Decline in semen concentration and morphology in a sample of 26 609 men close to general population between 1989 and 2005 in France
STUDY QUESTION Are temporal trends and values of semen quality parameters in France identifiable in partners of totally infertile women? SUMMARY ANSWER Among a sample of 26 609 partners of totally infertile women undergoing an assisted reproductive technology (ART) procedures in the whole of France...
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| creator | Rolland, M. Le Moal, J. Wagner, V. Royère, D. De Mouzon, J. |
| description | STUDY QUESTION
Are temporal trends and values of semen quality parameters in France identifiable in partners of totally infertile women?
SUMMARY ANSWER
Among a sample of 26 609 partners of totally infertile women undergoing an assisted reproductive technology (ART) procedures in the whole of France over a 17-year period, there was a continuous decrease in semen concentration of about 1.9% per year and a significant decrease in the percentage with morphologically normal forms but no global trend for motility.
WHAT IS KNOWN ALREADY
A global decrease in human sperm quality is still debated as geographical differences have been shown, and many criticisms have risen concerning studies with small and biased study populations or inappropriate statistical methodology. However, growing biological, toxicological, experimental and human exposure data support the endocrine disruptors' hypothesis assuming that fetal exposure to endocrine disruptors could impair reproductive outcomes.
STUDY DESIGN, SIZE, DURATION
This was a retrospective and descriptive study using data registered by Fivnat, the professional association in charge of statistics for ART in France during the 1989–2005 study period. Data were provided by 126 main ART centres over the whole metropolitan territory. The source population included 154 712 men, aged 18–70, who were partners of couples undergoing their first ART cycle and for whom semen quality indicators (concentration, total motility and percentage of morphologically normal forms), measured on fresh ejaculated semen, were available.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The study population was 26 609 partners of women who had both tubes either absent or blocked. The temporal trends for each indicator of semen quality were modelled using a generalized additive model that allowed for nonlinear relationships between variables and were adjusted for season and age. In-depth sensitivity analyses included the reiteration of the analysis on data from a second spermiogram available for each man and on another subsample of men diagnosed as fertile. Variables such as centre, technique (standard in vitro fertilization or intra-cytoplasmic sperm injection) and an interaction factor between technique and time were also included in the model.
MAIN RESULTS AND THE ROLE OF CHANCE
There was a significant and continuous decrease in sperm concentration of 32.2% [26.3–36.3] during the study period. Projections indicate that concentration for a 35-year-old man w |
| doi_str_mv | 10.1093/humrep/des415 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4042534</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/humrep/des415</oup_id><sourcerecordid>1419373770</sourcerecordid><originalsourceid>FETCH-LOGICAL-c553t-966547332e2312f7cc450b388a506e3d6b9c9a2fb833486621e412d9f1f03d493</originalsourceid><addsrcrecordid>eNqFkU1v1DAURS0EosPAki3yEhahfrbjxBukqtAWaSQ2sLYc52UmyLGDnbTqmj9OpmnLx4aVLfu8c_V0CXkN7D0wLU4P85BwPG0xSyifkA1IxQouSvaUbBhXdQGg4IS8yPk7Y8u1Vs_JCRccBFT1hvz8iM73AWkfaMYBA3UxOAxTslMfA7WhpUNM4yH6uL89UpZmO4weaewoV1QxTe_GfMxIp0j3GDBZT8c4zn6VNDjd4MKArvWdkTNWHl0XyS5hL8mzzvqMr-7PLfl28enr-VWx-3L5-fxsV7iyFFOhlSplJQRHLoB3lXOyZI2oa1syhaJVjXba8q6phZC1UhxQAm91Bx0TrdRiSz6s3nFuBmzXLb0ZUz_YdGui7c3fP6E_mH28NpJJXgq5CN6tgsM_Y1dnO3N8YwBcV0xcw8K-vQ9L8ceMeTJDnx16bwPGORuQoEUlqoXekmJFXYo5J-we3cDMsWSzlmzWkhf-zZ97PNIPrf7OjvP4H9cv4l2wrg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1419373770</pqid></control><display><type>article</type><title>Decline in semen concentration and morphology in a sample of 26 609 men close to general population between 1989 and 2005 in France</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Rolland, M. ; Le Moal, J. ; Wagner, V. ; Royère, D. ; De Mouzon, J.</creator><creatorcontrib>Rolland, M. ; Le Moal, J. ; Wagner, V. ; Royère, D. ; De Mouzon, J.</creatorcontrib><description>STUDY QUESTION
Are temporal trends and values of semen quality parameters in France identifiable in partners of totally infertile women?
