Is Male Infertility Contributing to Falling Birth Rates?

Yves here. All around the world, there is ample evidence of human activity level exceeding what the planet can support, from an huge level of species die off to global warming induced wild weather changed to severe air pollution in large cities across Asia to endemic microplastics pollution. So the idea that birth rates are falling in high-resource-consuming countries ought to be treated as a welcome development, and one that can be managed as robotics and (we are told) AI will greatly reduce labor needs and thus alleviate if not completely end the classic bugaboo of rising dependency levels, as in fewer workers relative to the total population. But oh noes! That like so many things would take industrial policy, which advanced economies have foresworn.

Unfortunately, the Trump Administration and the snake oil salesman installed as HHS chairman RFK, Jr. in particular are making the possibility of a “Let’s make America whiter” campaign running up against low reproduction rates among the non-Hispanics and the effort to choke off immigration. The US was forecast to show a fall in population as of the 2000 census; it was both 1990s immigration and higher birth rates among Hispanics that produced the unexpected rise.

Of course, there is another level to this issue, of advanced (and even middle ranking, see Thailand) relying on immigration for lower-wage labor and to bolster growth as native population increases stall out. Most developed economies, unlike the US during its very large later 1800s-early 1900s immigration wave, are not doing much to assist in assimilation. That means the newcomers are much more visibly alien, stoking not-uncommon tendency towards tribalism and rejection of out-groups. And of course businesses want immigration to suppress wage rates, so unless there are very strong worker protections, laborers have a legitimate beef.

And with the public expecting more and more from medicine, the level of press coverage of fertility treatments and surrogacy suggests that more prospective parents who have difficulty conceiving doggedly pursue treatments rather than adopting.

My beef with articles like starts with the headline, which in fairness reflects Administration hobbyhorses. Falling male fertility is a big deal as a health issue. It should highlight concerns about population-wide factors that are damaging virility, from depression (which is correlated with lower sperm counts) to diet to pollutants. I am amazed by occasional reports of the level of medications and recreational drugs in public water supplies, with no discussion of whether there is an affordable way to reduce their level. That’s one indicator of pervasive public health negligence. Even if there are no easy answers, I don’t see the question being entertained.

By Joshua Cohen, an independent health care analyst and freelance writer based in Boston, and the author of Undark’s Cross Sections column. Originally published at Undark

For decades, U.S. marriage rates have been on the decline while the average age at which Americans have children has risen. Alongside this, birth rates have dropped — a phenomenon the Health and Human Services Secretary Robert F. Kennedy, Jr. has called a “national security threat.” Within Donald Trump’s administration’s Make America Great Again movement, pro-natalists opine that society’s existence could be at stake.

Kennedy issued a warning at a White House press briefing in October, arguing that the fertility rate is not high enough to ensure the American population remains stable. The rate dropped to a historic low in 2023 and continued to slide in 2024. The total fertility rate that year was less than 1.6 live births per woman of childbearing age. This is well below the replacement rate of 2.1<, at which population size remains constant from generation to generation. Many women are proactively choosing to have no or fewer children. But for those who do wish to get pregnant, yet struggle with infertility, President Trump has announced that he will work with a drugmaker to offer several fertility medications at a heavy discount and make it easier for employers to offer fertility benefits.

The administration has not, however, spoken publicly about specific treatments geared toward men. And until recently, the topic of male infertility was somewhat taboo, even though it plays a role in roughly half of all cases in which a woman struggles to get pregnant.

A man’s age, health, and weight can all contribute to infertility. Research suggests this is because these variables influence sperm count and testosterone levels — both of which appear to be on the decline. Kennedy has repeatedly expressed alarm about these declines, with exaggerated claims such as this, from an October press event: “Today, the average teenager in this country has 50 percent of the sperm count, 50 percent of the testosterone as a 65-year-old man.”

But what role does male biology play in declining birth rates? Could addressing this help the administration meet its fertility-boosting goals? The answer, it turns out, is complicated.


Over the years, researchers have asked if sperm counts really are on the decline. More recently, one group developed what some critics now call the “sperm count decline hypothesis,” which posits that sperm counts are falling and that a low sperm count is an indicator of sub-optimal health, which could impact fertility.

A 2017 meta-analysis, for example, based on data from North America, Europe, Australia, and New Zealand, foundthat sperm count had declined by 52 percent between 1973 and 2011. A follow-up in 2022 by some of the same authors showed a similar reduction across an even wider range of countries. Rossella Cannarella, a clinician and researcher at Italy’s University of Catania who was not involved in either study, told Undark that the findings track with the results of her own research and with what she sees in patients in her clinical practice. She attributes the lessening in sperm count to pollution and metabolic disorders such as obesity, among other things.

