Journal of Human Reproductive Science
Home Ahead of Print Current Issue Archives
   Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size    Users online: 621

ORIGINAL ARTICLE Table of Contents   
Year : 2008  |  Volume : 1  |  Issue : 1  |  Page : 15-18

Declining semen quality among south Indian infertile men: A retrospective study

Division of Reproductive Medicine, Kasturba Medical College, Manipal University, Manipal, India

Date of Submission14-Jun-2007
Date of Decision05-Jan-2008
Date of Acceptance07-Jan-2008
Date of Web Publication24-Mar-2008

Correspondence Address:
S K Adiga
Division of Reproductive Medicine, Department of Obstetrics and Gynecology Kasturba Medical College, Manipal University, Manipal - 576 104
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-1208.38972

Rights and Permissions



Background : Male reproductive function has recently attracted increasing attention due to reports on time-related decline in semen quality. Furthermore, regional differences in the semen quality have also been reported. Aim : To investigate the semen quality among large cohort of infertile individuals at a regional level, in terms of the sperm concentration, total sperm motility, sperm morphology and incidence of azoospermia over a period of 13 years. Setting : University infertility clinic at Kasturba Hospital, Manipal which is a tertiary healthcare centre serving the general population. Design : Retrospective analysis. Materials and Methods: This includes a total of 7770 subjects who presented for semen analysis from 1993 to 2005. The data regarding ejaculate volume, sperm density, motility, morphology and the incidence of azoospermia were collected. Statistical Analysis Used : One way analysis of variance (ANOVA), regression analysis and Chi square analysis. Results : The average sperm density among infertile men during 2004-2005 was 26.61 ± 0.71 millions/mL which was significantly lower than the average sperm density observed in 1993-1994 (38.18 ± 1.46 millions/mL). Similar trend was also observed for sperm motility (47.14% motile sperms vs. 61.16%) and normal sperm morphology (19.75% vs. 40.51%). Interestingly, the incidence of severe oligospermia (mean sperm density <10 millions/mL) observed in 2002-2005 and 1993-1997 demonstrated a significant inverse relationship ( P < 0.001). Conclusion : Our study provides the first evidence that the quality of human semen evaluated for infertility is deteriorating in the southern part of the India over the years, probably due to environmental, nutritional, life style or socioeconomic causes.

Keywords: Azoospermia, infertility, reproductive function, semen quality, seminal parameters, sperm concentration, sperm decline, spermatozoa

How to cite this article:
Adiga S K, Jayaraman V, Kalthur G, Upadhya D, Kumar P. Declining semen quality among south Indian infertile men: A retrospective study. J Hum Reprod Sci 2008;1:15-8

How to cite this URL:
Adiga S K, Jayaraman V, Kalthur G, Upadhya D, Kumar P. Declining semen quality among south Indian infertile men: A retrospective study. J Hum Reprod Sci [serial online] 2008 [cited 2023 Mar 29];1:15-8. Available from:

Concerns over a global decline in sperm quality have attracted the attention of the scientific community and public alike. Time and over again, numerous studies have been published, supporting a compromise in sperm quality or dismissing the same. [1],[2],[3],[4],[5] Although, the reason for this remains unclear, it is suggested that environmental factors are mainly responsible for alteration in the semen quality. [6],[7]

Analysis of retrospective data indicates that sperm counts may have declined in some parts of the world, but there seem to be geographical variations in the semen quality. [8],[9],[10] The reason for geographic variations in semen characteristics is unclear but may be due to environmental, nutritional, socioeconomic or other unknown causes. [11] Although, the baseline semen quality and sperm functional parameters in fertile Indian men have been documented, [12] the first report investigating changes in semen characteristics in Indian men over the period of time demonstrated no significant decline in sperm count from 1990 to 2000. [4] In view of high-population density, heterogeneous nature of the Indian population, climatic differences and dietary habits, it is necessary to know whether similar trend exists within the different parts of the same country. The aim of this study is to investigate the semen quality among South-Indian men seeking infertility evaluation, in terms of the sperm concentration, total sperm motility, sperm morphology and incidence of azoospermia at a regional level over a period of 13 years.

