Infertility is becoming more prevalent, affecting millions of people worldwide. In women, infertility rates have reached 122.38 million cases in 2019, representing an 86% rise since 1990.

Environmental toxins like endocrine-disrupting chemicals (“EDCs”), microplastics and electromagnetic fields (“EMFs”) significantly impact reproductive health and fertility in both men and women.

Lifestyle and health factors such as obesity, sexually transmitted infections, diet and stress also contribute to declining fertility rates across different populations.

Recommended strategies to boost fertility include minimising toxic chemical exposure, eating real, whole organic foods, managing stress, maintaining a healthy weight and reducing EMF exposure.

Consider supplementing with progesterone to protect your reproductive health, as this hormone counteracts the effects of EDCs and supports pregnancy from conception to delivery.

Environmental Toxins and Poor Health Trends Threaten Fertility Worldwide

By Dr. Joseph Mercola

Infertility is a condition that affects many people, yet diagnosing and addressing it remains a challenge. Traditional diagnostic methods often focus on hormonal levels and reproductive organ health, overlooking broader social, environmental and lifestyle factors. This narrow approach leads to incomplete or inaccurate diagnoses, leaving people without a clear understanding of their condition.

Moreover, the stigma surrounding infertility often discourages people from seeking help. Conventional treatments like assisted reproductive technologies, while beneficial for some, fail to address the underlying causes. These methods are also invasive, costly and don’t always guarantee success.

A more holistic approach that considers not only medical care but also lifestyle, diet and the societal factors shaping reproductive health is essential to address infertility and mitigate its effects on your quality of life.

Infertility in Women Is on the Rise

In women, infertility is characterised by the inability to conceive after one year of regular, unprotected intercourse. Recent research published in Gynaecologic and Obstetric Investigation¹ shows an alarming increase in female infertility. In 2019, there were 122.38 million cases of female infertility worldwide, marking an 86% increase since 1990.

When adjusting for age differences across populations, the proportion of women experiencing infertility rose by 24%, and the overall impact on health (measured by years of life affected) increased by 25%. The biggest increases were seen in middle- and upper-middle-income countries, highlighting this as a global concern. North America had the highest rates of infertility, while East Asia had the lowest.

Infertility extends beyond the inability to conceive – it also profoundly affects your physical health and emotional well-being, leading to feelings of frustration, anxiety and depression. Beyond the personal struggle, infertility disrupts the natural reproductive process, making it a significant concern for individuals and societies.

What’s Causing Infertility Rates to Increase?

Infertility stems from a complex link between social, economic and health factors. A recent study published in Social Science and Medicine² reframes infertility as more than an individual health issue, focusing on its ties to social, structural and environmental conditions. Key factors include economic status, high cost of living, delayed family planning, gender roles and racial or ethnic backgrounds.

Health trends such as rising obesity rates and the prevalence of sexually transmitted infections (“STIs”) further worsen the problem. A recent article published in The New York Times³ highlights concerns from experts who warn about these emerging health trends in the United States that exacerbate infertility.

“Obesity can impact ovulation in women,” Dr. Mary Rosser, the director of Integrated Women’s Health at Columbia University Irving Medical Centre, told The New York Times. Excess weight disrupts hormonal signals required for regular menstrual cycles and is closely linked to polycystic ovary syndrome (“PCOS”). Studies show that between 70% and 80% of women with PCOS struggle with infertility and they also face a higher risk of miscarriage.⁴

Moreover, STIs, if left untreated, lead to complications that impact reproductive organs. STI rates in the United States have been rising for decades, though some have recently levelled off. The US Centres for Disease Control and Prevention (“CDC”) attributes this long-term increase to factors like decreased condom use and the closure of clinics offering STI testing and treatment.⁵

Chlamydia and gonorrhoea are particularly concerning because they cause pelvic inflammatory disease (“PID”) and permanent damage to the fallopian tubes, Dr. Rosser explained. Many STIs are asymptomatic, meaning they often go untreated until they have already harmed fertility.⁶

Experts Warn About Toxins Threatening Fertility

The New York Times article⁷ also explored the impact of exposure to harmful chemicals and substances found in personal care products, air pollution, plastics, pesticides and even food. These environmental toxins are pervasive and affect the general population, who encounter them daily through multiple sources.

Among the most troubling are endocrine-disrupting chemicals (“EDCs”) like phthalates, bisphenol A (“BPA”) and per- and poly-fluoroalkyl substances (“PFAS”), often called “forever chemicals.” Research has extensively linked these substances to reproductive health issues.