In a newly released report for the Health and Environment Alliance, an EU-based not-for-profit, Cannarella warns of the dangers of chemical pollution in fueling a “growing male health crisis.” This includes male infertility — with evidence suggesting a possible association with exposure to harmful chemicals and other so-called endocrine disruptors. These are natural or synthetic substances found in plastics, food packaging, and pesticides that can interfere with hormones such as estrogen, testosterone, and thyroid. Notably, at that October White House press briefing, Kennedy emphasized the possible role of endocrine disruptors in the fertility rate decline.

Endocrine disruption is posited to take place through exposure to substances in the air, food, and water, as well as through the skin. Endocrine disruptors in food can impact the beneficial microbes living in a person’s gut. Germar Pinggera, a clinician and researcher at the Innsbruck Medical University, told Undark that pollution, poor diet, and an imbalanced microbiome can be detrimental to sperm production, as well as sperm quality. These factors, he suggests, may all be affecting fertility.

At the same time, Pinggera said that while some studies point to a decrease in sperm count, “there are still other data that aren’t confirming that.”

In a press release, the lead author of a recent meta-analysis suggested that among men in the U.S. with no known fertility challenges, “sperm counts are largely stable and haven’t changed significantly” in recent years. Moreover, it’s unclear whether sperm quality has declined. According to a 2022 review published in Nature Reviews Urology, researchers have observed a trend in some geographic areas, but available data doesn’t indicate that semen quality is necessarily deteriorating worldwide or in the Western world.

Furthermore, a reevaluation of the 2017 meta-analysis cited above suggests there could be issues with respect to how sperm counts were measured. Researchers identified inconsistencies in the sperm count decline hypothesis and proposed an alternative framework that asserts that sperm count varies within a wide range, much of which can be considered normal.

Critics of the sperm count decline hypothesis also contend that it takes for granted that sperm count is an accurate predictor of male fertility. Experts disagree about what exactly the fertility implications are of a reduced sperm count. Male fertility involves multiple components, including sperm count, concentration, shape, and motility, in addition to testosterone levels, age, and other characteristics. And male fertility can’t be seen independently from female fertility, say, in the context of a couple trying to conceive spontaneously or with assistive reproductive technologies. Here, it’s essential to evaluate the interactions between sperm, the female reproductive tract, and the egg.


What about the role of testosterone, the hormone responsible for changes that occur in boys during puberty, including production of sperm and the maintenance of certain biological functions related to reproduction in adult men? Levels of testosterone generally peak during adolescence and early adulthood. As a male ages, his testosterone level gradually diminishes — typically around 1 percent annually after age 30 or 40.

Testosterone is essential for sperm production, but it isn’t the only necessary ingredient. Other hormones are also involved, including luteinizing hormone — which stimulates testosterone production — and follicle-stimulating hormone, making it difficult to parse the precise role each hormone plays in infertility.

And while Kennedy has asserted that young men’s testosterone levels have plummeted over the decades, the scientific literature tells a more nuanced story. A 2021 publication, for example, found that testosterone levels have diminished among young adult males from 1999 to 2016 by around 25 percent. Further, researchers observed that among adolescent and young adult males, testosterone deficiency is 20 percent.

Still, Geoff Werstuck, a professor at McMaster University in Ontario, wrote in an email to Undark that the “relative speed of the decline is absolutely noteworthy.” An endocrinologist from the Cleveland Clinic also pointed to the accelerated decline in testosterone and appeared to link it to a similar set of elements likely causing a reduction in sperm count.

But not everyone agrees about the extent of the decline. Adith Arun, a researcher at the Center for Outcomes Research and Evaluation at Yale New Haven Hospital, wrote in an email to Undark that a shift occurred over time in terms of measurement techniques that makes it hard to make firm comparisons. The cutoff for low total testosterone was not updated to account for use of these new techniques. In a follow-up email, he noted that this may in turn “result in overstating the fraction of self-reported healthy individuals with low total testosterone values.”

And Werstuck noted that “because of a lack of good historical data” it’s difficult to determine when the testosterone downturn began and “precisely how large the effect is.” He also said that he doesn’t believe there is “strong data to support or discount” the various factors that have been hypothesized as causing the trend.


All of this means that the exact role of male biology in declining birth rates is unclear.