   Materials and Methods Top

The data for the present analysis were obtained from patients visiting university infertility clinic at Kasturba Hospital, Manipal which is a tertiary healthcare centre serving the general population mainly from three states of the country, namely Karnataka, Kerala and Goa. The study was based on the retrospective review of a total of 7770 subjects, who had their semen examined as a part of the infertility evaluation, at the clinic, between the years 1993 and 2005. All patients were asked to provide semen sample after 3-5 days of ejaculatory abstinence. Semen specimens were produced by masturbation directly into a sterile plastic container, in a room specially provided for this purpose and located adjacent to the laboratory. After liquefaction, semen processing and analysis was performed according to the World Health Organization recommendations. [13],[14] Seminal volume was determined in a graduated tube. During the entire period of study, sperm concentration was assessed by conventional method using Makler counting chamber (Sefi Medical Instruments, Israel) and expressed in millions/mL. The sperm motility was assessed in at least 100 sperms and expressed as percent of motile sperm (sum of rapid progression plus slow progression sperm). [13] Sperm morphology was assessed by Leishmen's stain from 1993 to 1998 and by Eosin-Nigrosin stain from 1999 to 2005. Basic descriptive statistics (means ± standard error) were calculated for the study groups. Statistical analysis of the means between different study periods was performed using one-way analysis of variance (ANOVA) for normality distribution. Regression analysis was carried out using Statistical Package for the Social Sciences (SPSS) statistical package. Chi-square test was performed for analyzing the azoospermia incidence. A P -value < 0.05 was considered statistically significant.

   Results Top

The descriptions of seminal parameters for all the 7770 participants are presented in [Table - 1]. The data showed statistically significant differences in the seminal characteristics of the subjects analyzed between the time gap of 13 years, i.e., 1993-1994 and 2004-2005 most notably in the sperm density, motility and normal sperm morphology, assessed according to the WHO criteria. The mean sperm density among infertile men during 2004-2005 was 26.61 ± 0.71, which was significantly lower than the average sperm density observed in 1993-1994 (38.18 ± 1.46 millions/mL). Similar trend was observed for sperm motility (47.14% motile sperms vs. 61.16%) and also sperm morphological abnormalities (19.75% normal forms vs. 40.51%). The results of the regression analyses exploring the relationship between semen parameters and time period are presented in [Figure - 1]. The results clearly demonstrated an inverse (linear) association with count ( r = −0.14339), motility ( r = −0.20505) and morphology ( r = −0.58372), suggesting a consistent time-related decline in the semen quality.

Most noticeably, there was a significant increase in the number of patients with severe oligospermia (sperm count <10 millions/mL) in 2002-2005 when compared to 1993-1997. In contrast, the number of subjects having a mean sperm count >40 millions sperm/mL reduced significantly in 2002-2005 when compared to 1993-1997 (26.07% vs. 40.61%), showing an inverse relationship. However, no significant difference in the incidence was observed for the sperm count ranging from 20 to 40 millions/mL [Figure - 2]. Similarly, there was no significant difference in the incidence of severe asthenospermia between 1993-1997 and 2002-2005 (data not shown). A marked but non-significant increase was noted in the volume of the semen and the incidence of azoospermia between 1993-1994 and 2004-2005 [Table - 1].

   Discussion Top

This is the first study to analyze the semen quality in large group of Indian men and our data clearly illustrates that quality of human semen is deteriorating over the period of 13 years. Our findings support previous reports that the quality of human semen seems to be declining in other parts of the world. [1],[2],[15],[16] In particular, the decline in sperm count was 30.31% where as sperm motility and morphology was reduced by 22.92% and 51.25%, respectively, between the time span of 13 years. Furthermore, the regression analysis also confirmed a true decline in the semen quality over this period. During the period of study, there were very few changes in the techniques and personnel involved in the analysis of semen. Technicians adhered to strict quality control and the equipments used were same throughout the entire study period.