EDCs work by adhering to hormone receptors and directly interfering with the functioning of your steroid hormones, which are vital for pregnancy and foetal development. As a result, these chemicals change how many receptors are present in cells as well as affect the creation, movement, levels and breakdown of hormones in your blood.

“Even very low levels of exposure to endocrine disruptors can increase the risks of reproductive health issues,” said Tracey Woodruff, director of the Programme on Reproductive Health and the Environment at the University of California, San Francisco.⁸

Microplastics – Another Pervasive Source of EDCs

If you’ve followed my articles, you know I’ve consistently warned about the dangers of EDCs. Another important point that I would like to bring up is the presence of EDCs in microplastics, which are ubiquitous in our environment.

Dr. Oluyemisi Famuyiwa, founder of the Montgomery Fertility Centre, links microplastic exposure to declining semen quality, noting that men today are significantly less fertile than previous generations.⁹ Research supports this, with studies showing microplastics accumulate in the testes, causing stress, inflammation and reduced testosterone.¹⁰

Further, a 2024 study published in Toxicological Sciences¹¹ confirmed the presence of microplastics in both human and canine testes. From 23 human male participants, researchers detected an average of 328.44 microgrammes of microplastics per gramme of testicular tissue, with polyethylene being the most common type.

Female fertility is similarly affected. Research¹² shows that microplastics accumulating in the ovaries disrupt follicle dynamics, leading to fewer mature follicles and an increase in cystic and atretic follicles. Follicles play an essential role in ovulation and fertility, and their natural decline with age is accelerated by microplastic exposure. Studies also report that these particles contribute to oxidative stress and impair the ovaries’ antioxidant defences.

Research published in Environment International¹³ also found microplastics in the placenta, where they interfere with maternal-foetal communication, immunity during pregnancy and foetal development. Such disruptions result in complications like preeclampsia and restricted foetal growth.

What’s on Your Dinner Plate Also Affects Your Fertility

Poor food choices add to your toxic load, too. For example, conventional fruits and vegetables today are sprayed with pesticides, including glyphosate, the active ingredient in Roundup. These chemicals are particularly problematic, as they are known endocrine disruptors.

High pesticide exposure from pesticide-treated fruits and vegetables has been associated with an 18% lower in-vitro fertilisation (“IVF”) success rate in women. They were also 26% less likely to have a live birth if they did become pregnant.¹⁴ This clearly illustrates why it’s better to opt for organic, pesticide-free produce.

And if you’re always fond of eating processed foods like frozen pizzas, pancakes and waffles, be warned – these products contain sodium aluminium phosphate, a known neurotoxin that impacts your reproductive health. Used in food products as an emulsifying agent and stabiliser, this ingredient, albeit classified as “safe to consume,”¹⁵ have long-term damaging effects on your fertility.

Microwaves – The Invisible Factor Damaging Your Reproductive Health

Another stealth environmental factor that increases your risk of infertility is your exposure to electromagnetic fields (“EMFs”) and radiofrequency radiation from wireless technologies, like cell [or mobile] phones and Wi-Fi. In fact, I believe this is the most significant reason why sperm counts are dwindling today.¹⁶

According to a 2023 study published in the journal Fertility and Sterility,¹⁷ men who use their cell phones more than 20 times a day have significantly lower sperm concentrations and sperm counts than those who use their phones once a week or less.

Microwave radiation has been found to disrupt cellular function through the activation of voltage-gated calcium channels (“VGCCs”) in cell membranes. When exposed to microwaves, these channels release an excess of calcium ions into the cell – up to a million ions per second.

This surge in intracellular calcium triggers the production of nitric oxide (NO) within cells and mitochondria. Nitric oxide interacts with superoxide to form peroxynitrite, a compound known to cause oxidative stress.

Peroxynitrites also generate hydroxyl free radicals, which are among the most destructive free radicals, capable of inflicting significant damage to mitochondrial and nuclear DNA, cellular membranes and proteins. This cascade of damage ultimately leads to mitochondrial dysfunction.

Research has highlighted the reproductive risks associated with such exposure. For example, a 2013 children’s health panel on cell phone and Wi-Fi exposure noted that sperm are particularly vulnerable due to the sensitivity of the testicular barrier. Studies have shown that mitochondrial DNA in sperm is damaged at three times the rate when exposed to microwave radiation.¹⁸

Additionally, numerous in-vivo and in-vitro studies have confirmed that electromagnetic fields (“EMFs”) impair reproductive function. A paper published in Clinical and Experimental Reproductive Medicine,¹⁹ found that EMF exposure affects sperm motility, with the degree of damage varying based on the frequency, intensity and duration of exposure.

