期刊
HUMAN REPRODUCTION
卷 37, 期 4, 页码 629-638出版社
OXFORD UNIV PRESS
DOI: 10.1093/humrep/deac011
关键词
population growth; fertility rates; social factors; genetics; sperm counts; testicular cancer; ART
Over the past few decades, fertility rates have declined significantly in almost every country, mainly due to social factors such as education of women and a shift in life's purpose. Environmental and lifestyle factors also play a role, particularly in male reproductive health. The demographic transition and increased use of assisted reproductive technologies contribute to the exacerbation of infertility.
Over the past half-century, the world has witnessed a steep decline in fertility rates in virtually every country on Earth. This universal decline in fertility is being driven by increasing prosperity largely through the mediation of social factors, the most powerful of which are the education of women and an accompanying shift in life's purpose away from procreation. In addition, it is clear that environmental and lifestyle factors are also having a profound impact on our reproductive competence particularly in the male where increasing prosperity is associated with a significant rise in the incidence of testicular cancer and a secular decline in semen quality and testosterone levels. On a different timescale, we should also recognize that the increased prosperity associated with the demographic transition greatly reduces the selection pressure on high fertility genes by lowering the rates of infant and childhood mortality. The retention of poor fertility genes within the human population is also being exacerbated by the increased uptake of ART. It is arguable that all of these elements are colluding to drive our species into an infertility trap. If we are to avoid the latter, it will be important to recognize the factors contributing to this phenomenon and adopt the social, political, environmental and lifestyle changes needed to bring this situation under control.
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