Carlsen E, Giwercman A, Keiding N, Skakkebaek N E
University Department of Growth and Reproduction, Rigshospitalet, Copenhagen.
BMJ. 1992 Sep 12;305(6854):609-13. doi: 10.1136/bmj.305.6854.609.
To investigate whether semen quality has changed during the past 50 years.
Review of publications on semen quality in men without a history of infertility selected by means of Cumulated Index Medicus and Current List (1930-1965) and MEDLINE Silver Platter database (1966-August 1991).
14,947 men included in a total of 61 papers published between 1938 and 1991.
Mean sperm density and mean seminal volume.
Linear regression of data weighted by number of men in each study showed a significant decrease in mean sperm count from 113 x 10(6)/ml in 1940 to 66 x 10(6)/ml in 1990 (p < 0.0001) and in seminal volume from 3.40 ml to 2.75 ml (p = 0.027), indicating an even more pronounced decrease in sperm production than expressed by the decline in sperm density.
There has been a genuine decline in semen quality over the past 50 years. As male fertility is to some extent correlated with sperm count the results may reflect an overall reduction in male fertility. The biological significance of these changes is emphasised by a concomitant increase in the incidence of genitourinary abnormalities such as testicular cancer and possibly also cryptorchidism and hypospadias, suggesting a growing impact of factors with serious effects on male gonadal function.
研究过去50年精液质量是否发生了变化。
通过《医学累积索引》和《近期期刊目次》(1930 - 1965年)以及MEDLINE银盘数据库(1966年 - 1991年8月)筛选出无不育史男性精液质量的相关出版物进行综述。
1938年至1991年间发表的61篇论文中共纳入14,947名男性。
平均精子密度和平均精液量。
以每项研究中男性数量加权的数据进行线性回归分析显示,平均精子计数从1940年的113×10⁶/ml显著降至1990年的66×10⁶/ml(p < 0.0001),精液量从3.40ml降至2.75ml(p = 0.027),这表明精子生成量的下降比精子密度下降更为明显。
过去50年精液质量确实出现了下降。由于男性生育能力在一定程度上与精子数量相关,这些结果可能反映了男性生育能力的整体下降。泌尿生殖系统异常(如睾丸癌,可能还有隐睾症和尿道下裂)发病率的同时增加强调了这些变化的生物学意义,提示对男性性腺功能有严重影响的因素的影响日益增大。