Environmental factors in declining human fertility

Niels E. Skakkebaek, Rune Lindahl-Jacobsen, Hagai Levine, Anna-Maria Andersson, Niels Jorgensen, Katharina M. Main, Ojvind Lidegaard, Laerke Priskorn, Stine A. Holmboe, Elvira V. Brauner, Kristian Almstrup, Luiz R. Franca, Ariana Znaor, Andreas Kortenkamp, Roger J. Hart, Anders Juul

Research output: Contribution to journalReview articlepeer-review

157 Citations (Scopus)

Abstract

A severe decline in child births has occurred over the past half century, which will lead to considerable population declines, particularly in industrialized regions. A crucial question is whether this decline can be explained by economic and behavioural factors alone, as suggested by demographic reports, or to what degree biological factors are also involved. Here, we discuss data suggesting that human reproductive health is deteriorating in industrialized regions. Widespread infertility and the need for assisted reproduction due to poor semen quality and/or oocyte failure are now major health issues. Other indicators of declining reproductive health include a worldwide increasing incidence in testicular cancer among young men and alterations in twinning frequency. There is also evidence of a parallel decline in rates of legal abortions, revealing a deterioration in total conception rates. Subtle alterations in fertility rates were already visible around 1900, and most industrialized regions now have rates below levels required to sustain their populations. We hypothesize that these reproductive health problems are partially linked to increasing human exposures to chemicals originating directly or indirectly from fossil fuels. If the current infertility epidemic is indeed linked to such exposures, decisive regulatory action underpinned by unconventional, interdisciplinary research collaborations will be needed to reverse the trends.

This article discusses trends in human reproductive behaviour and health that are associated with infertility. These changes have occurred over a period of only a couple of generations, so environmental factors are suggested to have a role.

Original languageEnglish
Pages (from-to)139-157
Number of pages19
JournalNature Reviews Endocrinology
Volume18
Issue number3
Early online date15 Dec 2021
DOIs
Publication statusPublished - Mar 2022

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