At a discussion in August organized by the Harvard University T.H. Chan School of Public Health, one panelist said that much of the decline comes from teenagers and young women delaying childbearing. The expert, Margaret McConnell — an associate professor of in the Department of Global Health and Population at Harvard University — cautioned that aggregate family size over a woman’s lifetime has not fallen nearly as pointedly as the annual fertility rate.

“We’re seeing this as part of an ongoing process of fertility delay” Leslie Root, a fertility and population policy researcher at the University of Colorado Boulder, told Newsweek. “We know that the U.S. population is still growing, and we still have a natural increase — more births than deaths.”

The “ongoing process of fertility delay” that Root refers to may partially reflect reproductive agency. Women can make informed decisions about their reproduction that in turn depend on a host of factors that include their career paths, ability to afford raising a family, and technological advances such as IVF and egg-freezing. These can influence the age at which individuals marry, preferences regarding family size, and the general reproductive behaviors in women and men in American society.

And so, despite the panicked rhetoric about fertility and sperm counts, there remain a host of unresolved questions, many of which extend beyond the realm of science into social factors.

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37 comments

  1. IM Doc

    Just as in the COVID disaster with so many issues there, I must report that I am seeing things in the realm of this article that I have never seen before. I am also hearing this discussed and noted by many colleagues all over the country. There is a growing realization that the medical leadership, not just the agencies but also the medical boards and agencies like ACP, AAP, ABIM, etc, have completely and totally abandoned any pretense of science and accurate data collection. What I am basically saying…….what I am seeing here on the ground in this regard is completely different from what is being reported by the naysayers and others in the article above. They fooled us for awhile with COVID. That is a lesson that the older and wiser among us will never forget.

    Yes, there is definitely something going on with fertility among men. I am seeing things in the past 5-10 years that I have never seen before in my entire career. What is the exact cause? I have no idea. I do not have the ability to even begin investigating this. Our national medical leadership does, and what we get from them is denial and navel-gazing……statistical games and “modeling”.

    I had never seen even a single time in 35 years a young man with a testosterone level below about 300 until about 8 years or so ago. When I say young, I mean under 35 or so. Not once. The first one was a 28 year old obese inactive male – profound fatigue – with a testosterone level of 82. I would see an occasional young man with overwhelming fatigue and decades ago that would almost always be some kind of psychiatric problem. Nowadays, I have a panel of labs I perform on these fatigued young men – there is an absolute explosion of them – and am horrified to see just how many have testosterone levels under 250. Under 30 year old men should be in the prime of their reproductive lives – this number should be at least 500 and often up to 1000. Shockingly, there have been several in their 20s that have testosterone levels of a 90 year old at under 50.

    What I am able to notice about these young men as a group. Many of them are obese, some of them are quite obese. Many of them play on computers all day. There is an obvious lack of any kind of exercise or physical fitness in this group. I know it is hard to believe for the “toxic masculinity” screamers – but young men by their very nature are supposed to be doing intense physical activity. That often borders on very intense. In our culture, this is often called “toxic”. In the past, this has been accomplished in activities that are solidly masculine. Physical fitness, weight lifting, intense physical work, even fighting and boxing, etc. All of these things for the past generation or so are now associated on social media as being “toxic” “right-wing” or even “fascist”. Instead of the hard work of their male elders channeling this needed behavior into appropriate outlets, we have as a society done everything we can to denigrate it. The bill has now come due.

    Among other things I have noticed. There is an outsize representation in this hypogonadal cohort in men of those who have been on drugs like Adderall and SSRIs all their lives. Almost all of the affected ones are big consumers of processed foods like chips, candy, Pepsi, etc. Many of them use lots of marijuana. Also, this seems to be happening much more commonly in the 20 and up crowd in the men who are not having regular sexual interactions – I guess the word is incel. Among this group, there is almost always an intense rage, resentment, bad vibes about their lives. It is very difficult to know if the underlying behavior is what is causing the problem OR if the hypogonadal problem is causing the behavior and attitudes.

    The problem is not uncommon. I have heard all kinds of theories over the past few years from colleagues trying to figure out what is going on – are there poisons in the plastic lining of every food in the grocery store?, is it possible that drug by products are not getting filtered out of the sewer systems and all the drugs are entering the water? for the most part, we just started dosing kids with daily meds in the past generation or just a bit longer—-could these meds be playing some kind of role in development? how big of a problem is obesity and inactivity in this situation? why are so many docs like me seeing a huge bifurcation in their patients – the kids and young men who are very physically active, who do intense work and exercise, seem to not be the ones affected?

    The other problem that is the big unspoken issue in the “fertility crisis” is that far too many of our young people are waiting far too long to become parents. No, we really cannot have it all. If women wait until their 30s which huge numbers of them are right now – it is much much more difficult. But to even mention this simple biological fact in our culture and discourse paints one as a bigot misogynist.

