Abstract
In North European countries, a significant difference in semen quality among young men has been shown. Men from the western countries, Denmark, Germany and Norway, have lower semen quality than men from the eastern countries Finland, Estonia and Lithuania. Similarly, men in the western countries have a higher risk of testicular cancer. According to the testicular dysgenesis syndrome (TDS) concept that suggests a link between risk of impaired semen quality and increased risk of testicular cancer, Spanish men would be expected to have a semen quality at a normal level because of their very low testis cancer risk. We therefore investigated 273 men from the Almeria region in the Southern Spain to test this hypothesis. The men delivered semen samples, underwent physical examinations, had a blood sample drawn and provided information on lifestyle and reproductive health parameters. The investigations took place from November 2001 to December 2002. Adjusting for effects of confounders, the median sperm concentration and total sperm count were 62 (95% confidence interval 47–82) million/mL and 206 (153–278) million, respectively. The median numbers of motile and morphologically normal spermatozoa assessed according to strict criteria were 59% (57–62%) and 9.4% (8.6–10.0%), respectively. The median total testosterone and calculated free androgen index were 28 nm (26–30) and 95 (88–103), respectively. Assuming that the investigated men, to a large extent, are representative of the population of young men the Southern Spain, the results show that these have normal semen quality and reproductive hormone levels as expected in a population with a low incidence of testicular cancer.
Highlights
The publication by Carlsen et al (1992) that utilized historical data indicated an overall decrease in human semen quality worldwide
It has been suggested that an impaired development of foetal testes might lead to increased risks of cryptorchidism, hypospadias, decreased spermatogenesis or testis cancer (Jacobsen et al, 2000; Skakkebæk et al, 2001)
In satisfying the inclusion criteria, all men lived in the Almeria province: 85.5% in Almeria city and the remaining 14.7% in the surrounding smaller cities
Summary
The publication by Carlsen et al (1992) that utilized historical data indicated an overall decrease in human semen quality worldwide. A re-analysis found this decrease to be more pronounced for Europeans than for Americans (Swan et al, 2000) These publications indicated differences in semen quality between men from different countries, which were corroborated by studies of fertile men (Auger et al, 1997; Jørgensen et al, 2001; Swan et al, 2003). Young men from the general populations in Denmark, Germany and Norway have been shown to have worst semen qualities, Swedish and Lithuanian men, intermediate, and Finish and Estonian men, best (Jørgensen et al, 2002; Punab et al, 2002; Richthoff et al, 2002; Paasch et al, 2008). Similar geographical trends have been observed for testicular cancer with men from Denmark, Germany and Norway having the highest incidence rates (Huyghe et al, 2007; Chia et al, 2010). The concept links the pathogenesis a 2011 The Authors International Journal of Andrology a 2011 European Academy of Andrology
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