[HN Gopher] NIH-funded research to address rising male infertility
       ___________________________________________________________________
        
       NIH-funded research to address rising male infertility
        
       Author : PaulHoule
       Score  : 73 points
       Date   : 2021-09-16 15:57 UTC (7 hours ago)
        
 (HTM) web link (news.cornell.edu)
 (TXT) w3m dump (news.cornell.edu)
        
       | dilap wrote:
       | Exhibit A:
       | 
       | https://pubmed.ncbi.nlm.nih.gov/32504693/
       | 
       | Exhibit B:
       | 
       | https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC3076650/
        
       | GDC7 wrote:
       | Testosterone levels are plummeting as well:
       | 
       | https://www.urologytimes.com/view/testosterone-levels-show-s...
       | 
       | More generally risktaking is down across the board.
       | 
       | Cigarette smoking, stimulants, party drugs use, alcohol, sexual
       | intercourses are also in a freefall compared to the 80s.
       | 
       | As always people laughed at Japan, first it was Japan's economy,
       | then its social trends, finally its sexual trends...
       | 
       | But make no mistake, that's where we are headed. The future
       | belongs to Africa and partially South America.
       | 
       | Men are made to be dumb, reckless and horny, the moment they
       | become cerebral, emotional and scared that's the signal that
       | society is on the brink of collapse.
       | 
       | We are in uncharted territory, men never behaved like they are
       | now in the whole history of the human specie
        
         | manachar wrote:
         | > Men are made to be dumb, reckless and horny, the moment they
         | become cerebral, emotional and scared that's the signal that
         | society is on the brink of collapse.
         | 
         | This statement is wholly unsupported by history or science.
        
           | user-the-name wrote:
           | It is also a favourite far-right bit of ideology.
        
           | elzbardico wrote:
           | Given the prevalence of armed conflict in human history, I
           | have trouble agreeing that OP's statement, even if did in
           | jest, isn't supported by history.
           | 
           | It takes a whole lot of dumbness and recklessness to enter
           | wars.
        
             | watwut wrote:
             | That is because when you look closely at factors that led
             | to those wars, you find people reacting on self interest in
             | situations where going to war is has high chance of being
             | beneficial to them.
             | 
             | It is easy to create slogans and such. But real history
             | when you look at it is not as simple as dumb guys being
             | dumb.
        
           | fallingknife wrote:
           | "History" could be renamed "men acting dumb, reckless, and
           | horny" and it would basically be accurate.
        
           | GDC7 wrote:
           | Past performance is not an indicator of future outcomes.
           | 
           | We are quite literally watching Japan disappear in front of
           | our eyes.
           | 
           | The West is about to start contracting as well.
           | 
           | The only areas which are growing are India, Africa and South
           | America.
           | 
           | The future can't be bright when you inesorably shrink day
           | after day.
        
             | ssully wrote:
             | If past performance is not an indicator of future outcomes
             | than why did you reference history(the past) in your last
             | point to reinforce what you think will be happening in our
             | future?
        
           | meetups323 wrote:
           | It's a fair characterization of the mouse utopia experiments
           | of John B. Calhoun, modulo some anthropomorphism.
           | https://news.ycombinator.com/item?id=28555652
        
             | moussrr1 wrote:
             | Those "experiments" have long since been recognized as
             | broken and invalid. The mice were severely overcrowded,
             | because Calhoun didn't actually understand the animals'
             | need for spread out, large territories, and was more
             | concerned with churning out dozens of ridiculous mouse-
             | panopticons.
             | 
             | Mice have biological processes that are sometimes analogous
             | to humans, making them useful for some forms of
             | experimentation. Their social behavior is anything but
             | human-like.
        
         | spywaregorilla wrote:
         | There's no evidence that japan has lower testosterone than an
         | average country. The only study I could find suggested it had a
         | higher average than the US.
        
           | satellites wrote:
           | That supports what others have commented, which is that
           | obesity is likely the main culprit, at least in terms of low
           | testosterone. The US has a much worse obesity problem than
           | Japan does.
        
             | fallingknife wrote:
             | It's consistent with the hypothesis, but way too general of
             | a correlation to show causality.
        
               | zinclozenge wrote:
               | I don't see why, there's a physiological basis for it.
               | It's well known that fat cells have higher level of
               | aromatase which converts testosterone to estradiol.
        