Solutions to Boost Fertility Naturally

There are indeed various factors that compromise your ability to reproduce, but I believe following some basic common-sense strategies and healthy lifestyle habits will help address the root of infertility. Here’s a summary of my recommendations:

How to Use Progesterone

Before you consider using progesterone, it is important to understand that it is not a magic bullet and that you get the most benefit by implementing a Bioenergetic diet approach that allows you to effectively burn glucose as your primary fuel without backing up electrons in your mitochondria that reduces your energy production. My new book, ‘Your Guide to Cellular Health: Unlocking the Science of Longevity and Joy’, covers this process in great detail.

Once you have dialled in your diet, an effective strategy that can help counteract oestrogen excess is to take transmucosal progesterone (i.e., applied to your gums, not oral or transdermal), which is a natural oestrogen antagonist. Progesterone is one of only four hormones I believe many adults can benefit from. (The other three are thyroid hormone T3, DHEA and pregnenolone.)

I do not recommend transdermal progesterone, as your skin expresses high levels of 5-alpha reductase enzyme, which causes a significant portion of the progesterone you’re taking to be irreversibly converted primarily into allopregnanolone and cannot be converted back into progesterone.

Ideal Way to Administer Progesterone

Please note that when progesterone is used transmucosally on your gums as I advise, the FDA believes that somehow converts it into a drug and prohibits any company from advising that on its label. This is why companies like Health Natura promotes their progesterone products as “topical.”

However, please understand that it is perfectly legal for any physician to recommend an off-label indication for a drug to their patient. In this case, progesterone is a natural hormone and not a drug and is very safe even in high doses. This is unlike synthetic progesterone called progestins that are used by drug companies, but frequently, and incorrectly, referred.

Dr. Ray Peat has done the seminal work in progesterone and probably was the world’s greatest expert on progesterone. He wrote his PhD on oestrogen in 1982 and spent most of his professional career documenting the need to counteract the dangers of excess oestrogen with low LA diets and transmucosal progesterone supplementation.

He determined that most solvents do not dissolve progesterone well and discovered that vitamin E is the best solvent to optimally provide progesterone in your tissue. Vitamin E also protects you against damage from LA. You just need to be very careful about which vitamin E you use as most supplemental vitamin E on the market is worse than worthless and will cause you harm not benefit.

It is imperative to avoid using any synthetic vitamin E (alpha tocopherol acetate – the acetate indicates that it’s synthetic). Natural vitamin E will be labelled “d alpha tocopherol.” This is the pure D isomer, which is what your body can use.

There are also other vitamin E isomers, and you want the complete spectrum of tocopherols and tocotrienols, specifically the beta, gamma and delta types, in the effective D isomer. As an example of an ideal vitamin E, you can look at the label on our vitamin E in our store. You can use any brand that has a similar label.

You can purchase pharmaceutical grade bioidentical progesterone as Progesterone Powder, Bioidentical Micronised Powder, 10 grammes for about $40 on many online stores like Amazon. That is nearly a year’s supply, depending on the dose you choose.

However, you will need to purchase some small stainless steel measuring spoons as you will need a 1/64 tsp, which is 25 mg and a 1/32 tsp, which is 50 mg. A normal dose is typically 25-50 mg and is taken 30 minutes before bed, as it has an anti-cortisol function and will increase GABA levels for a good night’s sleep.

Unfortunately, this vendor frequently runs out of product, and if that’s the case, then you can use Simply Progesterone by Health Natura. It’s premixed with vitamin E and MCT oil. Again, while Health Natura states that its product is for “topical use only,” I recommend applying it transmucosally, by rubbing it on your gums.

If you are a menstruating woman, you should take the progesterone during the luteal phase or the last half of your cycle, which can be determined by starting 10 days after the first day of your period and stopping the progesterone when your period starts.

If you are a male or non-menstruating woman, you can take the progesterone every day for four to six months and then cycle off for one week. The best time of day to take progesterone is 30 minutes before bed as it has an anti-cortisol function and will increase GABA levels for a good night’s sleep.

This is what I have been personally doing for over a year with very good results. I am a physician so do not have any problems doing this. If you aren’t a physician, you should consult one before using this therapy, as transmucosal progesterone therapy requires a doctor’s prescription.