SUMMARY ANSWER
Among a sample of 26 609 partners of totally infertile women undergoing an assisted reproductive technology (ART) procedures in the whole of France over a 17-year period, there was a continuous decrease in semen concentration of about 1.9% per year and a significant decrease in the percentage with morphologically normal forms but no global trend for motility.
WHAT IS KNOWN ALREADY
A global decrease in human sperm quality is still debated as geographical differences have been shown, and many criticisms have risen concerning studies with small and biased study populations or inappropriate statistical methodology. However, growing biological, toxicological, experimental and human exposure data support the endocrine disruptors' hypothesis assuming that fetal exposure to endocrine disruptors could impair reproductive outcomes.
STUDY DESIGN, SIZE, DURATION
This was a retrospective and descriptive study using data registered by Fivnat, the professional association in charge of statistics for ART in France during the 1989–2005 study period. Data were provided by 126 main ART centres over the whole metropolitan territory. The source population included 154 712 men, aged 18–70, who were partners of couples undergoing their first ART cycle and for whom semen quality indicators (concentration, total motility and percentage of morphologically normal forms), measured on fresh ejaculated semen, were available.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The study population was 26 609 partners of women who had both tubes either absent or blocked. The temporal trends for each indicator of semen quality were modelled using a generalized additive model that allowed for nonlinear relationships between variables and were adjusted for season and age. In-depth sensitivity analyses included the reiteration of the analysis on data from a second spermiogram available for each man and on another subsample of men diagnosed as fertile. Variables such as centre, technique (standard in vitro fertilization or intra-cytoplasmic sperm injection) and an interaction factor between technique and time were also included in the model.
MAIN RESULTS AND THE ROLE OF CHANCE
There was a significant and continuous decrease in sperm concentration of 32.2% [26.3–36.3] during the study period. Projections indicate that concentration for a 35-year-old man went from an average of 73.6 million/ml [69.0–78.4] in 1989 to 49.9 million/ml [43.5–54.7] in 2005. A significant, but not quantifiable, decrease in the percentage of sperm with morphologically normal forms along the 17-year period was also observed. There was no global trend but a slight, significant increase in total motility between 1994 and 1998 was observed. The results were robust after sensitivity analysis.
LIMITATIONS, REASONS FOR CAUTION
Socioeconomic status could not be controlled for. Despite universal access to medical services in France, couples undergoing ART are expected to have a higher educational level on average compared with those of the general population. Therefore, the real values in the general population could be slightly lower than those presented and the decrease possibly stronger, as the population study is less likely to smoke or be overweight, two factors known to impair semen quality.
WIDER IMPLICATIONS OF THE FINDINGS
As the men were selected without a priori knowledge regarding their semen quality characteristics, the results are expected to be close to the values in the general French population. The very large sample size and the robustness of the results confer great statistical power and credibility to the results. To our knowledge, it is the first study concluding a severe and general decrease in sperm concentration and morphology at the scale of a whole country over a substantial period. This constitutes a serious public health warning. The link with the environment particularly needs to be determined.
STUDY FUNDING/COMPETING INTEREST(S)
No specific funding was sought for this study. The authors have no conflict of interest to declare.
