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Category Archives: Human Reproduction

SEA STARS SHED LIGHT ON HUMAN REPRODUCTION – Faculty of Science – Simon Fraser University News

Michael Hart and his colleague Daryn Stover sifted through mounds of data going back over a million years in their quest to find out whether humans carry the same allele differences as sea stars. Why? To find out more about evolutionary processes that could have important implications on fertility.

Hart explains that natural selection is at play in the fertilization process of sea stars, making some pairs of sea stars more likely to conceive than others. We discovered that the fertility rate of mated sea stars depends on what forms of reproductive genes they have. Male and female sea stars with certain types of gene pairs might successfully produce many offspring, while sea stars with other combinations of gene pairs were much less successful, says Hart.

Hart says, this finding suggests that, over time, genetic incompatibility could cause populations of sea stars to gradually separate into different species. The concept of genetic incompatibility in these organisms led Hart to wonder if this might be true for humans as well.

To Harts surprize, he found that human populations are not evolving to become reproductively isolated from each other. In other words, large molecular differences exhibited by sea stars preclude successful mating with each other, leading to the evolution of different species. But this is not the case in humans.

Instead, Hart explains, human selection seems to be favouring the evolution of two different alleles or variants of each of these three genes (ZP2, ZP3 and C4BPA) that are necessary for reproduction and present in all human populations going back to the common ancestor we share with Neanderthals.

We think the cause of this pattern is selection that favours some pairs of mates with matching pairs of sperm and egg alleles: matching leads to higher fertility, mismatching leads to lower fertility. We dont have direct evidence for this because it is hard to watch fertilization occur in mammals, but in other animals like sea stars we can directly observe interactions between eggs and sperm of females and males with different combinations of alleles, and we see a pattern where some pairs of male and female alleles have higher reproductive success than others Hart says.

Hart is excited that his research could potentially lead to understanding some causes of infertility in humans. He explains that, if (mis)matching of these three genes really does explain fertility variation in some human groups, then that might suggest screening for these three genes in couples that are seeking treatment for infertility.

Hart says, We dont know enough yet about how the ZP proteins interact with sperm in order to imagine how mismatching between them could be treated medically, but screening for these genes might be helpful as a way to rule out such mismatches as one possible cause of infertility.

Hart accepts that there is much work to be done before firm outcomes for humans can ever be made, but hes delighted to find parallels between the genetics and evolution of marine invertebrates and the evolution of my own species.

Hart presented this research at the 2016 annual meeting of the Society for Integrative and Comparative Biology in Portland, Oregon.

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Infertility: Sperm need a breakthrough for fertilization – EurekAlert

image:

Beating pattern of a human sperm cell before (left) und after (right) activation of CatSper. The more powerful beat is required to fertilize the egg

Credit: University of Mnster / Strnker group

In half of the couples that are unable to conceive a child, the infertility is due to the man. A new study identifies the defective function of CatSper, an ion channel controlling calcium levels in sperm, as a common cause of seemingly unexplained male infertility. CatSper-deficient human sperm fail to fertilize the egg, because they cannot penetrate its protective vestments. Thus far, this sperm channelopathy has remained undetectable. Scientists from Mnster, Germany, have unravelled CatSpers role in infertility using a novel laboratory test that identifies affected men. Based on the results of the study, which has been published in the scientific journal The Journal of Clinical Investigation, diagnostics and care of infertile couples can be improved.

One in six couples fail to conceive a child. The underlying cause often remains unresolved. In fact, in about one third of infertile couples, the mans semen analysis yields no abnormalities in the number, motility, or morphology of the sperm. This poses a problem: the lack of a clear diagnosis prevents an evidence-based selection of a therapy option. As a result, affected couples often experience unsuccessful treatments.

How do men fail to conceive a child despite normal semen parameters? An interdisciplinary team of scientists from the University of Mnster in Germany, set out to answer this question. For quite a while, we have considered CatSper a prime suspect says Prof. Timo Strnker from the Centre of Reproductive Medicine and Andrology (CeRA). Some years ago, Strnker and colleagues revealed that sperm use CatSper as a sensor to detect messenger molecules released by the egg. These molecules activate CatSper, which leads to an influx of calcium into the flagellum, changing its beating pattern.