         | aantix wrote:
         | Is there a cheap way to measure ~ Testosterone levels?
        
           | elzbardico wrote:
           | In the normal world, it is a very cheap lab exam. In the US
           | probably it costs 10x what it costs in any other place.
        
         | satellites wrote:
         | As others have said: sedentary lives in front of screens,
         | declining nutrition and rising obesity are all culprits.
         | Western media loves to gawk at Japan from a cultural
         | perspective but I would be careful about drawing social
         | parallels there. It's easy to cherry-pick social trends to
         | confirm bias one way or another. But the physical and material
         | conditions people live in are very tangible and demonstrably
         | unhealthy.
        
       | [deleted]
        
       | spywaregorilla wrote:
       | This comes up every now and then, and I take a look at some
       | research and it always seems pretty clear that it's obesity.
       | 
       | edit: the phthalates comes up every time. Yeah it does seem to
       | have some effect, but the effect sizes found in papers doesn't
       | seem to be that huge, meanwhile the effect size of obesity is
       | very large, and the prevalence of it is observably growing
       | rapidly. You also have to consider that the people with the most
       | bioaccumulant shit like this are the people with large reserves
       | of fatty tissue to absorb it.
        
         | giantg2 wrote:
         | It seems like a combination of issues.
         | 
         | The obesity thing tends to hold across many other species too.
         | I would guess you are right about this being the main driver. A
         | classic example would be dealing with animal husbandry and
         | obese pigs. Fertility in obese females can be impacted too.
         | 
         | A variety of toxins have been shown to cause fertility issues
         | too, such as lead and pesticides. It's also possible that
         | estrogen and estrogen mimicking compounds found in drinking
         | water could fall into this category (estrogen can adversely
         | affect male fertility).
         | 
         | Testoterone is also a factor which has seen a large decline
         | over the last 50 years. Obesity and sedentary lifestyle can
         | cause a decline in testorerone and other hormones/enzymes
         | related to sperm.
         | 
         | Then there's a possible link to RF reducing sperm quality.
         | Although I think this is probably a secondary factor that might
         | exacerbate the others.
        
           | jxramos wrote:
           | That's an interesting idea, but I'm not sure the anatomy
           | lines up. Like the mass of belly fat and fatty liver pressing
           | down from above in upright humans resting on the pudendal
           | artery wouldn't be the same as how the mass hangs on
           | quadrupeds. This is an interesting line of thought too, like
           | what organs get compressed under gravity from increased mass
           | assuming it's primarily a mechanical problem.
        
             | giantg2 wrote:
             | I'm not talking about anatomy, but rather physiology
             | (obesity affects hormones related to sperm). Do you have
             | some information to suggest this is an anatomical issue
             | (other than sleep apnea) rather than physiological one?
        
               | jxramos wrote:
               | nothing specific other than speculating about hearing
               | about stuff around that bottom part of the body: lower
               | sperm count, slower bowel movements with constipation and
               | stuff. I wonder if there's anything else anatomical down
               | there that could potentially get disrupted from extra
               | mass bearing down on it.
        
         | poorjohnmacafee wrote:
         | If obesity it perhaps should be studied as a realtime pushback
         | against modern diets by nature/natural selection, in reducing
         | unhealthy people from the gene pool.
        
         | elil17 wrote:
         | An interesting series of articles that came up on HN a couple
         | months ago makes the argument that both infertility and obesity
         | arise from environmental contaminates (although not necessarily
         | phthalates). Regardless of whether you agree with the arguments
         | presented, I think it's really interesting to see just how
         | complex of a problem it is to figure out what's going on.
         | 
         | https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-p...
        
           | marcosdumay wrote:
           | Well, if we control the epidemics of sedentarism and obesity
           | doesn't follow, those complex causes may be worth investing
           | on. But we have a very simple pair of problems (bad nutrition
           | and sedentarism) that are able to explain more than all the
           | obesity around without any need for a contributing cause.
           | 
           | (Anyway, the odds that there isn't any contributing cause on
           | the tons of changes we made on the world are pretty small,
           | and it's important to study those for individual health. It's
           | just for societal health that there's no mystery to solve.)
        
