Chapter 1: Reproductive Shock: Hormonal Havoc in Our Midst 1 Reproductive Shock: Hormonal Havoc in Our Midst The Spermageddon Scare In late July 2017, it seemed as if every media outlet around the globe had become obsessed with the state of human sperm counts. Psychology Today cried, "Going, Going, Gone? Human Sperm Counts Are Plunging," while the BBC declared, "Sperm Count Drop Could Make Humans Extinct," and the Financial Times announced, "?''Urgent Wake-Up Call'' for Male Health as Sperm Counts Plummet." A month later, Newsweek published a major cover story on the same subject: "Who''s Killing America''s Sperm?" By the end of the year, my scientific paper "Temporal Trends in Sperm Count: A Systematic Review and Meta-Regression Analysis," which sparked these stories--and hundreds of others around the world--was ranked number 26 among all referenced scientific papers published worldwide, according to Altmetric''s 2017 report. This truly was the drop heard round the world. These days, the world as we''ve known it feels as though it''s changing at warp speed. The same could be said for the status of the human race. It''s not only that sperm counts have plummeted by 50 percent in the last forty years; it''s also that this alarming rate of decline could mean the human race will be unable to reproduce itself if the trend continues. As my study collaborator Hagai Levine, MD, asks, "What will happen in the future--will sperm count reach zero? Is there a chance that this decline would lead to extinction of the human species? Given the extinction of multiple species, often associated with man-made environmental disruption, this is certainly possible.

Even if there is low probability for such a scenario, given the horrific implications, we have to do our best to prevent it." This is especially worrisome because the sperm-count decline that''s occurring in Western countries is unabating; it''s steep, significant, and continuing, with no signs of tapering off. As Danish researcher and clinician Niels Skakkebaek, MD, who was the first person to alert the scientific community to the role of environmental factors in sperm decline, said, "It''s an inconvenient message, but the species is under threat, and that should be a wake-up call to all of us. If this doesn''t change in a generation, it is going to be an enormously different society for our grandchildren and their children." Indeed, if the decline continues at the same rate, by 2050 many couples will need to turn to technology--such as assisted reproduction, frozen embryos, even eggs and sperm that are created from other cells in the laboratory (yes, this is actually being done)--to reproduce. A Dystopian Future? Some of what we''ve been thinking of as fiction, from stories such as The Handmaid''s Tale and Children of Men , is rapidly becoming reality. In the winter of 2017, I presented my sperm-decline findings at the One Health, One Planet conference, which focused on the interconnected health of different species on the planet, the damage being inflicted by our mad "industrialization" of the environment, and its devastating effects on frogs, birds, polar bears, and other species. After presenting the results of our analysis, which were shocking enough to the audience, I spoke for the first time about what sperm decline could mean for Homo sapiens .

That night, I awoke from a dream, feeling incredibly anxious as I suddenly realized the full implications of the story I''d put together--that given the declines in sperm count and testosterone levels and the increases in hormonally active chemicals that are being spewed into the environment, we really are in a dangerous situation for mankind and world fertility. This was no longer only a matter of scientific study for me. I felt and remain genuinely scared by these findings on a personal level. In some ways, the picture looks even worse when you delve deeper because it''s not just an issue for men. Women, children, and other species are also having their reproductive development and function commandeered in a dysfunctional direction. In some countries throughout the world, including the United States, a massive sexual slump is underway, due to declines in people''s sex drives and interest in sexual activity; men, including younger guys, are also experiencing greater rates of erectile dysfunction. In animals, there have been changes in mating behavior, with more reports of male turtles humping other male turtles, and female fish and frogs becoming masculinized after being exposed to certain chemicals. Taken together, these trends are causing scientists and environmentalists to wonder, How and why could this be happening? The answer is complicated.

Though these interspecies anomalies may appear to be distinct and isolated incidents, the fact is that they all share several underlying causes. In particular, the ubiquity of insidiously harmful chemicals in the modern world is threatening the reproductive development and functionality of both humans and other species. The worst offenders: chemicals that interfere with our body''s natural hormones. These endocrine-disrupting chemicals (EDCs) are playing havoc with the building blocks of sexual and reproductive development. They''re everywhere in our modern world--and they''re inside our bodies, which is problematic on many levels. Here''s why: Hormones--particularly, two of the sex hormones, estrogen and testosterone--are what make reproductive function possible. Both the amount of each hormone and the ratio between these hormones are important for both sexes. The sweet spots for these ratios are different for each sex: depending on whether you are a man or a woman, your body needs optimal amounts of estrogen and testosterone, not too much or too little of either one.

To make it more complicated, the timing of their release can alter reproductive development and functionality, and the transport of hormones can be an issue as well--if they don''t get to the right place at the right time, essential processes such as sperm production or ovulation won''t be set into motion. Endocrine-disrupting chemicals, as well as lifestyle factors--including diet, physical activity, smoking, and alcohol or drug use--can alter these parameters, sending levels of these crucial hormones in the wrong direction. High-Altitude Worries Another, no less important or complicated, question, is, What do these reproductive changes mean for the fate of the human race and the future of the planet? It''s not just a matter of survival--whether humans will continue to be able to reproduce or whether the human race will die out in a Children of Men -type scenario. These issues have subtler, more personal consequences as well. Take declining sperm counts: statistically, this phenomenon goes hand in hand with many other problems for males, including an increased risk for cardiovascular disease, diabetes, and premature mortality (you''ll learn more about these downstream health hazards in chapter 8). And again, this isn''t just about men. Not only is women''s fertility being affected, even if less obviously or dramatically, but sperm quality can be altered by changes that occur when male fetuses are in the mother''s womb. At that time the fetus is affected by the mother''s choices and habits, which means that women can serve as conduits for potentially harmful chemical exposures.

Contrary to previous belief, the womb does not protect the fetus against chemical assault, and a developing fetus has few defenses against the infiltration of chemicals. Looked at another way, the most important events in a male''s life, in terms of sexual and reproductive development, occur while he''s still in utero. Babies and children are more vulnerable to these chemical assaults than adults, but those who are most vulnerable haven''t been born. The sperm decline signals changes that affect everybody. As some population experts and scientists put it, "a demographic time bomb" is on the horizon--future generations won''t be able to meet the financial and caretaking needs of an ever-increasing number of older adults and retired workers, given the declining fertility rate. And the changes in sexual development taking place all over the world appear to have been accompanied by an apparent rise in gender fluidity,I which is not a negative development, in my opinion. The point is, human sexuality and society are in flux, and this flux affects us all. It''s as if the snow globe has been shaken, altering the reproductive landscape inside--only this is happening in real life.

What comes to mind when you see a reference to the "1 percent effect," a common phrase in the cultural lexicon? Most people think of socioeconomic status, namely a ranking in the top 1 percent of wealth in the United States. Not me. I think of the fact that the rate of adverse reproductive changes in males is increasing by about 1 percent per year. This includes the rates of declining sperm counts and testosterone levels, increasing rates of testicular cancer, and the projected worldwide increase in the prevalence of erectile dysfunction. On the female side of the equation, miscarriage rates are also increasing by about 1 percent per year. A coincidence? I think not. Questioning the Issues If you''re skeptical about all this, that''s fair enough. I used to be, too.

Whether it''s because I''m a trained scientist or a natural-born skeptic, I''ve always been a firm believer in Albert Einstein''s assertion that "blind belief in authority is the greatest enemy of truth." That axiom has underscored al.