    Again, other than noting the intense sudden problem over the past decade, and noting who seems to be involved, I have no idea what is going on. But rest assured, the problem is very real.

    Reply
    1. Yves Smith Post author

      The first big study reporting on a global decline in sperm counts was in 1992, looking at the period 1938 to 1990. That finding has been confirmed and it was an advanced economy development as of then:

      In 1992 Carlsen et al. reported a significant global decline in sperm density between 1938 and 1990 [Evidence for Decreasing Quality of Semen during Last 50 Years. Br Med J 305:609-613 (1992)]. We subsequently published a reanalysis of the studies included by Carlsen et al. [Swan et al. Have Sperm Densities Declined? A Reanalysis of Global Trend Data. Environ Health Perspect 105:1228-1232 (1997)]. In that analysis we found significant declines in sperm density in the United States and Europe/Australia after controlling for abstinence time, age, percent of men with proven fertility, and specimen collection method. The declines in sperm density in the United States (approximately 1.5%/year) and Europe/Australia (approximately 3%/year) were somewhat greater than the average decline reported by Carlsen et al. (approximately 1%/year). However, we found no decline in sperm density in non-Western countries, for which data were very limited. In the current study, we used similar methods to analyze an expanded set of studies.

      https://pmc.ncbi.nlm.nih.gov/articles/PMC1240129/

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      1. IM Doc

        Although somewhat related, declining testosterone levels and declining sperm counts are 2 different things.

        The testosterone issue is truly something that has just exploded in the past decade or two.

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        1. Yves Smith Post author

          Agreed, but RFK, Jr, seems more concerned about sperm count when I agree your and your colleagues’ findings about testosterone levels point to something very serious.

          Also looks like a big explanatory variable regarding young men being so easily deterred by admittedly often awfully demanding young women. I have heard many tales of then young men being very persistent in their pursuit of women, as in taking a lot of rejection as well as upping their pursuit skills (usually flirting, it is amazing how many men don’t get that well applied humor is very appealing).

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    2. Cian

      Your comments about tostesterone make sense, and it’s shocking that there’s not been more priority been placed on researching this. However even in cultures that are far healthier than the US (e.g. Japan, parts of Europe) you’re seeing significant collapses in birth rates, suggesting other factors may be involved (or more likely – there’s a wide mix of complex, interlocking, factors).

      I do think the US is kind of an outlier. As a European who moved to the US, I’ve been shocked by both the diet of the US and how little exercise one gets in routine life. I used to walk everywhere just doing regular activities, whereas in the US this is almost impossible. When I was at school we had far more recess (and we were active during recess), we had PE multiple times a week (whereas my kids went most of the year without any PE at school).

      And regular food is so bad here. Why is even the bread sweet? What the hell even is American cheese? Why salad dressings? So I can believe that the US is uniquely affected by these things, given that this is a global phenomenon, and US ‘quirks’ are not particularly global, there has to be more going on. It’s kind of shocking that more research isn’t going into this.

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    3. Cian

      Among other things I have noticed. There is an outsize representation in this hypogonadal cohort in men of those who have been on drugs like Adderall and SSRIs all their lives. Almost all of the affected ones are big consumers of processed foods like chips, candy, Pepsi, etc.

      The problem here is that the groups who are on prescription drugs, are also doing the other bad things (lack of exercise, too many video games, snack food) – so it’s hard to identify a single cause.

      And without being an too much of an old man, the negative changes of even the past 20 years are shocking. It used to be normal to walk to school. I was a bookish kid, but I was outside way more than any of the younger kids I know today (even the outdoorsy kids). And there was just way less sugar in the diet. And while as someone who received a late life diagnosis for ADHD – I do think it was under diagnosed – I refuse to believe that most of the kids getting Adderall today actually need it.

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    4. ibaien

      “The other problem that is the big unspoken issue in the “fertility crisis” is that far too many of our young people are waiting far too long to become parents. No, we really cannot have it all. If women wait until their 30s which huge numbers of them are right now – it is much much more difficult. But to even mention this simple biological fact in our culture and discourse paints one as a bigot misogynist.”

      maybe several decades of wage stagnation, offshoring, financialization, asset bubbles, etc etc etc etc have made it so that young people would be committing fiscal suicide if they had kids in their prime reproductive years. blaming this on women wanting to ‘have it all’ is *a* take…

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      1. IM Doc

        Thank you so much for your take. I am certain that especially two groups of my patients will find your kind words very comforting. Not everything in life is about money. That is a very important lesson I have learned as a physician watching people spool out their lives before my eyes.