The decline in the semen quality coincides with an increasing incidence of abnormalities of the male genital tract including testicular cancer and cryptorchidism in various countries. [17],[18] More importantly, the increase in the incidence of sperm morphological abnormalities in addition to low-sperm count observed in this study indicates qualitative impairment of spermatogenesis and perhaps of the  Sertoli cells More Details. [19] Since the criteria to assess morphologically normal sperm has been modified in our centre from 1999 where all the borderline abnormalities were considered as abnormal, this could have caused a sudden decline in the percentage of morphologically normal sperm from 1999 to 2000 onwards.

The reason for decline in semen quality is possibly due to environmental, nutritional, socioeconomic or other unknown causes. [1],[2],[9],[11],[20] In utero exposures to exogenous estrogenic compounds are capable of altering neonatal testicular development and reducing sperm production in adult men. [19],[20],[21],[22] Diethylstilbestrol is thought to be responsible for an increase in abnormalities of reproductive tract and for reduction in the output and fertilizing potential of sperm of male offspring. [23]

In view of substantial geographical and ethnic variation in semen quality reported by several investigators, [9],[12],[24],[25],[26],[27] it is necessary to investigate population-based trends in semen quality over time. Earlier studies indicated decline in the semen quality in some parts of the world, but there seem to be geographical variations in the time-related decline in semen quality. [9],[10],[11],[27],[28],[29],[30] The baseline sperm concentration and motility for Indian men was reported as 68.22 ± 15.14 millions/mL and 40.95 ± 9.15%, respectively [12] and a previous study failed to demonstrate any change in the semen quality among infertile men in the northern part of the India for a period of 11 years. [4] In contrast, the mean sperm count observed in our study was 26.61 millions/mL which was much lower than the above-mentioned baseline value of 68.22 millions/mL for Indian men. [12] However, there was no significant difference in the motility between two studies, suggesting a definite decline in the sperm concentration in the southern part of the India.

The present study has several limitations. (1) The subjects included here were infertile patients and do not represent the general population, (2) no data are available on the factors affecting semen quality such as occupation of the subjects, smoking, food habits and level of stress and (3) the duration of study is only 13 years which may be too short to come to any conclusion. However, longer study period may be influenced by many factors like change in laboratory staff, equipments, methodology over the period of time.

India has high heterogeneous human population density contributing to approximately 25% of the global population. Due to diverse environmental, nutritional and socioeconomic factors and climate conditions, it is important to assess the semen quality in different parts of the country for further validation of the statement. The significant time-related decline in semen quality observed in this study has important implications with respect to fertility and further studies using large cohort of normal subjects with additional information on their occupation, socioeconomic condition, life-style related factors are warranted in order to confirm the findings of current report.

   Acknowledgments Top

The authors acknowledge the help of Mrs. Jayalaxmi Pai and Mrs. Sandhya Patil for collecting the data.

