Male infertility has become a public health problem on a global scale, with recent studies showing an alarming increase in the number of cases.
In the last three decades, the rate of male infertility has registered an estimated increase of 76%, and Romania is no exception to this worrying trend. One in five couples in our country face fertility problems, and about 15 percent of couples are affected by infertility, a rate that exceeds the global average.
In addition to the increase in cases of infertility, doctors also draw attention to the natural decline of testosterone in men. On average, the level of this hormone declines by 1 percent per year, usually starting around age 30 to 40. Although this gradual decline is considered a normal part of aging, its cumulative effects are dramatic when viewed over several generations.
Dr. Mihail Pautov, communication expert and research assistant in general surgery at the Fundeni Clinical Institute, explained to Adevărul the simple mechanism by which any man can understand the size of the problem.
“Men’s testosterone levels drop by 1% every year after the age of 30. Any man can easily calculate how much testosterone his grandfather had at the same stage in his life based on that. If your grandfather was the age you are now in your 40s, that means that at that time he may have had 40% more testosterone than you. That could be just one of the reasons why infertility levels are skyrocketing. The scientific community has not identified a single reason, because there can only be one factor“, said the doctor.
The human body, overtaken by the pace of changes to which the economic system forces us to adapt
The causes of this phenomenon are multiple and interconnected, and Dr. Pautov emphasizes that they cannot be reduced to a single element. In his view, the fundamental problem is that the human body was not designed for today’s world and the demands of today’s economic system, and technological and social change has occurred far too quickly for our biology to keep up.
“The reasons are varied, and it’s because we don’t have bodies designed for the world we live in. Everything is changing faster and faster. Your body is designed to walk outside, to do physical work, to be in the sun, to be surrounded by friends, to have moments of anxiety when you go hunting, but also to relax, not to be tense for very long periods like we are. Just think about the fact that our bodies are used to sleep in the dark and in the cold”explained the specialist.
Contemporary lifestyles, marked by sedentary lifestyles, grueling work schedules and social isolation, contribute significantly to fertility decline. The doctor pointed out that the effects are not limited to infertility, but are reflected in a whole range of modern ailments.
“Now our bodies are constantly stressed, socially we benefit from less authentic contact with other people than ever before, people have started to have two jobs where they sit on the chair, they have vices, and all these cumulatively decrease, among other things, fertility. But it’s not just about fertility. Likewise, the incidences of heart disease, the number of cases of depression, the rate of obesity and all kinds of other conditions are increasing. And the root cause of it all is that the lifestyle we currently have is not sustainable.” added Dr. Pautov.
Stress, loneliness and technology, aggravating factors
One of the biggest factors affecting male fertility is chronic stress, and this is largely fueled by a lack of authentic social connections. According to the doctor, there are studies that prove the importance of close friendships for human health.
“There are studies that show very clearly that every man should have at least 3 close friends who are always in touch. We are talking about the kind of friends that you know you can rely on for anything. Society today does not give you the time and context for that, which inherently increases stress levels, because people feel more and more alone. Stress is one of the very important factors that decrease fertilitya”, explained Dr. Mihail Pautov.
In addition to stress, seemingly harmless everyday habits have a direct impact on fertility.
“Also, we all have mobile phones that we keep in our pockets, laptops that we keep on our laps, all of which increase the temperature around the scrotum, increasing the rate of infertility. Tobacco, alcohol, also decrease fertility. All of these factors have to be taken together and we have to understand that we were not designed for the environment we live in and the habits that we have developed very recently if we look at the whole of history.” warned the specialist.
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An unprecedented change in human history
To put the matter into perspective, Dr. Pautov makes a comparison between the activities of our distant ancestors and the pace of contemporary life.
“If we look at the activities of a Homo Sapiens 200,000 years ago, comparing them to those specific to a contemporary lifestyle, the differences are staggering. Until 200 years ago, when the Industrial Revolution came, nothing was moving at the pace it is today.
Then, in just the last 30 years came the internet, in the last 14 years came the smartphone, and in the last 3 years came artificial intelligence. On the scale of history, what we’ve been going through for the past 30 years should have been extremely irrelevant, but our lives have changed completely“, concluded the doctor.
The wider issue of fertility
According to the latest data from the World Health Organization (WHO), approximately 1 in 6 adults globally experience infertility in their lifetime, which represents a prevalence rate of approximately 17.5%.
WHO estimates that this rate is relatively uniform worldwide, with a prevalence of 17.8% in high-income countries and 16.5% in middle- and low-income countries, indicating that infertility is a major public health challenge regardless of region or level of development.
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At the European level, data collected by the European Society of Human Reproduction and Embryology (ESHRE) indicate a steady increase in the use of assisted reproductive techniques (ART), a sign of increasing infertility.
In 2021, more than 1.1 million ART procedures were reported in 37 European countries, an increase of 20% compared to the previous year. Also, approximately 25 million citizens of the European Union suffer from infertility, and access to treatments varies significantly between Member States.
In approximately 40-50% of infertility cases globally, the cause is attributed exclusively or predominantly to the male factor. The most worrying data shows that sperm count and quality have declined dramatically worldwide in recent decades.
A large systematic review reports a 40-60% decline in sperm count globally since 1973, with an average loss of nearly 1 million sperm per milliliter per year.
Other studies published in specialized journals confirm this significant decline, estimating a decline of approximately 60% over the past 50-60 years in men presenting to fertility clinics. Factors often cited include environmental toxins, stress, diet, obesity, smoking, and other lifestyle choices.
In Romania, the incidence of infertility is similar to the European and global average. Statistical data from 2024 show that 17.1% of the fertile population surveyed were or are infertile.
Specialists in reproductive health in Romania draw attention to an early depletion of the ovarian reserve in women and to the increase in risk factors associated with lifestyle, such as stress, unhealthy diet, exposure to toxins and chemicals, which contribute to decreased fertility in both women and men.