           | PragmaticPulp wrote:
           | The second article in the series cites a 25% increase in
           | calories consumed during the period where obesity is rising,
           | but then tries to wave that away as inconsequential.
           | 
           | It seems obvious that obesity is the result of the increased
           | caloric intake with secondary effects from the increasingly
           | sedentary lifestyles we all lead.
           | 
           | Environmental toxins might play a tertiary role, but it's
           | definitely the calories driving most of the obesity issue.
        
             | Y_Y wrote:
             | It does seem painfully simple that consuming more energy
             | than you burn/excrete is going to turn you into a sink, and
             | a lot of that surplus energy is going to be stored as fat.
             | (And the opposite process applies when you consume less
             | than you use.)
             | 
             | Is this an oversimplification, or is the average
             | education/propaganda/understanding so confused, and so
             | overwhelmed with different nutrition ideas that the wood is
             | being missed for the trees?
        
           | jeffreyrogers wrote:
           | I read that blog series and it makes a decent case that there
           | is some environmental contaminant that matters (or a
           | combination of several), but it can't be the whole story
           | because things like gastric bypass definitely work. Also just
           | from observing obese people eat it is clear that few of them
           | eat in a way conducive to weight loss. Perhaps some
           | environmental contaminant causes them to crave calorically
           | dense, non-satiating foods, but that seems doubtful to me.
           | 
           | Edit: The other thing I noticed when reading the series was
           | that the author had a habit of discounting anything that
           | refuted his thesis (calling it a minor effect and so forth),
           | while giving greater credibility to similarly weak evidence
           | for his theory.
        
           | spywaregorilla wrote:
           | I don't particularly buy it. Again, sure, maybe it has a
           | statistically significant effect, but it is undoubtedly
           | dwarfed by people chugging sugary drinks and being more
           | sedentary. A casual search suggests sugar consumption has
           | increased 9 fold since the 1800s and 2 fold since the 1900s.
           | The poor in particular are cornered into purchasing sugary
           | foods due to weird economics around corn subsidies. And what
           | do you know? They're the fattest by far.
           | 
           | If it were mostly environmental you'd see broader gains.
           | variation. But in my little bubble in upper middle class
           | Massachusetts, I don't know ANYONE who is obese. In other
           | areas of the country it's hard to find anyone who isn't.
        
             | atom_arranger wrote:
             | The linked site does suggest a reason Massachusetts would
             | have less overweight people, based on their exposure to
             | environmental contaminants.
        
               | spywaregorilla wrote:
               | Sure. But you'll find plenty of fat people in poorer
               | areas of massachusetts.
        
             | orwin wrote:
             | Maize fructose has probably a bigger effect than cane
             | sugar, because it also hit poor populations.
        
         | wyager wrote:
         | There is probably some bidirectional causality between
         | decreasing T levels and rising obesity.
        
           | eloff wrote:
           | I think that's pretty firmly established. It's also a leading
           | cause of ED.
        
             | hnuser123456 wrote:
             | So is circumcision.
        
         | betwixthewires wrote:
         | Or perhaps the correlation between obesity and low fertility is
         | not causation, obesity could very well be a symptom of whatever
         | is causing it, alongside low fertility.
        
           | spywaregorilla wrote:
           | Obesity is fairly well documented to cause poor fertility in
           | animal studies
        
         | newaccount2021 wrote:
         | If it truly is obesity at work, then the research will be
         | buried.
         | 
         | There are too many obese people...they could elect a President
         | if they wanted. You can't offend them.
         | 
         | The CDC director refuses to finger-wag at the US public even
         | though there is a solid correlation between obesity and covid
         | outcomes. Why can't we say this? No politician is willing to
         | tick off the obese, that's why.
        
         | omgwtfbyobbq wrote:
         | Do you have any links? Offhand I would suspect exercise, but I
         | guess that's hard to differentiate from obesity.
        
         | supperburg wrote:
         | People who eat meat and animal fat and cut out sugar report
         | getting pregnant after years of not being able to. They also
         | report iso-caloric weight loss, resolution of diabetes 2,
         | thickening of hair and many other positive health heuristics.
         | Obesity, diabetes and metabolic considerations are an absolute
         | powder-keg of medical progress just waiting for mainstream
         | acceptance
        
           | watwut wrote:
           | The people getting pregnant after eating meat are unlikely to
           | be men.
        