The study has been authorized by the Commission Nationale de l'Informatique et des Libertés (CNIL), the national authority for the protection of personal data collected on individuals (authorization no DE-2010-063 dated 08/09/2010).</description><identifier>ISSN: 0268-1161</identifier><identifier>EISSN: 1460-2350</identifier><identifier>DOI: 10.1093/humrep/des415</identifier><identifier>PMID: 23213178</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Commissions ; Endocrine Disruptors - toxicity ; Environmental Exposure ; France - epidemiology ; Humans ; Infertility, Male - epidemiology ; Life Sciences ; Male ; Middle Aged ; Nonlinear Dynamics ; Original ; Other ; Reproductive Techniques, Assisted ; Retrospective Studies ; Semen - drug effects ; Semen Analysis ; Sperm Count ; Sperm Motility</subject><ispartof>Human reproduction (Oxford), 2013-02, Vol.28 (2), p.462-470</ispartof><rights>The Author 2012. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2012</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c553t-966547332e2312f7cc450b388a506e3d6b9c9a2fb833486621e412d9f1f03d493</citedby><cites>FETCH-LOGICAL-c553t-966547332e2312f7cc450b388a506e3d6b9c9a2fb833486621e412d9f1f03d493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,1579,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23213178$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-01129703$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Rolland, M.</creatorcontrib><creatorcontrib>Le Moal, J.</creatorcontrib><creatorcontrib>Wagner, V.</creatorcontrib><creatorcontrib>Royère, D.</creatorcontrib><creatorcontrib>De Mouzon, J.</creatorcontrib><title>Decline in semen concentration and morphology in a sample of 26 609 men close to general population between 1989 and 2005 in France</title><title>Human reproduction (Oxford)</title><addtitle>Hum Reprod</addtitle><description>STUDY QUESTION
Are temporal trends and values of semen quality parameters in France identifiable in partners of totally infertile women?
SUMMARY ANSWER
Among a sample of 26 609 partners of totally infertile women undergoing an assisted reproductive technology (ART) procedures in the whole of France over a 17-year period, there was a continuous decrease in semen concentration of about 1.9% per year and a significant decrease in the percentage with morphologically normal forms but no global trend for motility.
WHAT IS KNOWN ALREADY
A global decrease in human sperm quality is still debated as geographical differences have been shown, and many criticisms have risen concerning studies with small and biased study populations or inappropriate statistical methodology. However, growing biological, toxicological, experimental and human exposure data support the endocrine disruptors' hypothesis assuming that fetal exposure to endocrine disruptors could impair reproductive outcomes.
STUDY DESIGN, SIZE, DURATION
This was a retrospective and descriptive study using data registered by Fivnat, the professional association in charge of statistics for ART in France during the 1989–2005 study period. Data were provided by 126 main ART centres over the whole metropolitan territory. The source population included 154 712 men, aged 18–70, who were partners of couples undergoing their first ART cycle and for whom semen quality indicators (concentration, total motility and percentage of morphologically normal forms), measured on fresh ejaculated semen, were available.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The study population was 26 609 partners of women who had both tubes either absent or blocked. The temporal trends for each indicator of semen quality were modelled using a generalized additive model that allowed for nonlinear relationships between variables and were adjusted for season and age. In-depth sensitivity analyses included the reiteration of the analysis on data from a second spermiogram available for each man and on another subsample of men diagnosed as fertile. Variables such as centre, technique (standard in vitro fertilization or intra-cytoplasmic sperm injection) and an interaction factor between technique and time were also included in the model.
MAIN RESULTS AND THE ROLE OF CHANCE
There was a significant and continuous decrease in sperm concentration of 32.2% [26.3–36.3] during the study period. Projections indicate that concentration for a 35-year-old man went from an average of 73.6 million/ml [69.0–78.4] in 1989 to 49.9 million/ml [43.5–54.7] in 2005. A significant, but not quantifiable, decrease in the percentage of sperm with morphologically normal forms along the 17-year period was also observed. There was no global trend but a slight, significant increase in total motility between 1994 and 1998 was observed. The results were robust after sensitivity analysis.
LIMITATIONS, REASONS FOR CAUTION
Socioeconomic status could not be controlled for. Despite universal access to medical services in France, couples undergoing ART are expected to have a higher educational level on average compared with those of the general population. Therefore, the real values in the general population could be slightly lower than those presented and the decrease possibly stronger, as the population study is less likely to smoke or be overweight, two factors known to impair semen quality.
WIDER IMPLICATIONS OF THE FINDINGS
As the men were selected without a priori knowledge regarding their semen quality characteristics, the results are expected to be close to the values in the general French population. The very large sample size and the robustness of the results confer great statistical power and credibility to the results. To our knowledge, it is the first study concluding a severe and general decrease in sperm concentration and morphology at the scale of a whole country over a substantial period. This constitutes a serious public health warning. The link with the environment particularly needs to be determined.