        1) Those 30 or 40 something couples who have literally spent hundreds of thousands – their entire retirement basically – on unsuccessful IVF all the while crying to me that how could they have been so stupid not to have their kids earlier. Many of them have actually expressed that they had all the same feelings in their 20s as you have indicated above.

        2) The even massively larger cohort of 60 70 and 80 somethings, often single, but quite a few married, who have arrived in their golden years with all kinds of medical or mental issues and have no kids to help guide them through. This is a very common situation in the Baby Boomers; not so much in GenX and not so much in the generation immediately preceding the Boomers. There is no one to make sure they have groceries, no one to make sure they are OK. For the simple demographic reason that women live longer, most of these single patients are women. Again, many of them state they felt the same that you do (or at least variations of it) in their younger years but really lament the massive mistakes they have made with their lives – the most troubling mistake of all was not having kids. Unfortunately, I hear this all the time. The last time was just this past week when an 82 year old woman said to me “Helen Gurley Brown said lots of things – she never told us that we would end up like this”. I take care of so many patients who are in this situation. Certainly, these social issues add great cost onto our health care and social systems. It is by no means even close to being the biggest financial problem we face – but it certainly contributes to the problems. Just last night I admitted an 85 year old single woman. Severe congestive heart failure. She has no kids. She sat at home alone for days with no one to call just slowly getting more and more swollen. Instead of a simple doctor visit she could have done days ago, it will turn into a costly week-long admission.

        I really do wish that people that harbor feelings as you express above could spend but one day with me. It would almost be like the Ghost of Christmas Future for you.

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        1. Yves Smith Post author

          As a single woman who was clear at the age of 6 that I did not want to be a mother and is now officially elderly, I have to disagree with you. I have no regrets about not having children.

          I think having children is the cruelest thing people do (even with doing so with genuine good intentions), and even more so now in a time of social and ecological breakdown. Every major religion has as a significant if not main purpose reconciling its followers to the inevatibility of suffering and death.

          And from the mercenary perspective of haivng children as a sort of old age insurance policy, that regularly does not work out in our atomized society. I also know many older women (more my mother’s generation: it has to be worse with younger cohorts) where a once-married wife with kids had her husband die first and has her offspring do pretty much squat to help, sometimes because they can’t (they live in a a different city, both spouses work, there isn’t the money and career bandwdith from them to upend their lives, even before the cases where no one child wants to volunteer to take care of the elderly parent(s) and have the siblings be free riders) …unless there was money, and then you got all sorts of Little Foxes behavior or even rank exploitation. Look at Brooke Astor, once a member of New York’s top elite, who was in her own urine in her expensive apartment, as one of many examples.

          Brooke Astor was a writer, and socialite who lived a long life that’s one for the books. Brooke herself was well-aware of how interesting her life was that she wrote two memoirs. After her third husband, Vincent Astor, died, she was left in charge of the Astor Foundation, and she rose to prominence even more as a philanthropist. The biggest and worst publicity Brooke had unfortunately happened during the last few years of her life.

          Brooke’s son, Tony Marshall was exposed for committing elderly abuse. Brooke Astor suffered from Alzheimer’s Disease and other age-related ailments, and to aggravate Brooke’s life conditions, her son Tony was embezzling funds from Brooke’s estate and was neglecting Brooke’s wellness.

          https://www.justiceclearinghouse.com/resource/brooke-astor-story-hard-learned-lessons-address-elder-abuse-financial-exploitation/

          Moreover, those prospective parents who spent a fortune on IVF could have adopted instead. There are tens of thousands of adoption-eligible children in the US who could use a home. Admittedly a small sample but all the people I know personally who adopted had their kids turn out well and are very happy they took that decision.

          If you don’t have kids (and per above, even if you do), it is incumbent upon you to take good care of yourself physically when you are young, particularly with diet and exercise. Many don’t do that.

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          1. Wukchumni

            I have no regrets about not fathering children, the survival of the human race isn’t dependent upon me or anybody in that regard.

            As far as kids go, I know of no family in my circle of family & friends with more than 3 offspring, a sea change from when I was born, where big families of 5 were commonplace. most have 1 or 2 children now.

            Societal pressure to bear children simply isn’t there as it used to be, a lack of contributing factor.

            One of the big reasons evangs want every sperm to come to fruition, is dogma is highly aware that children follow the religious path of their parents, and need more adherents.