         | JohnWhigham wrote:
         | BPA/BPB in plastics is another source. Unfortunately, this one
         | is basically unavoidable since even if one doesn't own any of
         | those plastics at home, there's bound to be some food product
         | that uses a plastic container. Even more so, we don't know
         | anything about how long it takes to leach into the food, what
         | plastics do/don't contain it, stuff like that.
         | 
         | Plastics should just be banned from touching food entirely.
        
           | pxeboot wrote:
           | If you have running water in your home, every drop likely
           | flows through hundreds of feet to miles of plastic pipe
           | before you drink it. Even if you have a private well and
           | copper plumbing, your pump and other components almost always
           | contain plastic parts that make contact with the water.
        
           | pvarangot wrote:
           | I think it really depends on the food. Like processed or
           | skinned meat absorbs more than seeds or dry food, frozen
           | absorbs less, or something like that. I haven't read about it
           | for a while but that's what I remember was kind of like the
           | consensus about where to start looking into if it's feasible
           | to ban BPA.
        
         | vnjxk wrote:
         | I always thought it was the rise of porn
        
           | bobthechef wrote:
           | That's ED.
           | 
           | P.S. The use of "fertility" to describe men is weird and
           | seems recent. Fertility is passive and receptive and thus
           | better fits women (hence the use in agriculture to describe
           | the earth). Virility is a better term because it is active.
           | Some people seem to falsely claim that it doesn't refer to
           | procreative or generative power, but it does as this entry in
           | Etymology Online[0] shows (emphasis mine):
           | 
           | "period of manhood," 1580s, from French virilite, from Latin
           | virilitatem (nominative virilitas) "manhood," from virilis
           | "of a man, manly, worthy of a man," from vir "a man, a hero,"
           | from PIE root wi-ro- "man." Meaning _" power of procreation_,
           | capacity for sexua[l] intercourse" is from 1590s; sense of
           | "manly strength" is recorded from c. 1600.
           | 
           | There's not much power to procreate if you have a low sperm
           | count.
           | 
           | [0]
           | https://www.etymonline.com/word/virility#etymonline_v_30873
        
             | orwin wrote:
             | I think "lack of fertility" to design low sperm
             | count/inviable spermatozoids is accurate. Lack of virility
             | would be impossibility to use your own penis for different
             | reasons. 10-8 year ago i knew a trans who was fertile and
             | could give sperm to her lesbian friends, but lacked
             | virility.
             | 
             | The female counterpart of virility should be femininity.
             | 
             | DNA and knowledge of the specific of procreation is
             | probably as recent as the use of fertility.
             | 
             | Wanted to comment about obesity but i guess most people
             | said what i wanted to say, so i'm rebounding on a tangent
             | for my own self-esteem, sorry.
        
             | elzbardico wrote:
             | Technically you're right.
             | 
             | But If I was a researcher, I would stay clear of using a
             | term that could be understood as some kind of endorsement
             | of toxic masculinity, heteronormativity or whatever.
             | 
             | Better to use the slightly less accurate term, overloading
             | its original meaning with a new one, and avoid being the
             | subject of a witch hunt.
        
           | slothtrop wrote:
           | you're thinking of ED
        
           | uuddlrlr wrote:
           | Why would that increase infertility?
        
             | blix wrote:
             | From a purely observation perspective, pornography
             | consumption has increased dramatically at the same time as
             | falling fertility. Even if a mechanism isn't obvious, it at
             | least seems like there is a possibility of a connection.
             | 
             | Studies have indicated that long-term pornography use
             | correlates with erectile dysfunction and loss of interest
             | in sexual relationships. It's not hard to imagine that
             | fertility might be related to these other aspects of
             | reproductive health. Unfortunately few long-term studies
             | seem to focus on fertility specifically.
             | 
             | Short term studies on the influence of porn find that novel
             | sexual stimulus seems to increase sperm quality while it
             | attenuates in response to repeated exposure to the same
             | stimulus. This is bad news for real life humans who cannot
             | change as rapidly or dramatically as one can switch videos.
        
             | macksd wrote:
             | None of these things is infertility directly, but they
             | might be what the parent comment is thinking of. I hear of
             | links between ejaculation and prostate health a lot, but
             | that's usually a positive relationship. Sex therapists that
             | I read do seem to universally deny any link between
             | moderate to excessive masturbation and impotence. There are
             | correlations between ED and the rise of Internet porn
             | usage, but that also correlates with the availability of
             | medicines to treat ED and thus the marketing of a solution
             | to a problem.
        