To scrutinize whether this is essential for fertilization, the researchers developed a simple laboratory test that enabled them to determine the activity of CatSper in sperm from almost 2300 men. This revealed that about one in a hundred infertile men with unremarkable semen parameters indeed features a loss of CatSper function. The most common cause is genetic variants in genes encoding one of CatSpers components, adds the Reproductive Geneticist Prof. Frank Tttelmann, Mnster.

Sperm require the changes in flagellar beating mediated by CatSper to break through the eggs protective coat. Another important finding of the study: CatSper-related male infertility also involves failure of medically assisted reproduction via intrauterine insemination, involving the application of sperm via a catheter into the uterus right before ovulation, or classical in-vitro fertilization (fertilization in the petri dish). This is not surprising, considering that these treatments still require the sperm to break through the egg coat. Affected men/couples could only conceive a child via the ICSI method, which involves the manual injection of a sperm cell into the egg.

Thanks to this comprehensive research endeavour, we can now identify and diagnose this channelopathy, enabling evidence-based treatment of affected couples, summarizes Prof. Sabine Kliesch, Head of the Department of Clinical and Surgical Andrology at the CeRA. Thereby, we minimize the medical risk for the couples and maximize the chances of success.

The function of sperm is not only controlled by CatSper but also various other proteins. These are also in the focus of the Clinical Research Unit (CRU326) Male Germ Cells, which, funded by the German Research Council, provided the collaborative framework for the current study. The overarching aim of the researchers in Mnster is to systematically elucidate the role of these proteins in (in)fertility, improving diagnostics and care of affected couples.

In half of the couples that are unable to conceive a child, the infertility is due to the man. A new study identifies the defective function of CatSper, an ion channel controlling calcium levels in sperm, as a common cause of seemingly unexplained male infertility. CatSper-deficient human sperm fail to fertilize the egg, because they cannot penetrate its protective vestments. Thus far, this sperm channelopathy has remained undetectable. Scientists from Mnster, Germany, have unravelled CatSpers role in infertility using a novel laboratory test that identifies affected men. Based on the results of the study, which has been published in the scientific journal The Journal of Clinical Investigation, diagnostics and care of infertile couples can be improved.

One in six couples fail to conceive a child. The underlying cause often remains unresolved. In fact, in about one third of infertile couples, the mans semen analysis yields no abnormalities in the number, motility, or morphology of the sperm. This poses a problem: the lack of a clear diagnosis prevents an evidence-based selection of a therapy option. As a result, affected couples often experience unsuccessful treatments.

How do men fail to conceive a child despite normal semen parameters? An interdisciplinary team of scientists from the University of Mnster in Germany, set out to answer this question. For quite a while, we have considered CatSper a prime suspect says Prof. Timo Strnker from the Centre of Reproductive Medicine and Andrology (CeRA). Some years ago, Strnker and colleagues revealed that sperm use CatSper as a sensor to detect messenger molecules released by the egg. These molecules activate CatSper, which leads to an influx of calcium into the flagellum, changing its beating pattern.

To scrutinize whether this is essential for fertilization, the researchers developed a simple laboratory test that enabled them to determine the activity of CatSper in sperm from almost 2300 men. This revealed that about one in a hundred infertile men with unremarkable semen parameters indeed features a loss of CatSper function. The most common cause is genetic variants in genes encoding one of CatSpers components, adds the Reproductive Geneticist Prof. Frank Tttelmann, Mnster.

Sperm require the changes in flagellar beating mediated by CatSper to break through the eggs protective coat. Another important finding of the study: CatSper-related male infertility also involves failure of medically assisted reproduction via intrauterine insemination, involving the application of sperm via a catheter into the uterus right before ovulation, or classical in-vitro fertilization (fertilization in the petri dish). This is not surprising, considering that these treatments still require the sperm to break through the egg coat. Affected men/couples could only conceive a child via the ICSI method, which involves the manual injection of a sperm cell into the egg.

Thanks to this comprehensive research endeavour, we can now identify and diagnose this channelopathy, enabling evidence-based treatment of affected couples, summarizes Prof. Sabine Kliesch, Head of the Department of Clinical and Surgical Andrology at the CeRA. Thereby, we minimize the medical risk for the couples and maximize the chances of success.

The function of sperm is not only controlled by CatSper but also various other proteins. These are also in the focus of the Clinical Research Unit (CRU326) Male Germ Cells, which, funded by the German Research Council, provided the collaborative framework for the current study. The overarching aim of the researchers in Mnster is to systematically elucidate the role of these proteins in (in)fertility, improving diagnostics and care of affected couples.