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        2. kareninca

          I was in a rehab center last month visiting a relative and observed two sons visiting their 88 y.o. mom (she was my relative’s roommate and I overheard a lot). They clearly cared about her but they were oblivious to the agony she was in and had no plans to do anything about it. I told the rehab people about her condition, and I told the sons about her condition, but no-one listened. It was clear that she is going to spend the rest of her life in hideous pain. Sorry but kids are not some fix-all. And those ones meant well; they were just clueless.

          I can’t picture creating a human being as a means to obtain future service. It doesn’t seem like an ethical thing to do; a person should be treated (and created) as an end in him or herself. I personally don’t think life is any sort of gift, so inflicting it on someone would not be a kindness.

          I have a neighbor who is a retired doctor who had 9 kids (8 from his first marriage; one from his second marriage) and they all hate him. His doormat wife (who looks like she is dying) drags his sorry carcass from ER to rehab to home to ER to rehab to home. He is such a rotten person that no-one in my condo complex can stand to try to help her since then they’d be around him. It is true that he’s getting tolerable care but it is not because he reproduced many times; it’s because he married a nurse. I hope the kid they had together will take care of her but I wouldn’t bet on it.

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          1. kareninca

            Also I have known several instances of only children who were sons who simply wanted nothing to do with their mothers; nothing at all, and refused all contact with them, even unto the mother’s death. It was horrible to see the desperation of those women; alone despite having had a kid whom they had raised with love and care.

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      2. eg

        This. Neoliberalism is inimical to human flourishing in all its dimensions. Should we be surprised that it causes ill health and suppresses reproduction in n-many ways?

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    5. Bad Coffee

      Regarding sexuality issues, we may perhaps paraphrase what Winton Churchill (probably) said of Americans: Academic research will surely find the right causes, after all other possibilities would be exhausted. It will probably be inconvenient to the woke scholastics.

      Reply
  2. voislav

    These studies are difficult to square because you have a myriad of factors at play. What role does increased stress play in this? What role does having kids at a latter age? What are other environmental factors at play (pollution, microplastics, etc.)? What about societal factors (income precarity, housing affordability)?

    I see testosterone (and other hormone) levels as a indicator, rather than cause of declining fertility. I would be interested to see this mirrored against the income brackets, I suspect that the lower and middle income brackets would have a pronounced effect than the high income bracket. To paraphrase Keanu Reeves in Good Fortune, “It turn out money solves most of life’s problems”.

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    1. JonnyJames

      This is way beyond my expertise, but yes, I would think that there may be links with increased psycho-social stress, increased socioeconomic disparities, declining standards of living, increasing depression, anxiety, and declines mental health. The US has very poor health care, low quality food products, and poor health outcomes generally, which I would also think correlate as well. As Yves points out in the intro, the neglect of public health, and the poor health care provision in general need to be considered.

      I personally find living in a declining society that is becoming increasingly dysfunctional and corrupt very disturbing. This general environment may well both decrease ability to reproduce (sperm counts etc.) and decrease the desire to bring children into a depressing, declining and even collapsing society. Anecdotally, journalist Ben Norton and his family moved to China, where they are raising their children.

      Anecdotally, the vast majority of my friends (now in their 50s) CHOSE not to have children, rather than had fertility issues. My brother and his wife chose not to have children as well.

      Or could it be a collective genetic mechanism to curb the reproduction of humans that has increased beyond the needs to propagate the species?

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    2. eg

      Off-hand I would guess that chronically elevated levels of cortisol aren’t helping any — in all health dimensions, including reproduction.

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  3. Anthony

    There is increasing evidence COVID-19 infections are one of the factors contributing to decreasing fertility rates worldwide.

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  4. Cian

    The problem with understanding environmental contributions to male (and female) infertility, is that there are far stronger social contributors that swamp any possible biological contributions.

    The largest contributions to declining fertility is female agency, followed by (somewhat fuzzily defined) male misogyny and financial security.

    The biggest reason for declining birthrates in the west are that families are having children later, and choosing to have fewer children. Given that fertility declines rapidly with age (particularly for women), it’s no surprise that we’re seeing increasing fertility problems, and this would possibly occur even if male/female fertility was increasing (e.g. if a 20 year old from 2025 has better fertility on average than one from 1985 – this wouldn’t make up for the fact that a 20 yo from 1985 would probably be having a child today at around 30-35). It’s kind of sad how few women seem to realize how significant delaying children can be on their chances of having children.

    Reasons for delaying children are education (a good thing – teenagers don’t make for great parents), career aspirations (mixed – and certainly made worse in cultures with toxic workplaces) and financial security (A big contributor to Italy’s collapse in childbirths is that so few young Italians can afford to move out of their parent’s house). Financial security also affects how many kids families are willing to have, though it seems to be relatively minor (e.g. – paid childcare is important, but it has a minor effect on birth rates).