STUDY FUNDING/COMPETING INTEREST(S)
No specific funding was sought for this study. The authors have no conflict of interest to declare.
The study has been authorized by the Commission Nationale de l'Informatique et des Libertés (CNIL), the national authority for the protection of personal data collected on individuals (authorization no DE-2010-063 dated 08/09/2010).</description><subject>Adult</subject><subject>Aged</subject><subject>Commissions</subject><subject>Endocrine Disruptors - toxicity</subject><subject>Environmental Exposure</subject><subject>France - epidemiology</subject><subject>Humans</subject><subject>Infertility, Male - epidemiology</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nonlinear Dynamics</subject><subject>Original</subject><subject>Other</subject><subject>Reproductive Techniques, Assisted</subject><subject>Retrospective Studies</subject><subject>Semen - drug effects</subject><subject>Semen Analysis</subject><subject>Sperm Count</subject><subject>Sperm Motility</subject><issn>0268-1161</issn><issn>1460-2350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAURS0EosPAki3yEhahfrbjxBukqtAWaSQ2sLYc52UmyLGDnbTqmj9OpmnLx4aVLfu8c_V0CXkN7D0wLU4P85BwPG0xSyifkA1IxQouSvaUbBhXdQGg4IS8yPk7Y8u1Vs_JCRccBFT1hvz8iM73AWkfaMYBA3UxOAxTslMfA7WhpUNM4yH6uL89UpZmO4weaewoV1QxTe_GfMxIp0j3GDBZT8c4zn6VNDjd4MKArvWdkTNWHl0XyS5hL8mzzvqMr-7PLfl28enr-VWx-3L5-fxsV7iyFFOhlSplJQRHLoB3lXOyZI2oa1syhaJVjXba8q6phZC1UhxQAm91Bx0TrdRiSz6s3nFuBmzXLb0ZUz_YdGui7c3fP6E_mH28NpJJXgq5CN6tgsM_Y1dnO3N8YwBcV0xcw8K-vQ9L8ceMeTJDnx16bwPGORuQoEUlqoXekmJFXYo5J-we3cDMsWSzlmzWkhf-zZ97PNIPrf7OjvP4H9cv4l2wrg</recordid><startdate>20130201</startdate><enddate>20130201</enddate><creator>Rolland, M.</creator><creator>Le Moal, J.</creator><creator>Wagner, V.</creator><creator>Royère, D.</creator><creator>De Mouzon, J.</creator><general>Oxford University Press</general><general>Oxford University Press (OUP)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope></search><sort><creationdate>20130201</creationdate><title>Decline in semen concentration and morphology in a sample of 26 609 men close to general population between 1989 and 2005 in France</title><author>Rolland, M. ; Le Moal, J. ; Wagner, V. ; Royère, D. ; De Mouzon, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c553t-966547332e2312f7cc450b388a506e3d6b9c9a2fb833486621e412d9f1f03d493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Commissions</topic><topic>Endocrine Disruptors - toxicity</topic><topic>Environmental Exposure</topic><topic>France - epidemiology</topic><topic>Humans</topic><topic>Infertility, Male - epidemiology</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nonlinear Dynamics</topic><topic>Original</topic><topic>Other</topic><topic>Reproductive Techniques, Assisted</topic><topic>Retrospective Studies</topic><topic>Semen - drug effects</topic><topic>Semen Analysis</topic><topic>Sperm Count</topic><topic>Sperm Motility</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rolland, M.</creatorcontrib><creatorcontrib>Le Moal, J.</creatorcontrib><creatorcontrib>Wagner, V.</creatorcontrib><creatorcontrib>Royère, D.</creatorcontrib><creatorcontrib>De Mouzon, J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rolland, M.</au><au>Le Moal, J.</au><au>Wagner, V.</au><au>Royère, D.</au><au>De Mouzon, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decline in semen concentration and morphology in a sample of 26 609 men close to general population between 1989 and 2005 in France</atitle><jtitle>Human reproduction (Oxford)</jtitle><addtitle>Hum Reprod</addtitle><date>2013-02-01</date><risdate>2013</risdate><volume>28</volume><issue>2</issue><spage>462</spage><epage>470</epage><pages>462-470</pages><issn>0268-1161</issn><eissn>1460-2350</eissn><abstract>STUDY QUESTION
Are temporal trends and values of semen quality parameters in France identifiable in partners of totally infertile women?