Journal of Clinical Investigation

Human fertilization in vivo and in vitro requires the CatSper channel to initiate sperm hyperactivation

2-Jan-2024

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Message from the Director of the Department of Sexual and … – World Health Organization

Pascale Allotey, Director Department of Sexual and Reproductive Health and Research including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP)

I was asked recently if there would be repercussions if we simply removed sexualfrom SRH and focused on reproductive health, ensuring a non-controversial agenda that targeted the proximal causes of maternal mortality. The question is indicative of the ever-present, escalating and worrisome sensitivities to sexual health and rights.

These are sensitivities that HRP has never shied away from. In fact, the question underscores the essential role of HRP, committed to generating evidence to support the health and wellbeing of all people everywhere.

There is no reproductive health without sexual health. Sexual health encompasses the promotion of bodily autonomy and agency, recognizing the importance of safe, healthy relationships throughout life. This requires access to information to enable choice. Sexual health ensures the prevention of and protection from sexually transmissible infections, unintended pregnancies and harms imposed by differential power relations. Sexual health seeks to provide high-quality screening, diagnosis and treatment for gynaecological and andrological conditions that underly infertility, sexual disorders and dysfunction and reproductive cancers. Over the life course, sexual health safeguards health and wellbeing, ensuring that we remain productive and not just reproductive.

A comprehensive approach to sexual and reproductive health is essential for gender equality. Research shows that the presence of services such as comprehensive sexuality education, contraception services, comprehensive abortion care and maternal health services all contribute to more empowered, healthier, happier communities. Critically, sexual and reproductive health are fundamental to gender equality and human rights.

In recent months, experts from WHO and HRP have been present and visible in global forums speaking to the importance of an approach to sexual and reproductive health that addresses peoples needs within and well-beyond reproduction.

In this newsletter you will find highlights from FIGO, where we launched the pivotal PPH Roadmap, as well as the World Health Summit where we launched the first Joint Statement on Selfcare with WHO, UNDP, UNFPA and the World Bank. Then there was the World Conference for Sexual Health where colleagues further emphasized the importance of sexual health and sexual pleasure as essential to wellbeing.

We have just launched a joint Call to Action on Climate Change and Maternal, Newborn and Child Health with WHO, UNICEF and UNFPA, alongside an advocacy brief by PMNCH and partners, and ahead of COP28.

The 16 Days of activism against gender-based violence commences 25 November and extends through 10 December. This year we are releasing a number of resources intended to empower health workers with the knowledge and tools they need, as sometimes the first and often the only point of contact for people experiencing violence.

Finally, as the year draws to a close, stay tuned as we focus on maternal health with an exciting Lancet Series launching on 7 December, followed by a BMJ Global Health series on the post-natal period.

Tribute to Dr Fathalla

Earlier this month thepublic health community lost one of its great champions, Dr Mahmoud Fathalla. He was a visionary of womens health who led the way on empowering women through sexual health and rights. I am proud to say his legacy carries on through today in everything we strive to do at HRP.

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Tribute to Dr Mahmoud Fathalla – World Health Organization

A visionary of womens health and rights, father of the Safe Motherhood movement, and voice behind Why Did Mrs. X Die?, Dr Mahmoud Fathalla, died on 10 November 2023 at the age of 88.

Dr Fathalla assumed his role as Director of the UNs Special Programme on Human Reproduction (HRP) from 1989 to 1992, after two years as Head of Research with HRP and the World Health Organization (WHO) and years of work as a renowned doctor and Professor of Obstetrics & Gynaecology at Assiut University, Egypt.

When asked what one prescription women need most for their health, Dr Fathalla answered power. While the concept of listening to women was astoundingly provocative at the time, his commitment to equality and equity informed every aspect of his work.

Convinced from experience that maternal health was inextricably influenced by social trauma, Dr Fathallas leadership at HRP brought a seismic shift from a focus on biomedical interventions to solutions that address the very personal contexts in which women live.

In 1990, Dr Fathalla invited the International Womens Health Coalition to advise HRP on how to effectively solicit and respond to womens perspectives on fertility regulation technologies and services.

They co-convened a landmark meeting which emphasized the equal participation by womens health advocates alongside contraception specialists. The resulting report, Creating Common Ground, demonstrated the value of listening, and led to ongoing engagement of womens health and rights advocates in research, policy development and decision making.