 Sources and References

• ¹ Gynecol Obstet Invest. 2024 Nov 21:1-21
• ² Social Science & Medicine 23 November 2024, 117557
• ^{3, 4, 5, 6, 7, 8} The New York Times, November 26, 2024
• ⁹ Kevin Pho, MD, “How Microplastics Affect Our Reproductive Health”
• ¹⁰ Front Endocrinol (Lausanne). 2023; 14: 1330396, Fertility Effects in Adult Males
• ¹¹ Toxicol Sci. 2024 Aug 1;200(2):235-240, Abstract
• ¹² Front Endocrinol (Lausanne). 2023; 14: 1330396, Fertility Effects in Adult Females
• ¹³ Environment International Volume 146, January 2021, 106274, Abstract
• ¹⁴ JAMA Intern Med. 2018;178(1):17-26
• ¹⁵ Michigan State University, September 21, 2020, What does the science say about safety?
• ¹⁶ SYB, March 13, 2024, Cell Phone Effects on Sperm and the Brain: The Dirty Secret of Cell Phone Testing
• ¹⁷ Fertility and Sterility, 2023;120(6), Results
• ¹⁸ ElectromagneticHealth.org August 29, 2013
• ¹⁹ Clin Exp Reprod Med. 2012 Mar; 39(1): 1–9
• ²⁰ Substack, Outspoken, March 7, 2024
• ²¹ Vaccine September 25, 2017; 35(40): 5314-5322
• ²² Covid19criticalcare.com
• ²³ Practo December 17, 2016
• ²⁴ Reuters March 30, 2016
• ²⁵ Appl Physiol Nutr Metab. 2017 Dec;42(12):1293-1306
• ²⁶ Medical Journal of Babylon April-June 2022; 19(2): 111-114
• ²⁷ Front. Endocrinol., 11 August 2022; 13
• ²⁸ Int Braz J Urol. 2007 Jan-Feb;33(1):50-6; discussion 56-7
• ²⁹ Fertility Center, What Does Progesterone Do in Pregnancy?
• ³⁰ American Journal of Obstetrics and Gynecology, 2020;223(2)

Source:  https://expose-news.com/2024/12/21/what-is-causing-infertility-and-what-can-you-do/

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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

Abstract

Graphical Abstract

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Sperm count is declining at an accelerated pace globally.

Introduction

In 2017, ‘Temporal Trends in Sperm Count: A Systematic Review and Meta-Regression Analysis’ was published by this journal (Levine et al., 2017). That article, which was widely discussed and highly cited, includes all eligible English-language publications in 1981–2013 that contained data on sperm count. We reported a very strong decline in sperm concentration (SC) and total sperm count (TSC) in North America, Europe, Australia/New Zealand (hereafter NEA) but too few studies have been published in South/Central America, Asia and Africa (hereafter SAA) to draw a conclusion about trends in those continents. We examined mean SC and TSC as a function of collection year, as approximated by the mid-year of the sample collection period. Because sample collection preceded the year of publication by an average of 6 years, our results were already somewhat dated by the time we published our analysis in 2017. Therefore, we conducted a new literature search in the spring of 2020 to identify eligible studies published between 1 January 2014 and 31 December 2019. Here, we report on global trends in SC and TSC in publications 1981 through 2019, which combines results of both searches and analyses. This expanded analysis addresses two important questions. With increased sample size, was a trend seen in South America, Africa and Asia? Did the trends we reported continue post-2011?

Recognition of the importance of male reproductive function, and sperm count, has increased since 2017 (Levine et al., 2018; United Nations Human Rights Office of the High Commissioner, 2019). The economic and societal burden of male infertility is now widely recognized, as is the unequal burden of male infertility which falls most heavily on low-income populations (Winters and Walsh, 2014; Hauser et al., 2015; Dupree, 2016; Skakkebaek et al., 2016). Increasingly strong evidence links reduced sperm count and concentration to increases in all-cause mortality and morbidity (Latif et al., 2017; Del Giudice et al., 2021; Ferlin et al., 2021). Links between sperm count and infertility are well-recognized (Bonde et al., 1998; Skakkebæk et al., 2022). Furthermore, the decline in sperm count is paralleled by declines in testosterone and increases in testicular cancer and male genital anomalies (Skakkebæk et al., 2022). In fact, the decline in semen quality and male reproductive health has recently been described as a crisis (De Jonge and Barratt, 2019). Relative to declines in sperm counts, these latter trends are far more difficult to document. There is currently no systematic collection of such data, making the examination of those trends difficult. Therefore, an international group of scientists, including several of the authors, has suggested the formation of a multidisciplinary monitoring system for reproductive health indicators that would provide ongoing surveillance of reproductive health outcomes (Le Moal et al., 2016).