    In addition, women often delay having children because they delay a long term relationship. Reasons for this are complex, but in countries like S. Korea and Japan – a big contributor seems to be engrained sexism. Even simple factors like men’s willingness to do housework can make a big difference.

    I’d be very surprised if bad diets and environmental pollution wasn’t having an effect – but proving it is pretty difficult in practice. Both for the reasons outlined in this article, and also due to other factors being far stronger.

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    1. Yves Smith Post author

      You don’t include the end of the stigma of divorce. Generally speaking, the woman is responsible for the offspring but in our society, the man has the option of being involved in the event of divorce.

      One in seven single mothers winds up bankrupt.

      That’s enough alone to create a lot more caution about having kids young and having not much in job prosepcts save being a Walmart cashier if your hubby dumps you or turns out to be a swine.

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    2. Aaron Peter

      I do not recall exact dates and numbers but France post WWII used to have a stable population — French women produced enough babies to replace the population. Coincidentally, there were a lot of services available to French moms: Day care, housekeepers provided by the State, etc.
      Then in a fit of “Reform” the wasteful services were eliminated. Surprise, fertility began to drop to match the rest of Europe, which did not have those services.
      I, for one, would not be interested in having a child if it meant living in poverty for the rest of my life. And for many American women, it does. There is the loss of your income during the time you are raising the child (at least until the kid is 4 and can go to school) or seeing most of your income going to pay for your childcare. There is the expense of raising the kid, which sees (at least anecdotally) to be increasing.

      Reply
  5. Wukchumni

    There I was in the naked city, another spermatozoa on the make-one of 100 million hoping to win the lottery, and then she asked me out on a date

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  6. alrhundi

    A lot of us are just too damn busy trying to afford to survive to have kids. We also enjoy our own time and realize what a drastic change children brings to your life. I think a lot of people my age (mid to late 20s) would rather spend their time traveling and enjoying life than raising children. For women it also affects your career, and most of us need both incomes to afford to live comfortably.

    At the same time the pull out method hasn’t failed me yet so maybe infertility is the reason. I try to go in the hot tub every few months just to help.

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  7. Dr. Nod

    Sunlight boosts vitamin D and testosterone. Anecdotally, young people spend a lot less time outside than they did 50 years ago and use a lot more sunscreen. By the way the relationship between sunshine and skin cancer is much more complex than Sunshine bad–sunscreen good. In fact the frequencies of melanoma and non-melanoma skin cancers have increased dramatically in the US since the 1970s when sunscreens first came into widespread use. There are complex pathways involving the tumor suppressor p53 and other proteins that regulate melanin production in response to sunlight and melanin is a terrific protection against skin cancer.

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  8. Stephanie

    Reply to motorslug: According to the World Population Review prostitution is legal in 54 countries, including many European and African countries and, it seems, most of South America. The United States, thanks probably due to federalism, is listed as “legal/illegal”. So then the question becomes whether male fertility is higher in these countries than those where prostitution is illegal, whether a particular legalization model (decriminalisation, abolitionism, full legalization) correlates with higher male fertility, whether pricing and other barriers to access affect male fertility, etc., or whether other cultural, economic, or environmental factors keep male fertility low in spite of sex work legalization. Sounds as if it would make for an interesting data review.

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  9. badphoton

    It seems to me that drops in fertility would be normal about now. Humans, though we seem to seldom think this way, are animals. Its not surprising when an animal population begins to exhibit reproductive difficulties when subject to overcrowding, resource limitations, or other environmental factors related to a too large population in relation to its environment.

    Its often stated that we have passed the carrying capacity of the earth. “We need almost two earths to keep up our level of resource depletion.” Why would we be any different. Human populations were relatively stable for many thousands of generations. Relatively. We’ve been hit by some serious environmental stresses unrelated to our population size in the past. (Ice ages, super volcanoes, etc) So the capacity to rebuild population sizes has always been there. I think that our recent (last few thousand years) run up in population is more the outlier than the norm.

    The specific mechanisms by which our population will be brought back to within environmental limits are probably only somewhat predictable in advance but shouldn’t be surprising that we are seeing them.

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    1. Bad Coffee

      Biologically, the prolonged exponential population growth in the past modernity has been an aberration. Dealing with resource limitations and overcrowding is a biological norm, in a sense. Not everyone has to be uber-fertile in a limited world.