HRP continued to conduct similar consultations throughout the 1990s, in every WHO region. This led to a series of Creating Common Ground publications, and influenced countless other epochal initiatives including the first safe abortion guidance document in 2001 and the forming of the Gender Advisory Panel (GAP) in 1995, which still reviews and provides advice on all aspects of HRPs work with attention to gender equality and considerations from a sexual and reproductive rights perspective.

Gentle, soft spoken and solitary, he was highly regarded by his colleagues who lovingly thought of him as a Sphinx. In the rare event that Dr Fathalla spoke, people listened. He often provided searing insights that cut through controversy.

When it came to the issue of abortion, he was forever motivated by his work as an obstetrician in Egypt, his own place of birth. Dr Fathalla often told the story of a woman he treated who had endured an unsafe abortion that left her uterus and intestines severely damaged.

In a speech on abortion he said, A woman can claim as her own her head, her hair, her hands, her arms, her upper body, her legs and her feet. She cannot claim the same right to the remaining area of her body, which appears to belong more to certain males of the species, moralists, politicians, lawyers, and others, all of whom claim to decide how this area is best utilized. Within this disputed territory the fetus happens to lie. Basically, the opposition to abortion was part of the wider spectrum of reproductive subordination of women. Men in the patriarchal societies have always reasoned that if women had control over their reproduction, they would also have the unthinkable: control over their own sexuality

The depth of Dr Fathallas commitment to building community, his passion for sexual and reproductive health and his humble, inexhaustible optimism in spite of many challenges is conveyed in his final thoughts and hopes for the future:

My very dear friends,

I asked my son Dr Mohamed to e-mail this message to you when I leave the stage of this present world. In saying farewell, I want to express my sincere appreciation and gratitude for our long association and friendship, and for our comradeship in serving noble causes. I consider myself fortunate and privileged to have known you and worked with you for a noble mission. We all can look back with satisfaction as we see a brilliant new generation moving forward with the torch. I wish you all many happy healthy productive years ahead, until we meet again in what I hope will be a better world and a rewarding life hereafter.

Warmest regards.

Yours sincerely,

Mahmoud

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Artificial wombs could someday be a reality here’s how they may … – The Conversation

Our reproductive lives are considerably different from those of our ancestors, thanks in part to health innovations that have taken place over the past few decades. Practices such as IVF, donor eggs and sperm, womb transplants, surrogacy and egg freezing, mean that for many, theres now more choice than ever before over whether, when and how to reproduce.

Yet, despite these advances, one aspect of reproduction has remained constant: the need to gestate (grow) foetuses in the womb. But what would happen to our notions of parenthood if technology made it possible to grow a foetus outside the human body?

Until recently, the idea of ectogenesis growing a foetus outside the body has been science fiction. But teams in the US, Australia and Japan have begun developing artificial wombs. Its hoped that this technology will someday save the lives of very premature infants.

Should I have children? The pieces in this series will help you answer this tough question exploring fertility, climate change, the cost of living and social pressure.

Trials have already been performed on animals with researchers reporting success in gestating lamb foetuses.

Meanwhile, a team in the Netherlands is developing a similar system using simulation technology. This approach mimics the birth of extremely premature infants using a manikin equipped with advanced monitoring and computer modelling. This allows the researchers to understand how an infant may develop in an environment that simulates the wombs conditions.

Although this may be many decades away, and is not the intended endpoint of current research, artificial womb technologies could eventually lead to full ectogenesis growing a foetus from conception to birth wholly outside the human body.

One barrier to research into full ectogenesis is current legislation worldwide, which either bans embryo research altogether or forbids growing human embryos for research beyond 14 days.

Legislation would therefore need to change for this kind of research to happen. Theres an increasing appetite for this among the international scientific community, but whether such a change would have public support is not known.

Full ectogenesis also raises important ethical, legal and social questions, which would need to be answered before it can be used.

In the UK, the person who gives birth is the childs legal mother regardless of genetics or intention. Growing a foetus in an artificial womb could however sever this link between gestation and motherhood.

Surrogacy has, to some extent, already challenged our legal and social conceptions of motherhood. The surrogate is the childs legal mother at birth, but parenthood can then be transferred to the intended parents via a parental order or adoption.

