Study: male infertility crisis 'grossly underreported'

Male infertility remains one of the least discussed corners of reproductive health, and specialists say the male share of fertility problems is grossly underreported — even as sperm counts slide across the globe. Doctors who treat couples struggling to conceive report that investigations still focus overwhelmingly on the woman, while the male partner often goes untested and the true scale of the problem stays hidden.

A report published by DW this week cites a 2026 review of studies in the journal Antioxidants finding that sperm counts have fallen globally by more than 51% since 1973, with the decline accelerating rather than slowing. Men are far less likely to be tested for fertility issues than women, the review found, leaving a large blind spot in public health data at the very moment the trend lines look most worrying. Public health researchers say that without better data on the male side, infertility policy will keep missing half the picture.

What drives male infertility? Physicians point to a long list of culprits: weight gain, stress, poor sleep, smoking, microplastics and cannabis use. Weight gain in particular affects the testes, which produce sperm and hormones such as testosterone. Many men also carry a stubborn misconception that a healthy sex life automatically means healthy sperm, a belief that actively discourages them from getting checked.

The stigma keeps men out of the clinic

Edidiong Akang, a reproductive biologist at the University of Lagos in Nigeria, told DW that male infertility is understated and called it a huge problem. In a study he led and published in the journal Scientific Reports, researchers analyzed semen samples from more than 17K men and found that the share of normally shaped sperm had deteriorated by about 50% between 2010 and 2019. Sperm motility — how well sperm swim toward the egg — had also dropped sharply, falling 87% in Nigeria over the same period.

Doctors do test men for sperm count and motility, yet too few men take the test. The silence carries real costs. When couples struggle to conceive, the diagnostic focus usually lands on the woman while the male partner's contribution goes unexamined, delaying answers and effective treatment for both.

The reporting gap has cultural roots as well. In many societies, childlessness is still treated as a woman's burden, which means men rarely face the questions — or receive the support — that might lead them to a clinic. Health campaigners say shifting that framing could do as much as any drug or device, because testing is cheap, quick and often the first step toward an answer.

Research suggests the causes run deeper than lifestyle alone. Another recent review highlighted endocrine-disrupting chemicals such as bisphenol A, phthalates and pesticides as prime suspects behind the decline, alongside obesity, sedentary behavior and chronic stress. These compounds are now central to male infertility research, and their persistence in the environment raises questions about effects that could stretch across generations.

New research keeps widening the list of suspects behind the slide. A study published this month in the journal Frontiers in Endocrinology analyzed semen samples from 179 men attending a fertility clinic in Jinan, China, and linked higher exposure to widely used neonicotinoid insecticides to noticeably lower sperm concentration — finding pesticide breakdown products at higher levels in semen than in urine. Epidemiologist Shanna Swan, quoted by The New Lede, called the association substantial and warned that population-wide chemical exposures could push men with borderline semen quality into subfertility or infertility, compounding the underreporting problem.

What men can actually do

For men concerned about fertility, physicians emphasize the basics first: maintaining a healthy weight, sleeping well, cutting back on smoking and limiting exposure to hormone-disrupting chemicals where possible. None of these steps requires a prescription, and each supports the hormonal systems that govern sperm production.

On supplements, the evidence is mixed. One review of antioxidant trials found associations with better sperm concentration and motility, but rated the certainty of the evidence as very low and cautioned against indiscriminate treatment. Men considering supplements are advised to talk to a clinician rather than self-prescribing from store shelves.

Addressing male infertility will require something less tangible too: normalizing the conversation. Fertility remains culturally coded as a women's issue in much of the world, which keeps men out of clinics and keeps research attention skewed. The numbers are moving in the wrong direction whether or not anyone is watching, according to DW's reporting — and the first step is admitting the blind spot exists.