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Bad ways to slow population growth Public Health

Avoid these Causes of Infertility

A solution has been found for overpopulation! Unfortunately, this is not a reason for celebration.

This essay is another in my all-too-long series of bad ways to control population. It joins essays on genocide, the Doctrine of Discovery and gun violence.

Sperm counts are declining around the world. Fortunately, most men still have enough sperm to become fathers when they want, but that might not be the case forever. There are even predictions, if the current trend continues, that the human species will cease to exist! Just how worried should we be about declining sperm counts?

A review article suggests that the average sperm counts in European and other “western” countries has declined markedly. The overall count has declined 50 to 60% from 1973 to 2011. Another study found the same—or worse—is true for Africa. Between 1965 and 2015 they found a decrease of more than 70%! Fortunately, as you remember from biology class, only one pollywog fertilizes an egg. However fertilization requires that a crowd accompany that one lucky sperm.

I look at these studies with some concern about their accuracy. However, it seems that men truly are making fewer sperm. In addition to this decrease, genital abnormalities and testicular cancer have become more common. What is affecting men so badly? Perhaps we can learn something by consulting “man’s best friend”.

Veterinarians have studied the reproduction of a group of guide dogs for decades, and found decreases in sperm quality and increases in genital abnormalities and testicular cancer. The dogs seem to reflect the same problems as men are facing! The question is: what is causing these problems?

The vets did something that most men would object to—testicular biopsies. These little bits of tissue were tested for several chemicals with names such as “PDBE28” “PCB153” and “DHEP”. The chemicals were found in the dog food, and in the biopsy tissue, too, in levels that inhibit fertility.

These chemicals have been developed in the last few decades to promote “better living through chemistry”. They are some of a huge number of organic chemicals that have beneficial uses and have found their way into our homes—and into our bodies.

Although we may not be aware, when we bring home new furnishings, they are often treated with chemicals such as PDBE28 to decrease the rate at which they burn. These chemicals are also in building materials, vehicles and plastics—they are ubiquitous. They may have saved lives because of their fire retardant properties, but they may also have changed many lives because of their biological effects. Almost all—97%—of people in the USA have detectable levels of this group of chemicals in their blood!

The shape of these artificial molecules is similar to the shape of some hormone molecules. Hormones are chemical messengers that tell distant parts of our bodies what to do. They fit into receptors that receive hormonal molecules and activate cells. The analogy of lock and key is often used because the hormonal molecule is usually specific to certain receptors on certain cells. Because their shape is similar, endocrine disrupting chemicals fit in receptors. The disruptor can either stimulate the cell or, if the “key” gets stuck in the “lock”, the disrupting chemical can block the action of the real hormone.

Switching to women, now. Female fertility is also decreasing. The epidemic of  obesity is affecting fertility, as is some women waiting too long to have children. Their bodies are also sensitive to the effects of endocrine disrupting chemicals. In a study of California women, those with high levels of PCBEs took longer to conceive a pregnancy than women with lower levels. 

There hasn’t been enough written in the press about endocrine disruptors, perhaps because this subject is very complicated. Two facts that stick in my mind are that endocrine disruptors have their strongest effect when they are very, very dilute— because of their combination of stimulating and blocking effects. This means that the usual testing done by the FDA may find little risk because they didn’t dilute the chemical enough—the opposite of the usual when testing for toxicity. Indeed, endocrine disruptors may have an effect when they are equal to a pinch of salt in an Olympic-sized swimming pool!

I plan to write more about endocrine disruptors since they are so pervasive and have so many bad effects. Time will tell if these chemicals will cause a significant decrease in our population. If they do, it will be involuntary—which is tragic.

©Richard Grossman MD 2018

Categories
Bad ways to slow population growth

Repudiate the Practice of Eugenics

Although Francis Galton started the modern eugenics movement in England in the 19th century, eugenics reached its peak in Germany during the Nazi era. Although sometimes well-meaning, eugenicists have done terrible things to human rights.

The history of eugenics actually goes back much further in history; apparently Plato advocated selective breeding of humans. Eugenicists advocate for higher rates of reproduction among people with desired traits and reduced rates or even sterilization of people with undesired traits.

Galton was the first person to study human variation in a systematic way. He observed that upper-class people tend to marry later and have smaller families, and suggested that eminent people be given incentives to have more children. He was concerned that small family size amongst the cognoscenti, along with poor people having lots of children, would cause a decrease in people’s mental ability.

Fortunately it seems as though Galton’s prediction has not come true. Over all, 

average intelligence is not decreasing significantly in the USA and actually may be increasing. This is a strike against eugenics.

In Germany the eugenic movement started in the late 19th century but didn’t become strong until 1927, when the Kaiser Wilhelm Institute of Anthropology, Human Heredity and Eugenics was founded. One if its early directors, Eugen Fischer, wrote a long treatise titled “Principles of Human Heredity and Race Hygiene”. Hitler read and was inspired by this treatise.

In 1933, when the Nazis came into power, it became illegal to oppose eugenics and the “Law for the Prevention of Hereditarily Diseased Offspring” was passed. It established “eugenic courts” throughout Germany. Doctors were required to report “inferior” people (including people with retardation or mental illness, hereditary blindness or deafness, or other hereditary diseases). Cases were then presented to genetic courts, which would decide if the people should be sterilized without their consent. Hundreds of thousands of people were kept from having children because of this law.

As time went on, elimination of “undesirables” by sterilization was not sufficient. From 1939 to 1945 people with birth defects or in psychiatric hospitals were murdered by order of the Nazis. These murders were in addition to millions who were killed because of their ethnic heritage, religious beliefs or sexual orientation.

German history illustrated the worst of eugenics, but the USA was not immune from tromping on reproductive rights. Carrie Buck was a case in point. She was a young woman who was able to read and write. Nevertheless Carrie was labeled “feeble-minded of the lowest grade, moron class” when admitted to the Virginia State Colony for Epileptics and Feebleminded in 1924. Three years later her tubes were tied, even though she wanted more children.

This was not an isolated case of a woman getting sterilized against her will; it was condoned by the Supreme Court of the United States. Ms. Buck was a test case brought to the Supreme Court to support eugenic sterilization. It appears that a “guinea pig” was needed and Buck was chosen because she was poor and had had a child out of wedlock (after being raped), despite being of normal intelligence.

Unfortunately, Carrie Buck was one of thousands of American women and men who were sterilized in the past without their consent. For instance, records from California institutions show that 20,000 people were approved for sterilization in the first half of the 20th century. The vast majority of these victims had Spanish surnames, reflecting the prejudices of the era. More recently 39 women in California prisons were sterilized without consent between 2005 and 2013. Retarded people, people of color  and prisoners still have human rights, don’t they?

Fortunately, laws that govern sterilization procedures are strict now as a reaction to the abuses that took place in this country. The person must be at least 21 years of age and must sign a special consent at least 30 days before the procedure. This is onerous in a way, because it means that some people who truly want to end their ability to reproduce miss out.

The Eugenic Protection Law in Japan subjected 16,500 people to forced sterilization. Over a quarter million indigenous women were sterilized against their will in Peru. The list goes on; eugenics wasn’t just practiced in Nazi Germany but in many other societies, including our own.

No one seems to be espousing eugenics now. It was a theory that has seen its heyday and has died. It was unjust, especially when in the hands of rulers such as Hitler or Fujimori. We now recognize that reproductive coercion is unnecessary and counterproductive.

© Richard Grossman, MD 2018