But artificial wombs could disrupt long-established norms in more profound ways, as there would no longer be a birth mother at all. The law would need to define who the legal mother is in such circumstances, and whether that definition applies to all mothers or only when artificial womb technologies are used.

The impact of artificial wombs on legal definitions of fatherhood may be less significant.

In the UK, the person who provides the sperm is normally the legal father of the child unless the child is born using sperm donated in a licensed clinic. In that case, the donor is not the legal father of any resulting child.

But fatherhood (or parenthood for same-sex couples) can also legally be attributed to someone via the Human Fertilisation and Embryology Act 2008. This allows someone not genetically related to the child to be recognised as their legal father or other parent. The provisions in this Act would apply to full ectogenesis because this will require IVF to create the embryo.

Full ectogenesis may result in more radical changes to the way we view legal parenthood. It may cause us not only to rethink our ideas of mother and father, but also the language used. Would it be more appropriate, for example, to always use the word parent, instead?

Artificial womb technology would also influence the personal decisions that people make about reproduction. It could drastically change the way the decision to become a parent fits into many peoples lives.

Like egg freezing and IVF, artificial wombs would make it possible for women in particular to have children later in life. It could also allow people to gestate multiple foetuses at once making it possible for them to complete their families within a far shorter time period than has previously been possible.

Artificial womb technology technology would make it easier for more people to have their own biological children including single men, same sex couples and women unable to become pregnant for health reasons. It would also mean that women would no longer have to undergo the significant risks and burdens associated with pregnancy and childbirth in order to have children.

In science fiction, artificial wombs are often a symbol of dystopia of technological incursion into natural processes and a means of government control (as in The Matrix or Brave New World). But artificial womb technology might instead add to the reproductive choices currently available making it possible for more people to become parents if they want to.

Full ectogenesis is still a long way off, but its important to discuss it now so that we can have a more informed view of the issues it raises. As with many aspects of human reproduction, artificial womb technology may be divisive.

Some will see it as a way to increase reproductive autonomy and equity, others as dangerous or even a threat to traditional family structures and values. More still will probably see its potential for both. Whatever your position, this technology could be on the horizon and its implications for society and our concept of parenthood merit careful consideration.

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Study Confirms Connection Between Exposure to Pesticides and … – Beyond Pesticides

(Beyond Pesticides, December 1, 2023) Even though researchers have noted since the 1970s that human fertility appears to be declining globally, doubt is still circulating that it is really happening and that pesticides could have anything to do with it. Very recently published studies, however, make it clear that, even without exact elucidation of the mechanisms by which pesticides damage male fertility, there is an unmistakable association of pesticides and many aspects of male reproductive health.

One of the new studies, a meta-analysis of 25 studies on the connection between pesticides and male reproductive problems, finds that men exposed to organophosphate (such as glyphosate and malathion) and carbamate (such as carbaryl and methiocarb) insecticides have lower sperm concentrations than the general population. This is especially true of men exposed in work settings. The senior author of the study, Melissa J. Perry,ScD of the George Mason University College of Public Health, told HealthNews, The evidence available has reached a point that we must take regulatory action to reduce insecticide exposure.

Human infertility is defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. Most public attention regarding infertility focuses on womens difficulties in getting pregnant, causing couples to resort to in vitro fertilization and surrogates. But about a third to half the time, a couples infertility results from problems with the male contribution. Mens reproductive health is measured by total sperm count, sperms ability to move, the incidence of malformed sperm or reproductive organ structure, testosterone levels and other criteria.

The relationships between aspects of male reproductive health such as sperm count, fertility and testicular cancer are not perfectly understood, but they are known to be interrelated. Low sperm counts can not only indicate decreased fertility, but also correlate with other markers of declining male reproductive health, including testicular tumors and testosterone levels. In 2017 Shanna Swan, PhD of the Icahn School of Medicine at Mount Sinai and colleagues published a major review of changes in sperm count between 1973 and 2011. They found that sperm counts declined by 52.4 percent over their study period.

Swan et al. also noted that reduced sperm count is a strong predictor of overall disease and death risk. In other words, sperm count reflects influences on health that go far beyond reproduction, and also that reproductive health is created by proper hormone balance, which many pesticides are well known to disturb.

Dr. Swan and colleagues wrote that chemical exposures, including pesticides (especially the endocrine disrupters) are plausible bad actors in the sperm count decline, but also said lifestyle factors such as diet and smoking are likely factors. High body mass index (BMI) and obesity have also been associated with low sperm counts.

