Aspire观点 | 男性生育力大幅度下降应敲响“警钟”

作者:Trevor Gill 单位:ASPIRE Media Relations 来源:ASPIRE2019 编者:
2019-5-2 阅读

Media Release, 2 May 2019

 

Asia Pacific congress on assisted reproduction to receive ‘wake up call’   on alarming decline in male fertility

 

A world authority on human reproductive health is calling for a global response to an alarming decline in male fertility with an estimated one in 20 young men today having sperm counts low enough to impede conception.

 

Christopher Barratt, Professor of Reproductive Medicine at the University of Dundee in Scotland, said the world had not “woken up” to the impending crisis of male infertility and its longer-term economic and societal consequences.

 

He will highlight the need for a concerted global response to this issue as a keynote speaker at the 9th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2019) in Hong Kong this week.

 

Professor Barratt, formerly Director of the World Health Organisation’s Male Fertility Expert Working Group, said assisted reproductive technology was a highly newsworthy, multi-billion dollar enterprise to assist the one in six couples struggling to achieve their dream of having a baby.

 

He said success rates from procedures such as IVF, often including Intra Cytoplasmic Sperm Injection (ICSI) – where a single sperm is injected into an egg to assist fertilisation – had captured the attention of the general public.

 

“The perception from the outside is that all is well in the world of male reproduction, but this is an illusion,” he said. “Lack of knowledge and data about male infertility and how to treat it means that boosting a couple’s chances of having a baby will usually involve costly and invasive intervention for the female partner.

 

“In a world in which we claim to be addressing inequalities between men and women, the fact that the female partner often has to bear the burden of male infertility is an infringement of basic human rights and dignity.”

 

Professor Barratt said sperm counts had been declining steadily for the past 40 years and, while environmental factors may be the cause, the specific reason for this disturbing trend was only “educated guesswork.”


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In some countries, including Scandinavia, there has been extensive research in this area, however in other parts of the world, including Africa, Asia and South America, there is little definitive data on male infertility.

 

Professor Barratt praised the Australian Government for a recent announcement that it was investing millions of dollars in a national men’s health strategy, including research into the causes and prevention of male infertility.

 

“Australia has grasped the nettle on this issue,” he said.  “It is a shining light example that needs to be replicated around the world.”

 

Professor Barratt said the ASPIRE Congress in Hong Kong provided a powerful platform to promote awareness of male infertility in the Asia Pacific region of four billion people, representing about 60 per cent of the global population.

 

“We must engage medical professionals to develop the drive and energy to deal with this global health issue,” he explained. “Now is the time for an urgent wake-up call. The first step is to galvanise the professions into action and also to get a groundswell from patients pushing for this to be done.

 

“This should involve in part better promotion of positive lifestyle issues to help men make more informed choices about their reproductive health.

 

“Little progress has been made in developing new diagnostic tools or medical management strategies for male infertility beyond the advent of ICSI. Quality semen analysis could be part of the strategy of action as we now know for sure that semen samples analysed in different laboratories give different results, hence diagnostic and prognostic information.”

 

As sperm counts decline, the chances of achieving conception are less.  Many men and women are also now delaying having children beyond prime reproductive age and in some parts of the world, including the European Union, family sizes are below population replacement level.

 

“The combined impacts of these factors equate to a very negative outlook,” Professor Barratt said.

 

For further information on the ASPIRE Congress, go to the website www.aspire2019.com

 

亚太地区辅助生殖大会:男性生育力大幅度下降应敲响“警钟”

 

一位世界级的人类生殖健康权威人士呼吁全球应对男性生育力大幅度下降。据估计,现在每20名年轻男性中就有一名男性精子数量低,以至于阻碍受孕。

 

苏格兰邓迪大学生殖医学教授克里斯托弗·巴拉特说,全球并没有意识到即将发生的男性生育力危机及其带来的长远经济后果和社会效应。

 

克里斯托弗·巴拉特教授会在本周,于香港举行的第九届亚太地区生殖医学会议(ASPIRE 2019)上作为主要发言人发表演讲,强调全球应对这一问题的必要性。

 

世界卫生组织男性生育专家工作组前任主任巴拉特教授表示,每六对夫妇中就有一对因不育而就医,辅助生殖技术可提供协助,这是一项极具新闻价值,且价值数十亿美元的产业。

 

他说,体外受精联合胚胎移植等技术的成功率已引起了公众的注意,该技术包括卵胞浆内单精子显微注射技术 - 单一精子注射入卵子内使其受精。

 

“外界对不孕大多存在误解,认为男性不需负有责任,”他说。 “人们关于男性不育症知识和数据的缺乏以及对于治疗方法认识的不全面,意味着不孕症夫妇生育机会的提高通常只能以对女性采用侵入性干预手段和昂贵的费用为代价。

 

“在我们声称要解决男女不平等问题的当下社会,多数女性不得不承担男性不育的负担,这是对基本人权和尊严的侵犯。”

 

巴拉特教授说,过去40年来,精子数量正在以一定的比例下降,令人不安。虽然环境因素可能是其原因,但这只是“基于一定根据做出的猜测”。

 

在一些国家,包括斯堪的纳维亚半岛,对此进行了广泛的研究,但在世界其他地区,包括非洲,亚洲和南美洲,关于男性不育症的确切数据很少。

 

巴拉特教授称赞澳大利亚政府最近宣布将在国家男性健康策略上投入数百万美元,致力于对男性不育症的原因和预防方法的研究。

 

“澳大利亚直接和有力的尝试解决难题”他说。 “这是全世界都需要仿效的很好的榜样。”

 

巴拉特教授表示,香港ASPIRE大会提供了一个强有力的平台,以提高亚太地区对男性不育的认识,亚太地区共40亿人口,约占全球人口的60%。

 

他解释说:“我们必须聘请医学专业人士,以提供应对这一全球性健康问题需要的动力和能量。”“现在是敲响警钟的时候了。首要步骤是激励专业人士采取行动,同时从患者那里获得动力进一步推动工作进展。

 

“这项工作会涉及加强宣传积极的生活方式,以帮助男性在生殖健康方面做出更明智的选择。

 

“在卵胞浆内单精子显微注射技术出现之后,在研发男性不育新的诊断工具或医疗管理策略方面的几乎没有取得什么进展。精液质量分析可以作为行动策略的一部分,因为我们现在确信不同实验室分析精液样本给出的结果不同,从而获得更多的诊断和预后信息。”

 

当精子数量下降时,受孕成功率也会下降。在一些地区,很多男性和女性会推迟生育,错过了最佳生育年龄,甚至在欧洲的一些国家,家庭规模缩小以至低于人口替代水平。

 

“这些因素的综合影响使得前景不容乐观,”巴拉特教授说。

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