SUMMARY ANSWER
Among a sample of 26 609 partners of totally infertile women undergoing an assisted reproductive technology (ART) procedures in the whole of France over a 17-year period, there was a continuous decrease in semen concentration of about 1.9% per year and a significant decrease in the percentage with morphologically normal forms but no global trend for motility.
WHAT IS KNOWN ALREADY
A global decrease in human sperm quality is still debated as geographical differences have been shown, and many criticisms have risen concerning studies with small and biased study populations or inappropriate statistical methodology. However, growing biological, toxicological, experimental and human exposure data support the endocrine disruptors' hypothesis assuming that fetal exposure to endocrine disruptors could impair reproductive outcomes.
STUDY DESIGN, SIZE, DURATION
This was a retrospective and descriptive study using data registered by Fivnat, the professional association in charge of statistics for ART in France during the 1989–2005 study period. Data were provided by 126 main ART centres over the whole metropolitan territory. The source population included 154 712 men, aged 18–70, who were partners of couples undergoing their first ART cycle and for whom semen quality indicators (concentration, total motility and percentage of morphologically normal forms), measured on fresh ejaculated semen, were available.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The study population was 26 609 partners of women who had both tubes either absent or blocked. The temporal trends for each indicator of semen quality were modelled using a generalized additive model that allowed for nonlinear relationships between variables and were adjusted for season and age. In-depth sensitivity analyses included the reiteration of the analysis on data from a second spermiogram available for each man and on another subsample of men diagnosed as fertile. Variables such as centre, technique (standard in vitro fertilization or intra-cytoplasmic sperm injection) and an interaction factor between technique and time were also included in the model.
MAIN RESULTS AND THE ROLE OF CHANCE
There was a significant and continuous decrease in sperm concentration of 32.2% [26.3–36.3] during the study period. Projections indicate that concentration for a 35-year-old man went from an average of 73.6 million/ml [69.0–78.4] in 1989 to 49.9 million/ml [43.5–54.7] in 2005. A significant, but not quantifiable, decrease in the percentage of sperm with morphologically normal forms along the 17-year period was also observed. There was no global trend but a slight, significant increase in total motility between 1994 and 1998 was observed. The results were robust after sensitivity analysis.
LIMITATIONS, REASONS FOR CAUTION
Socioeconomic status could not be controlled for. Despite universal access to medical services in France, couples undergoing ART are expected to have a higher educational level on average compared with those of the general population. Therefore, the real values in the general population could be slightly lower than those presented and the decrease possibly stronger, as the population study is less likely to smoke or be overweight, two factors known to impair semen quality.
WIDER IMPLICATIONS OF THE FINDINGS
As the men were selected without a priori knowledge regarding their semen quality characteristics, the results are expected to be close to the values in the general French population. The very large sample size and the robustness of the results confer great statistical power and credibility to the results. To our knowledge, it is the first study concluding a severe and general decrease in sperm concentration and morphology at the scale of a whole country over a substantial period. This constitutes a serious public health warning. The link with the environment particularly needs to be determined.
STUDY FUNDING/COMPETING INTEREST(S)
No specific funding was sought for this study. The authors have no conflict of interest to declare.
The study has been authorized by the Commission Nationale de l'Informatique et des Libertés (CNIL), the national authority for the protection of personal data collected on individuals (authorization no DE-2010-063 dated 08/09/2010).</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>23213178</pmid><doi>10.1093/humrep/des415</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Human reproduction (Oxford), 2013-02, Vol.28 (2), p.462-470 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4042534 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Aged Commissions Endocrine Disruptors - toxicity Environmental Exposure France - epidemiology Humans Infertility, Male - epidemiology Life Sciences Male Middle Aged Nonlinear Dynamics Original Other Reproductive Techniques, Assisted Retrospective Studies Semen - drug effects Semen Analysis Sperm Count Sperm Motility |
| title | Decline in semen concentration and morphology in a sample of 26 609 men close to general population between 1989 and 2005 in France |
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