgargi, D., Mandrioli, D., & Perry, M. J. (2023) · Environmental Health Perspectives · doi:10.1289/ehp12678 · Cited by 20
Urinary concentrations of bisphenol A, parabens and benzophenone-type ultra violet light filters in relation to sperm DNA fragmentation in young men: A chemical mixtures approach.
Kiwitt-Cárdenas, J., Arense-Gonzalo, J. J., Adoamnei, E., Sarabia-Cos, L., Vela-Soria, F., Fernández, M., Gosálvez, J., Mendiola, J., & Torres-Cantero, A. (2023) · Science of the Total Environment · doi:10.1016/j.scitotenv.2023.169314 · Cited by 17
Self-citation
RETRACTED: Fluoride induces pyroptosis via IL-17A-mediated caspase-1/11-dependent pathways and Bifidobacterium intervention in testis
Cheng, A., Luo, H., Fan, B., Xiang, Q., Nie, Z., Feng, S., Qiao, Y., Wu, Y., Zhu, Q., Liu, R., et al. (2024) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2024.172036 · Cited by 18
Retracted
Association between semen microbiome disorder and sperm DNA damage
He, J., Ma, M., Xu, Z., Guo, J., Chen, H., Yang, X., Chen, P., & Liu, G. (2024) · Microbiology Spectrum · doi:10.1128/spectrum.00759-24 · Cited by 18
Exposome Profiling of Environmental Pollutants in Seminal Plasma and Novel Associations with Semen Parameters
Wu, H., Kalia, V., Manz, K. E., Chillrud, L., Dishon, N. H., Jackson, G. L., Dye, C. K., Orvieto, R., Aizer, A., Levine, H., et al. (2024) · Environmental Science & Technology · doi:10.1021/acs.est.3c10314 · Cited by 19
Self-citation
The consequences of climate change and male reproductive health: A review of the possible impact and mechanisms
Akhigbe, R. E., Oyedokun, P. A., Akhigbe, T. M., Hamed, M. A., Fidelis, F. B., Omole, A. I., Adeogun, A. E., Akangbe, M. D., & Oladipo, A. A. (2024) · Biochemistry and Biophysics Reports · doi:10.1016/j.bbrep.2024.101889 · Cited by 22
Reproductive toxicity of micro‐ and nanoplastics: Insights from experimental and human studies
Wehrli, L., Martin, O., Trasande, L., & Damdimopoulou, P. (2025) · Journal of Internal Medicine · doi:10.1111/joim.70038 · Cited by 21
Decline of Sperm Quality over the Last Two Decades in the South of Europe: A Retrospective Study in Infertile Patients
Grau, E. G., Lleberia, J., Costa, L., Guitart, M., Yeste, M., Benet, J., Amengual, M. J., & Ribas‐Maynou, J. (2022) · Biology · doi:10.3390/biology12010070 · Cited by 17
The lack of evidence behind over-the-counter antioxidant supplements for male fertility patients: a scoping review
Ligny, W. R. D., Fleischer, K., Grens, H., Braat, D. D. M., & de Bruin, J. P. (2023) · Human Reproduction Open · doi:10.1093/hropen/hoad020 · Cited by 17
Could the sperm epigenome become a diagnostic tool for evaluation of the infertile man?
Caroppo, E., & Skinner, M. K. (2023) · Human Reproduction · doi:10.1093/humrep/dead266 · Cited by 17
Product collaborative filtering based recommendation systems for large-scale E-commerce
Trinh, T., Nguyen, V.-H., Nguyen, N., & Nguyen, D.-N. (2025) · International Journal of Information Management Data Insights · doi:10.1016/j.jjimei.2025.100322 · Cited by 17
Nanoplastic PS and cadmium co-exposure accelerates ferroptosis mediated by HIF-1α-related signaling in spermatogonium
Zhang, Q., Guo, P., Zhou, X., Yang, C., Lu, Z., Wu, S., Lu, X., Yang, J., & Jin, C. (2025) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2025.05.402 · Cited by 16
Role of Redox-Induced Protein Modifications in Spermatozoa in Health and Disease
Onochie, C., Evi, K., & O’Flaherty, C. (2025) · Antioxidants · doi:10.3390/antiox14060720 · Cited by 20
Associations between urinary biomarkers of exposure to disinfection byproducts and semen parameters: A repeated measures analysis
Zhang, M., Liu, X., Deng, Y.-L., Liu, C., Zeng, J.-Y., Miao, Y., Wu, Y., Li, C., Li, Y.-J., Li, Y.-J., et al. (2023) · Journal of Hazardous Materials · doi:10.1016/j.jhazmat.2023.132638 · Cited by 16
The Role of Artificial Intelligence in Male Infertility: Evaluation and Treatment: A Narrative Review
Venishetty, N., Alkassis, M., & Raheem, O. A. (2024) · Uro · doi:10.3390/uro4020003 · Cited by 20
Climate change, microplastics, and male infertility
Daniels, D., & Eberhardt, A. B. (2024) · Current Opinion in Urology · doi:10.1097/mou.0000000000001201 · Cited by 16

Authors: Levine, H., Jørgensen, N., Martino-Andrade, A., Mendiola, J., Weksler-Derri, D., Jolles, M., Pinotti, R., & Swan, S. H.
Affiliations: Hebrew University of Jerusalem (IL)
University of Copenhagen (DK)
Department of Physiology, Federal University of Parana , Curitiba, Brazil
Instituto Murciano de Investigación Biosanitaria (ES)
Ben-Gurion University of the Negev (IL)
Icahn School of Medicine at Mount Sinai (US)
Corresponding author: Levine, Hagai
ORCID: Levine, Hagai
Jørgensen, Niels
Martino-Andrade, Anderson
Mendiola, Jaime
Weksler-Derri, Dan
Pinotti, Rachel
Swan, Shanna H
Venue: Human Reproduction Update
Publisher: Oxford University Press (OUP)
Published: 2022-11-15
Volume: 29
Issue: 2
Pages: 157-176
ISSN: 1355-4786 (ISSN-L)
1460-2369
DOI: 10.1093/humupd/dmac035
OpenAlex: W4309099580
Cited by: 728
References: 245
Citations by year: 2026: 206 · 2025: 205 · 2024: 183 · 2023: 130 · 2022: 3
FWCI: 21.07
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations: Human Reproduction Update (publishedVersion)
PubMed (publishedVersion)
Hispana (publishedVersion)
Funders: The Grantham Foundation for the Protection of the Environment
National Council for Scientific and Technological Development
Topics: Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
Health Sciences › Medicine › Urology › Male Reproductive Health Studies
Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords: sperm count, total sperm count, semen quality, male reproductive health, temporal trends, fertility status, semen volume, sperm concentration, meta-regression, Central and South America, Asia and Africa, 20th-21st century, lifestyle factors, reproductive toxicants
MeSH terms: Humans, Male, Regression Analysis, Semen, Sperm Count, Sperm Motility, Spermatozoa, Semen Analysis

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Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries

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