      It is still mysterious: Does the apparent prosperity play the role of a reliable signal (particularly to females) to tighten reproductive criteria for inevitable tougher times, or do we prioritise authentically stringent female choices just in time?

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  10. Cumin

    In a Dec 11. 2024 Great Simplification podcast, Nate Hagans talks with Jeremy Grantham: the Baby Bust. Grantham sees population declines from toxicity and endocrine disruption. Sorry I don’t know how to copy links or text.

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  11. J

    There’s pretty good evidence that high stress leads to low testosterone. It wouldn’t surprise me if stress were the underlying cause.

    Most/all of the findings in IM Doc’s list are stressors. Not to mention all the extra psychological stress right now from e.g. difficulty paying bills,Trump admin craziness, etc etc.

    Plus I think interpersonal communication is breaking down now too. People are lonely and isolated. In the past we had larger family groups and extended family that lived nearby. Now we often are part of small families distributed around the country. This is a terrible state for a human being: we are social animals.

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  12. caro

    Observing not overly struggling 20-somethings in central Europe lead me to believe there are 2 camps:
    Those assuming they will be much worse off than their parents, with an unlimited downwards movement on the socio-economic ladder quite likely, and COMPLETELY OUT OF THEIR CONTROL. They feel they are doing the best they can, but have no agency regarding their future well-being. They postpone getting kids, and try hard to improve their lot by building bulwarks against a dark future. A few nearing 30 realize the fertility trap is coming, and get pregnant despite doubts, a now or never situation.
    The other group has done so for a while, given up, and depending on random circumstances occasionally just give in and get pregnant at the drop of a hat. At that very moment they do not discuss the future again and close their eyes, living only today.
    I am talking about roughly 30 upper middle class well educated academics with matching parents, the social circle of my kids.
    I do belive the capitalized fragment above is the main reason for the birth rates we see today, the feeling of having no agency about one’s future. Some simply disregard it, the others freeze in terror.
    I know, it’s not at all scientific, but believe me, it impresses me a lot when i hear them doom-talking.

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  13. The Rev Kev

    I wonder if there is any thought being given as to what should be the actual population of the US. I never see any discussion about that except for that time some guy said that there should be a billion Americans. At the moment it is over a third of a billion but would it be so bad if the population went back to the 203 million that it was back in 1970?

    https://en.wikipedia.org/wiki/Demographic_history_of_the_United_States#Historical_Census_population

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  14. SittingStill

    I can’t help but suspect there is a relationship between this and increasing levels of gender dysphoria. (self perceived as a 61 yo)

    Altered physiological gender expression has been observed in fish populations that live in habitats with chronic exposure to endocrine disruptors.

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  15. Hickory

    This article mentioned endocrine disruptors but didn’t really discuss what they do. It mentions endocrine disruptors’ impact on gut biome, but that’s different than disrupting the endocrine system, which can hugely impact all aspects of our emotional, physical, sexual development and functioning. Any situation where a hormone should exist or should not exist in the body, that can be affected by endocrine disruptors, which obviously is a lot of situations.

    RFK Jr’s quote sounds off, but I think he misspoke: a present-day teenager’s sperm count and testosterone may well be 50% of a 65-year-old man’s at the time that 65 year old was a teenager; ie comparing present-day teenagers with their grandparents at the same age.

    The book Our Stolen Future was published in 1996 and described many of these symptoms plus more, including the steady increase in breast cancer as industrial pollution increased over the 20th century. Plenty more examples from nonhumans show the effects these pollutants can have on us, including increased homosexuality in birds and shrunken penises observed in alligators exposed to industrial pollutants.

    The chemicals and fossil fuel companies have billions of dollars to spend protecting their profits, and when RFK Jr says chemicals poison us and that’s a major problem, you’re seeing their response: spreading fear, uncertainty and doubt (FUD). Yes there are other causes of societal health problems, but there’s enough very solid research on chemical poisoning that no reasonable person would delay putting an end to it. Only multi-billion dollar FUD campaigns can muddy the waters on such a clear issue.

    The tobacco industry did everything they could to protect their profits at their customer’s and society’s expense. Ditto the fossil fuel companies who spread FUD around climate change. Ditto the pesticide companies who profit by poisoning food, and data companies that profit from feeding the surveillance state. The Catholic Church consistently protects the priests caught abusing children. We are surrounded by selfishness, with each industry protecting its own privileges and profits at the expense of the public at large. This sort of widespread greed and corruption is just normal in any society where a few people rule over everyone else. Free societies consistently avoid such corruption and greed, and if we’re willing to learn from them, they could help us see a path to living without this deep selfishness again.

    Reply

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