             | elzbardico wrote:
             | The lower cost of sexual release in porn leading to less
             | motivation to pursue relationships with the opposite sex,
             | an activity which in our current state of reproductive
             | preferences, moral values and technology is strongly
             | correlated with instances of human reproduction.
        
             | wsc981 wrote:
             | _> Why would that increase infertility?_
             | 
             | Indeed ... wasn't it supposed to cause blindness?
        
         | rich_sasha wrote:
         | I thought I remember reading it is dropping across the line,
         | including for fit and healthy individuals. Is that not right,
         | and if it is, what could that mean?
         | 
         | Sorry for lack of source, it's not my area.
        
           | spywaregorilla wrote:
           | I can recall only one article that was posted here which
           | included that, but I came away thinking it was misleading. It
           | binned weight categories(e.g. BMI ranges from X-Y) and showed
           | that over time, people were falling into heavier categories,
           | and that sperm outcomes were getting worse in every category
           | (heavily in the obese, less so in the normal weight range).
           | But if you eyeballed the curve it felt very likely that the
           | distribution of individuals was just shifting the the heavier
           | end within each category.
           | 
           | E.g. if a healthy BMI is 18-25, and you look at the the
           | average outcome for that group over time... if the whole
           | population gets fatter then the mean value in the 18-25 group
           | could shift from 20 to 22. So... take it as you will. Sorry
           | for no source here either.
        
       | meetups323 wrote:
       | We're in a Utopia. Utopias destroy purpose. Without purpose
       | intelligence can not exist, so the rate of apoptosis surpasses
       | the rate of reproduction. Obesity is a symptom of this, not the
       | cause.
       | 
       | This is Universe 25:
       | 
       | > According to Calhoun, the extinction consisted of two stages:
       | the "first death" -- characterized by the loss of purpose in life
       | beyond mere existence (including the loss of desire to mate,
       | raise young, or establish a role within society) -- and "second
       | death" marked by the literal end of life and the extinction of
       | Universe 25.
       | 
       | > "Males who failed withdrew physically and psychologically; they
       | became very inactive and aggregated in large pools near the
       | center of the floor of the universe. From this point on they no
       | longer initiated interaction with their established associates,
       | nor did their behavior elicit attack by territorial males," read
       | the paper. "Even so, they became characterized by many wounds and
       | much scar tissue as a result of attacks by other withdrawn
       | males."
       | 
       | https://historyofyesterday.com/the-horrifying-study-that-pre...
        
         | armchairhacker wrote:
         | I don't think we're in a utopia. Most people do have food,
         | comfort, and safety. But most don't have much free time (jobs),
         | good relationships, clean air, and an overall lack of stress
         | (plenty of things to worry about). Maybe we live in a society
         | like Universe 25, but it isn't a utopia.
         | 
         | Life is better than it used to be, but it's far from perfect.
        
         | moussrr1 wrote:
         | The "study" is horrifying because the mice were severely
         | overcrowded, and suffered some extreme psychological breakdowns
         | as a result. Not because it can predict human behavior and
         | socialization in any way. _2,200 mice_ stuffed in a 10 'x14'
         | pen? It's insanity. It's not even possible to make an analogy
         | for humans, because humans are fundamentally social, across
         | individuals and family units and more, in a way that mice are
         | not.
         | 
         | It's ridiculous pseudo-science that's taken at face-value as
         | presented by Calhoun only because it makes an empty clickbait
         | article sound deep.
        
       | scohesc wrote:
       | I mean, it's been called "survival of the fittest" since as long
       | as I can remember.
       | 
       | It's still turning out to be true, even with all our 21st century
       | medical knowledge of science. Healthy at every size? Not if you
       | want to procreate!
       | 
       | It's weird. I absolutely love the feeling of "I knew this was
       | very likely true and didn't need a study to prove it" and have a
       | study come out that proves my hunch was mostly correct or on the
       | right path. Probably some kind of suuuper duper biased positive
       | feedback loop but something like this just totally makes sense to
       | me. If you don't take care of your body, then things are going to
       | start breaking down earlier than expected.
        
       | betwixthewires wrote:
       | So say the NIH finds that some compounds in our environment that
       | get in our bodies are causing this. Leeching from plastic food
       | containers, chemical pesticides, soy, whatever it is. What do you
       | think is going to happen? The government is almost certainly not
       | going to destroy it's chemical or agriculture industries to
       | prevent this. No matter the findings nothing will come of it.
        