The broad implications of a global decline in sperm count, the data gaps left unfilled by our prior analysis and the controversies surrounding these issues warrant an up-to-date meta-analysis. This meta-analysis was conducted to address these aims.

Methods

This systematic review and meta-regression analysis was conducted, and the results reported, in accordance with Meta-analysis in Observational Studies in Epidemiology (Stroup et al., 2000) (Supplementary Table SI) and Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines (Liberati et al., 2009; Moher et al., 2009). Our research team included epidemiologists, andrologists and a medical librarian. Our predefined protocol was developed following best practices (Borenstein et al., 2009; Higgins and Green 2011; National Toxicology Program 2015) and informed by our previous study. Throughout, unless otherwise noted, the methods of the current study are those employed and published in the previous study (Levine et al., 2017), including keywords and databases searched, eligibility criteria and statistical methods.

Systematic review and study selection

A comprehensive search of the PubMed/MEDLINE and EMBASE was conducted, to identify English-language publications that reported primary data on human sperm count, published in 2014–2019, i.e. from the last date included in our prior search through 2019. On 15 May 2020, we searched MEDLINE/PubMed and Embase (Excerpta Medica database) for peer-reviewed publications meeting our inclusion criteria. Following the recommendation of the Cochrane Handbook for Systematic Reviews, we searched in title and abstract for both index (MeSH) terms and keywords and filtered out animal-only studies. We used the MeSH term ‘sperm count’, which includes seven additional terms, and to increase sensitivity, we added 13 related keywords (e.g. ‘sperm density’, ‘sperm concentration’).

All English-language studies that reported primary data on human SC were considered eligible for abstract screening. We evaluated the eligibility of all subgroups within a study. For example, in a case–control study, the control group might have been eligible for inclusion even though, based on our exclusion criteria, the case group was not.

We divided eligible studies into two fertility-defined groups: (i) studies of men unselected by fertility status, hereafter ‘Unselected’ (e.g. young men unlikely to be aware of their fertility, such as young men being screened for military service or college students) and (ii) studies of men whose partners had born a child or whose partners were pregnant regardless of pregnancy outcome, hereafter ‘Fertile’. ‘Total’ refers to both groups.

A study was excluded if participants were selected based on: (i) infertility or sub-fertility; (ii) their range of semen parameters (e.g. studies selecting normospermic men); and (iii) genital abnormalities, diseases or medications. We also excluded studies limited to men with exposures that may affect fertility, such as an occupational exposure, post-clinical trial intervention or smoking. Studies of candidates for vasectomy or semen donation were included only if semen quality was not a criterion for men’s study participation. We excluded studies that used non-standard methods for sperm collection (e.g. methods other than masturbation) or counting methods other than hemocytometer and studies with fewer than 10 men.

First, the publication was either excluded or advanced to full-text screening based on the title and abstract. Any publication without an abstract was automatically referred for full-text screening. Second, we reviewed the full text and assigned it to exclusion (and categorized the reason for exclusion) or to data extraction. We then confirmed study eligibility and identified multiple publications from the same study to ensure that estimates from the same population were not used more than once.

Data extraction

For each estimate, we extracted summary statistics on SC and TSC (mean, standard deviation, minimum, maximum, median and percentiles), semen volume (mean and measured method), sample size, sample collection years, data on covariates (fertility group, country, age, ejaculation abstinence time reported and per protocol, method of semen collection, method of assessing of SC and semen volume, selection of population, study exclusion criteria and number of samples per man). The range of permissible values, both for categorical and numerical variables and information on data completeness were recorded. Data were extracted on the total population as well as on all eligible subgroups.

Quality control

The current study followed the same protocol as used in the previous study. For the new search, we used Covidence systematic review software for the process of screening the articles that were not available for our prior search. In addition, one member of the research team was replaced. Screening of this extensive systematic review was conducted by a team of eight reviewers (H.L., N.J., A.M.-A., J.M., D.W.-D., M.J., R.P., S.H.S.). As in our previous analysis, the screening protocol was piloted and reviewers were trained by screening of 50 abstracts by all reviewers followed by a comparison of results, resolution of any inconsistencies and clarification of the protocol as needed. The same quality control process was followed for full-text screening and data extraction by all reviewers. All data were entered into digital spreadsheets with explicit permissible values (no open-ended entries) to increase consistency. After data extraction, an additional round of data editing and quality control of all studies was conducted by H.L. and M.J. The process ensured that each study was evaluated by at least two different trained reviewers.

Source Link: https://academic.oup.com/humupd/advance-article/doi/10.1093/humupd/dmac035/6824414

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