   References Top

1.Carlsen E, Giwercman A, Keiding N, Shakkebaek NE. Evidence for decreasing quality of semen during the past 50 years. Br Med J 1992;305:609-13.  Back to cited text no. 1    
2.Auger J, Kunstmann JM, Czyglik F, Jouannet P. Decline in semen quality among fertile men in Paris during the past 20 years. N Engl J Med 1995;332:281-5.  Back to cited text no. 2    
3.Lackner J, Schatzl G, Waldhor T, Resch K, Kratzik C, Marberger M. Constant decline in sperm concentration in infertile males in an urban population: Experience over 18 years. Fertil Steril 2005;84:1657-61.  Back to cited text no. 3    
4.Marimuthu P, Kapilashrami MC, Misro MM, Singh G. Evaluation of trend in semen analysis for 11 years in subjects attending a fertility clinic in India. Asian J Androl 2003;5:221-5.  Back to cited text no. 4    
5.Fisch H, Goluboff ET, Olson JH, Feldshuh J, Broder SJ, Barad DH. Semen analyses in 1,283 men from the United States over a 25-year period: No decline in quality. Fertil Steril 1996;65:1009-14.  Back to cited text no. 5    
6.Aneck-Hahn NH, Schulenburg GW, Bornman MS, Farias P, de Jager C. Impaired semen quality associated with environmental DDT exposure in young men living in a malaria area in the Limpopo Province, South Africa. J Androl 2007;28:423-34.  Back to cited text no. 6    
7.Toft G, Rignell-Hydbom A, Tyrkiel E, Shvets M, Giwercman A, Lindh CH, et al . Semen quality and exposure to persistent organochlorine pollutants. Epidemiology 2006;17:450-8.  Back to cited text no. 7    
8.Auger J, Jouannet P. Evidence for regional differences of semen quality among fertile French men. Hum Reprod 1997;12:740-5.  Back to cited text no. 8    
9.Jorgensen N, Andersen AG, Eustache F, Irvine DS, Suominen J, Petersen JH. Regional differences in semen quality in Europe. Hum Reprod 2001;16:1012-9.  Back to cited text no. 9    
10.Swan SH. Semen quality in fertile US men in relation to geographical area and pesticide exposure. Int J Androl 2006;29:62-8.  Back to cited text no. 10    
11.Fisch H, Goluboff ET. Geographic variations in sperm counts: a potential cause of bias in studies of semen quality. Fertil Steril 1996;65:1044-6.  Back to cited text no. 11    
12.Pal PC, Rajalakshmi M, Manocha M, Sharma RS, Mittal S, Rao DN. Semen quality and sperm functional parameters in fertile Indian men. Andrologia 2006;38:20-5.  Back to cited text no. 12    
13.World Health Organization WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4 th ed. Cambridge University Press: Cambridge, UK; 1992.  Back to cited text no. 13    
14.World Health Organization WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4 th ed. Cambridge University Press: Cambridge, UK; 1999.  Back to cited text no. 14    
15.Irvine S, Cawood E, Richardson D, MacDonald E, Aitken J. Evidence of deteriorating semen quality in the United Kingdom: Birth cohort study in 577 men in Scotland over 11 years. Br Med J 1996;312:467-71.  Back to cited text no. 15    