         | radicaldreamer wrote:
         | It's easy to say that but look at the reduction in smoking over
         | the last 20 years... it was unimaginable that the government
         | would crack down and actively reduce smoking and cigarette
         | accessibility and advertising but it did once the magnitude of
         | the harm was recognized and accepted.
        
       | giantg2 wrote:
       | For people interested in knowing (roughly) their own sperm count,
       | you can use a hemocytometer and a cheap ~600x microscope (like
       | the kid science kit ones) to measure your own. It's basically
       | measuring overall volume, putting some on the slide, and counting
       | so many squares. Then multiple that count to get to the 1ml
       | volume based on the volume of the squares and them multiple by
       | overall number of ml. And paying attention to how many are moving
       | vs not to get an idea of motility.
        
       | rkk3 wrote:
       | Would have appreciated if they had included references to
       | credible work that shows "Male infertility is on the rise" &
       | "significant declines in sperm quantity and quality occurring
       | across the human population worldwide in the past two decades"
       | rather than taking it as an accepted fact.
        
         | tomlue wrote:
         | See Shanna Swan and the Count Down book. This effect is already
         | established, many of the mechanisms are established, science is
         | discovering more mechanisms, but we already know enough to
         | start taking public health actions.
         | 
         | The epi evidence is clear and the mechanisms behind several
         | exposure like phthalates have been established in animal
         | studies and human epidemiological studies.
         | 
         | notable are:
         | 
         | 1. The question of declining sperm density revisited: an
         | analysis of 101 studies published 1934-1996.
         | 
         | 2. Environmental phthalate exposure in relation to reproductive
         | outcomes and other health endpoints in humans
        
       | nradov wrote:
       | There is some evidence that endocrine disruptor chemicals such as
       | phthalates (plastic softeners) are causing at least part of the
       | problem.
       | 
       | https://www.usatoday.com/story/news/2021/02/27/falling-sperm...
        
         | JohnWhigham wrote:
         | Anyone know of any water filters that remove phthalates/PFAS?
        
           | ashtonkem wrote:
           | Generally a good activated carbon filter will get most of it.
           | If you're feeling particularly paranoid, a reverse osmosis
           | filter will produce extremely clean water. So clean that
           | there are disagreements about whether it will actually leach
           | some of the salts and minerals back out from your body.
        
           | giantg2 wrote:
           | Not sure of a specific one. I think RO removes it. Also, I
           | think NAS has started certifying filters that remove PFAS.
           | You can test your water for PFAS to see if you need one too.
           | Sometimes the source of PFAS is from ones own plumbing and
           | not the supply (if your supplier has a test that has lower
           | levels than your home).
        
         | sneak wrote:
         | Seems like the problem will solve itself in a few generations.
        
           | bdamm wrote:
           | How so? By only breeding humans that are resistant to these
           | disruptors? Cue social catastrophe..
        
             | nisegami wrote:
             | In order for it to be a problem, there needs to be people
             | around to be affected.
        
             | orwin wrote:
             | Peak conventional was 2008, it's hard(er) to make plastic
             | from non-conventional oil, and plastic from plant don't
             | need phtalates (at least PLA doesn't, i know there is other
             | kind of plastic but i don't know about them).
        
             | jeffreyrogers wrote:
             | I don't understand how that would be a catastrophe. Similar
             | things have happened in the past (e.g. lactose tolerance in
             | some populations)
        
         | shahdi04 wrote:
         | Pthlates and other micro plastics do increase estrogen
         | production in both men and women
        
       | OrvalWintermute wrote:
       | Nicki Minaj has some contacts [1] she'd like to introduce to NIH
       | 
       | [1] https://nymag.com/intelligencer/2021/09/nicki-minaj-will-
       | tal...
        
       | cs702 wrote:
       | The opening paragraph reads like something straight out of
       | "Children of Men"[a]:
       | 
       | > Male infertility is on the rise, with significant declines in
       | sperm quantity and quality occurring across the human population
       | worldwide in the past two decades. The reason for this is poorly
       | understood, but scientists suspect ...
       | 
       | Hmm...
       | 
       | [a] https://en.wikipedia.org/wiki/Children_of_Men
        
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