Obesity is often cited as a lifestyle choice causing the reproductive problems, unrelated to factors like pesticide exposures. This is something of a straw man, however, because obesity itself can be an outcome of such exposures. For example, a 2022 review found that two carbamate insecticides and eight organophosphate insecticides were significantly associated with higher obesity prevalence, suggesting that obesity and low sperm count may have a common cause rather than a direct cause-and-effect relationship.

Pesticides present an especially vexing problem in that they affect organisms through many different pathways, often simultaneously. For example, organophosphates notoriously damage neurotransmitters, but they have also been associated with poor semen quality in exposed factory workers. Similarly, carbamates interfere with neurotransmitters and are known for disrupting thyroid and steroid hormones and increasing the risk of both non-Hodgkins lymphoma and dementia, but they have also been associated with chromosome damage in sperm. Far less scientific attention has been devoted to these chemicals effects on male reproduction than on their neurological ones, but the reproductive consequences may be even greater. For one thing, many pesticides, including organophosphates, can cross the placental barrier if the mother is exposed during pregnancy. Fetal exposures to organophosphates affect childhood cognition and coordination and predispose the child to develop cancer in later life.

But it gets worse. A fathers environmental exposures can alter not only his direct fertility but also his epigenetic patterns, and these can be passed from parent to child. Epigenetics are a suite of cell processes in which gene expression is controlled by molecules that block or open access to genes in the double DNA helix. In every cell of the body, this process continually operates to orchestrate the cells biochemistry and its relation to other cells and organs, but it does not change genes themselves. Epigenetic patterns are a kind of template or history of the habits and exposures of the parent, including smoking history, diet, pesticide exposures, alcohol and drug consumption, and social stress. Sperm are major contributors of epigenetic information passed from one generation to the next, and pesticides affect that information.

It is becoming clear that epigenetic information can function as molecular memory of past environmental exposures and be passed from one generation to another via the germline, according to the authors of a 2022 review by a pair of Georgetown University Medical Center and Lombardi Comprehensive Cancer Center scholars. Descendants of an exposed male may have no direct exposure themselves but be paying for the inadvertent sins of their fatherssins such as agricultural or factory work.

A 2023 update of the 2017 review of temporal trends in sperm count, also co-authored by Swan, expanded the geographical range of the study by including data on men in 53 countries on six continents to get a global picture rather than one focused on industrialized countries where data is more plentiful. They found strong evidence that sperm counts have declined globally. Disturbingly, the authors show that the downward trend in sperm counts has become steeper since 2000, accelerating beyond the already-worrisome rate seen in the 2017 meta-analysis. From 1972 to 1999, sperm count dropped by about one percent a year; since 2000, the rate has been about 2.6 percent.

The evidence has continued to mount that pesticides affect both male and female reproductive health, yet most of these chemicals remain on the market, contributing to the prospect of agricultural collapse and declining human population worldwide. There is no longer any time to waste. What Beyond Pesticides said in 2022 still holds: As the human civilization grapples with a range of cascading crises, from climate change to the insect apocalypse and global biodiversity crisis, we may be missing the chance to address one of the most critical aspects to the continuation of humanity as we now know it.

For more information on the fertility crisis, see Dr. Swans presentation to Beyond Pesticides 2021 National Pesticide Forum, Cultivating Healthy Communities, on Beyond Pesticides YouTube page.

All unattributed positions and opinions in this piece are those of Beyond Pesticides.

Sources:

Temporal trends in sperm count: a systematic review and meta-regression analysis https://pubmed.ncbi.nlm.nih.gov/28981654/

Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries https://academic.oup.com/humupd/article/29/2/157/6824414?login=false

Pesticides and Male Fertility: A Dangerous Crosstalk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707831/

Paternal Transmission of Stressed-Induced Pathologies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217197/

Scientific Literature Review Again Connects Pesticides and Male Fertility Problem

Sperm counts worldwide are plummeting faster than we thought https://www.nationalgeographic.co.uk/science-and-technology/2022/11/sperm-counts-worldwide-are-plummeting-faster-than-we-thought

The Sperm-Count Crisis Doesnt Add Up https://www.nytimes.com/2021/06/04/health/sperm-fertility-reproduction-crisis.html

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