I did not, in my twenties, expect the start of the following decade of my life to be consumed by thinking about sperm.
But by the time I turned 33, I’d been thinking about sperm almost daily for three years. Or rather, I’d been thinking about the absence of sperm and what this meant for my life. My husband and I wanted to build a family, but a year after we got married, he was diagnosed with severe male-factor infertility. We were relieved to have an explanation for why we hadn’t yet been able to conceive, but deeply unsure about how to move forward.
Using a sperm donor seemed like the logical next step to many of the people we shared our predicament with, including the doctors at our fertility clinic. But the emotional and ethical nuances of fertility treatments, it turns out, are far more complex when your own body, family, and hopes for the future are on the line. I felt bruised every time someone suggested using a sperm donor as if it were a simple choice to make; I felt angry about having to make such a consequential decision about how to build our family when it seemed like everyone around me was getting pregnant with ease.
Also, I wanted to know why this was happening to my husband and me—as if having a reason would soothe the raw edges of the loss of ever having biological children together.
While male-factor reproductive challenges are rarely spoken about openly, they’re far more common than many people realize. What I learned in my first few years of thinking way too much about sperm surprised me: according to the Cleveland Clinic, male-factor infertility contributes to at least half of all fertility challenges, despite the fact that fertility resources are overwhelmingly marketed toward women.
Even more troublingly, male reproductive problems are on the rise, and exposure to chemicals in our environment may be a significant contributing factor. Dr. Shanna Swan, a leading environmental medicine expert and author of the groundbreaking book Countdown, has loudly sounded the alarm about the impact of environmental exposures on human fertility. In 2017, Dr. Swan and other researchers published a paper showing a 28.5% overall decline in sperm count between 1973 and 2011 in North America, Europe, Australia, and parts of Asia.
Now, recent research published this month by Dr. Swan and her fellow researchers adds weight to the evidence of a profound, growing crisis in male reproductive health. The new study found that sperm counts seem to be declining even more rapidly than formerly understood and that the effects are being seen in geographic areas not previously studied. Overall, global sperm counts have dropped 1.4% per year since 1972. But after 2000, the study found, the rate of decline has nearly doubled to a decrease of 2.6% per year. And researchers now have data on declining sperm counts in South/Central America, Africa, and Asia. Male reproductive health is under threat around the world.
In her book Countdown, Dr. Swan talks at length about how environmental exposures may be contributing to growing rates of infertility. Many, if not all, of us are exposed every day to endocrine-disrupting chemicals like pesticides, phthalates, bisphenol A (BPA), and PFAS, which can interfere with our hormones and damage sperm quality, among other harms to reproductive health. Lifestyle factors can also play a role in fertility challenges, but some of these factors, like obesity, may be linked to exposure to environmental chemicals as well.
In an interview with Environmental Health News, Dr. Swan and fellow study author Dr. Hagai Levine noted that climate change might also be a factor in declining sperm counts, due to climate-related stress and heat waves, which have been linked to declining sperm quality. Emerging research suggests that air pollution might adversely affect sperm health too.
The implications of a continuing downward trend for sperm count are alarming on multiple levels. At the very least, they mean that more and more couples are likely to need medical assistance in building their families in the coming years.
I have feelings about this. My husband and I eventually did move forward with building our family with donor sperm, and every day, we benefit from the wonders of assisted reproduction: without it, our astonishing children wouldn’t be here. Many of my dearest friends used donor sperm to build their families, and on a spiritual level, I deeply believe that children come into the world the way they are meant to. Donor-conceived children belong, and all donor-assisted families are beautiful.
And yet, I’m deeply troubled by the growing crisis in male fertility—not just because of what this implies for the future of humanity in the long term, but because of what I know it will mean for the mental and emotional well-being of every couple who struggles to conceive. Navigating infertility can be heartbreaking, consuming, and traumatic, even for those who are lucky enough to successfully build the families they want.
We’ll likely never know what caused my husband’s infertility, and as I follow the emerging research on declining sperm counts, I’m still thinking about sperm a lot more than I’d like to. I’m trying my best to reduce my own children’s exposures to chemicals that might impact their reproductive health, and whenever possible, using my voice to push for the systemic changes we need to reduce our collective exposure to environmental harms.
Despite a challenging road to parenthood, I’m enormously grateful that my husband and I were able to build a beautiful family—and now I see it as my responsibility to do everything I can to protect others’ abilities to build the families they want too.