16.Zorn B, Virant-Klun I, Verdenik I, Meden-Vrtovec H. Semen quality changes among 2343 healthy Slovenian men included in an IVF-ET programme from 1983 to 1996. Int J Androl 1999;22:178-83.  Back to cited text no. 16    
17.Giwercman A, Skakkebaek NE. The human testis: An organ at risk? Int J Androl 1992;15:373-5.  Back to cited text no. 17    
18.Bussen S, Sutterlin M, Steck T, Dietl J. Semen parameters in patients with unilateral testicular cancer compared to patients with other malignancies. Arch Gynecol Obstet 2004;269:196-8.  Back to cited text no. 18    
19.Sharpe RM. Declining sperm counts in men: Is there an endocrine cause? J Endocrinol 1993;136:357-60.  Back to cited text no. 19    
20.Magnusdottir EV, Thorsteinsson T, Thorsteinsdottir S, Heimisdottir M, Olafsdottir K. Persistent organochlorines, sedentary occupation, obesity and human male subfertility. Hum Reprod 2005;20:208-15.  Back to cited text no. 20    
21.Sharpe RM. The roles of oestrogen in the male. Trends Endocrinol Metab 1998;9:371-7.  Back to cited text no. 21    
22.Delbes G, Levacher C, Habert R. Estrogen effects on fetal and neonatal testicular development. Reproduction 2006;132:527-38.  Back to cited text no. 22    
23.Fielden MR, Halgren RG, Fong CJ, Staub C, Johnson L, Chou K, et al . Gestational and lactational exposure of male mice to diethylstilbestrol causes long-term effects on the testis, sperm fertilizing ability in vitro and testicular gene expression. Endocrinology 2002;143:3044-59.  Back to cited text no. 23    
24.Richthoff J, Rylander L, Hagmar L, Malm J, Giwercman A. Higher sperm counts in Southern Sweden compared with Denmark. Hum Reprod 2002;17:2468-73.  Back to cited text no. 24    
25.Iwamoto T, Nozawa S, Yoshiike M, Hoshino T, Baba K, Matsushita T, et al . Semen quality of 324 fertile Japanese men. Hum Reprod 2006;21:760-5.  Back to cited text no. 25    
26.Gao J, Gao ES, Yang Q, Walker M, Wu JQ, Zhou WJ, et al . Semen quality in a residential, geographic and age representative sample of healthy Chinese men. Hum Reprod 2007;22:477-84.  Back to cited text no. 26    
27.Sripada S, Fonseca S, Lee A, Harrild K, Giannaris D, Mathers E, et al . Trends in semen parameters in the northeast of Scotland. J Androl 2007;28:313-9.  Back to cited text no. 27    
28.Macleod J, Wang Y. Male fertility potential in terms of semen quality: A review of the past, a study of the present. Fertil Steril 1979;31:103-16.  Back to cited text no. 28    
29.Paulsen CA, Berman NG, Wang C. Data from men in greater Seattle area reveals no downward trend in semen quality: Further evidence that deterioration of semen quality is not geographically uniform. Fertil Steril 1996;65:1015-20.  Back to cited text no. 29    
30.Rasmussen PE, Erb K, Westergaard LG, Laursen SB. No evidence for decreasing semen quality in four birth cohorts of 1,055 Danish men born between 1950 and 1970. Fertil Steril 1997;68:1059-64.  Back to cited text no. 30    


  [Figure - 1], [Figure - 2]

  [Table - 1]

This article has been cited by
1 Spatiotemporal trends in human semen quality
Jacques Auger, Florence Eustache, Cécile Chevrier, Bernard Jégou
Nature Reviews Urology. 2022;
[Pubmed] | [DOI]
2 Structure-based redesigning of pentoxifylline analogs against selective phosphodiesterases to modulate sperm functional competence for assisted reproductive technologies
Mutyala Satish, Sandhya Kumari, Waghela Deeksha, Suman Abhishek, Kulhar Nitin, Satish Kumar Adiga, Padmaraj Hegde, Jagadeesh Prasad Dasappa, Guruprasad Kalthur, Eerappa Rajakumara
Scientific Reports. 2021; 11(1)
[Pubmed] | [DOI]
3 Aphrodisiac and spermatogenic potential of alkaloidal fraction of Argyreia nervosa (Burm. f.) Bojer roots in male rats
Niraj Vyas, Manan Raval
Natural Product Research. 2021; : 1
[Pubmed] | [DOI]
4 Air pollutants and impairments of male reproductive health-an overview
Sunil Kumar, Anupama Sharma, Riddhi Thaker
Reviews on Environmental Health. 2021; 36(4): 565
[Pubmed] | [DOI]
5 Clinical presentations and semen characteristics of men attending the secondary referral infertility clinic at Mumbai, India
ShaguftaAfzal Khan, VijayR Kulkarni, RupinS Shah, JyotsnaS Gokral, PervinK Meherji, AshokD Vadigoppula, AnushreeD Patil, AishwaryaV Bhurke, PratibhaP Kokate, RamS Barai, SuchitraR Surve, DeepakN Modi, SmitaD Mahale, RahulK Gajbhiye
Journal of Human Reproductive Sciences. 2021; 14(4): 356
[Pubmed] | [DOI]
6 Xenobiotics Result in Hormonal and Enzymatic Dysregulations in the Red Mussel Mytilus galloprovincialis (Lamarck, 1819) (Bivalvia, Mytilidae)
Ibrahim Gaber, Abdallah Ahmad Atal, Mohamed Elghazaly
Pakistan Journal of Biological Sciences. 2020; 24(3): 409
[Pubmed] | [DOI]
7 Geographical differences in semen characteristics: Comparing semen parameters of infertile men of the United States and Iraq
Ayad Palani, Pallav Sengupta, Ashok Agarwal, Ralf Henkel
Andrologia. 2020; 52(3)
[Pubmed] | [DOI]
8 Aphrodisiac and Spermatogenic Potential of Ayurveda Formulation-Ashwagandhadi Lehya
Kanan G. Gamit, Niraj Y. Vyas, Piyush Chudasama, Manan A Raval
Journal of Biologically Active Products from Nature. 2020; 10(4): 285
[Pubmed] | [DOI]
9 A longitudinal study of semen quality among Chinese sperm donor candidates during the past 11 years
Junjie Liu, Yanpeng Dai, Yushan Li, Enwu Yuan, Quanxian Wang, Xingling Wang, Yichun Guan
Scientific Reports. 2020; 10(1)
[Pubmed] | [DOI]
10 Study of Evaluation of Causes of Male Infertility at a Tertiary Care Hospital
KM Umashankar, Ramya Cristy, Joyeeta Mukherjee, SN Banerjee, BN Seal, CL Drakshyani
Journal of South Asian Federation of Obstetrics and Gynaecology. 2016; 8(2): 113
[Pubmed] | [DOI]
11 Study Suggests Long-Term Decline in French Sperm Quality
Adrian Burton
Environmental Health Perspectives. 2013; 121(2): a46
[Pubmed] | [DOI]
12 Decline in semen concentration and morphology in a sample of 26 609 men close to general population between 1989 and 2005 in France
M. Rolland,J. Le Moal,V. Wagner,D. Royere,J. De Mouzon
Human Reproduction. 2013; 28(2): 462
[Pubmed] | [DOI]
13 Interpretation of spermiograms among infertile Egyptian males in the Suez Canal region
Rashad M. Mostafa,Mostafa M. Eyada,Shereen F. El Samaan,Halim M. Halim
Human Andrology. 2013; 3(1): 21
[Pubmed] | [DOI]
14 Association between the CTGF -945C/G polymorphism and systemic sclerosis: A meta-analysis
Xiufeng Zhang,Shengjie Nie,Xiaoyu Si,Ying Luo,Wenru Tang
Gene. 2012; 509(1): 1
[Pubmed] | [DOI]
15 Semen characteristics of fertile and subfertile men in a fertility clinic and correlation with age
Nadia A.S. Aleisa
Journal of King Saud University - Science. 2012;
[Pubmed] | [DOI]
16 Environmental chemical mediated male reproductive toxicity: Drosophila melanogaster as an alternate animal model
A.K. Tiwari, P. Pragya, K. Ravi Ram, D. Kar Chowdhuri
Theriogenology. 2011; 76(2): 197
[VIEW] | [DOI]
17 Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses
Ying Li, Hui Lin, Yafei Li, Jia Cao
Fertility and Sterility. 2011; 95(1): 116
[VIEW] | [DOI]
18 Methylenetetrahydrofolate reductase C677T polymorphism is not associated with male infertility in a South Indian population : MTHFR polymorphism in male infertility
G. T. Vani, N. Mukesh, P. Rama Devi, P. Usha Rani, P. P. Reddy
Andrologia. 2011; : no
[VIEW] | [DOI]
19 Has fertility declined in recent decades? : Declining fertility?
Acta Obstetricia Et Gynecologica Scandinavica. 2011; 90(2): 129
[VIEW] | [DOI]


Print this article  Email this article


    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
    Article in PDF (239 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

    Materials and Me...
    Article Figures
    Article Tables

 Article Access Statistics
    PDF Downloaded639    
    Comments [Add]    
    Cited by others 19    

Recommend this journal