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Analysis Monday, March 12, 2018

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How infertility treatment has left sperm science behind hey can make test-tube babies, grow human eggs in a lab and reproduce mice from frozen Ttesticle tissue, but when it comes to knowing how a man’s sperm can swim to, find and fertilize an egg, scientists are still floundering. Enormous advances in treating infertility in recent decades have helped couples conceive longed-for offspring they previously would not have had. Yet this progress has also been a workaround for a major part of the problem: Sperm counts are falling drasti- cally worldwide - and have been doing so for decades - and scientists say their honest answer to Xi mandate seals march of strongmen why is: “We don’t know”. Infertility is a significant global health problem, he Chinese Communist Party’s decision to give Chinese model the country has taken a decisive turn away from the with specialists estimating that as many as one in six President Xi Jinping a mandate to rule for life is fur- Human rights campaigners warn that authoritarians idea of a more pluralistic society with greater political couples worldwide are affected. In more than half of ther evidence of the world’s slide towards more and autocrats worldwide are exploiting discontent over freedoms. those cases, experts say, the underlying problem is T nationalist, authoritarian regimes, analysts said. China’s globalization, industrial decline, terrorism and migration And, thanks to its fast economic growth and growing in the male. Most of the focus of infertility research rubberstamp parliament, meeting in the imposing Great to justify their actions. According to the Freedom House military might, it is serving as a counter-example for the has been on women, however: on what can reduce Hall of the People for an annual session, made Xi the most human rights watchdog, democracy “faced its most democratic model - with fans in sometimes surprising their and on how that can be averted, com- powerful leader since Mao Zedong yesterday by scrap- serious crisis in decades” in 2017, which was the 12th places. “The great leaders of the world come from coun- pensated for or corrected with treatment. While this ping term limits that would have forced him to step down year in a row that individual freedoms were found to tries that are not great democracies,” said for- approach has produced results - and babies - it has after 2023. have declined. Furthermore, under Trump mer French president Nicolas Sarkozy also left scientifically sidelined. The decision moves one-party China further away the US has lost the moral authority to at a conference in Abu Dhabi last Treatments such as in-vitro fertilization (IVF) and from adopting a democratic system that many Western effectively condemn abuses in oth- weekend. Sarkozy, who faces multi- intracytoplasmic sperm injection (ICSI), where the thinkers and politicians had once assumed was inevitable er countries, critics say, while ple investigations over corruption sperm is placed into the egg rather than next to it, as the country opened up to global trade. It fits a pattern Europe is struggling with its allegations related to his one term bypass the male problem rather than treating it, said worldwide that has seen the model of liberal democracy - own nationalists in Hungary in office from 2007-2012, said Richard Sharpe, professor at the University of based on individual rights, the rule of law and the free and Poland. strong leadership in China, Edinburgh’s center for reproductive health. “The press - lose ground as many countries turn instead to “This illiberal temptation is Russia and Saudi Arabia treatments - some of them quite invasive - are to the more authoritarian forms of government. something we should not take meant there was “no pop- female partner. So the female is having to bear the “We think it (liberal democracy) is normal and obvious- lightly today and will doubt- ulism” there. burden of the male’s sub-fertility ...(And at the same ly it’s not, because in the whole of human history, democ- less constitute one of the bat- Kenneth Roth, director of time), we have a very crude snapshot of what is racy has not existed for all that long in terms of the inter- tles France, but also the Human Rights Watch, said going on in the male.” national order,” said George Magnus, associate at the European Union, will have to democratic leaders have a We know that sperm counts are dependent on China Centre at Oxford University. Regimes with illiberal undertake in 2018, including responsibility to speak out high levels of testosterone, and there is some knowl- leaders “reject the kind of democratic model we have kind with some of its members,” against autocracies and edge of links between sperm count and infertility, of grown up with,” he added. French President Emmanuel despots who depend on experts say. But beyond these basics, sperm’s intrica- These include Vladimir Putin of Russia, Turkey’s Recep Macron said in January. large-scale repression to cies remain largely undiscovered. “Without under- Tayyip Erdogan, and the Philippines’ Rodrigo Duterte, keep their grip on power. “It standing the biology of how normal sperm work, we who all came to power through the ballot box but have ‘Managed democracies’ is important for democratic can’t possibly understand how they don’t work, or since trampled democratic norms. Other global contem- In the 1990s, intellectuals leaders both to highlight the how to correct the problem,” Sarah Martins Da Silva, porary strongmen include Egypt’s Abdel Fattah Al-Sissi, such as Francis Fukuyama emptiness of the autocrats’ a specialist at the University who took part in a coup against a democratically elected questioned whether humanity political programs and to of Dundee told a London briefing this week. Islamist government. “It is certain that the club of man- had reached the “end of histo- stress the danger of enabling Sperm counts in men from America, Europe, aged (or guided) democracies is growing,” said Caroline ry”, with liberal democracy and leaders who claim to speak for Australia and New Zealand have dropped by more Galacteros, director of the Planeting strategic intelligence capitalism apparently victorious the majority,” he said. “China has than 50 percent in less than 40 years, according to consultancy in France. over communism and totalitari- been providing economic support pooled research published last year, described by In Europe, Hungary’s Viktor Orban has become a anism. But by the turn of the cen- to autocrats around the world and one of its authors as an “urgent wake-up call” for posterboy for what he calls a form of “illiberal democracy” tury, analysts were warning of the increasingly is trying to silence criti- further investigation. while US President Donald Trump also embodies a emergence of semi-authoritarian cism of its own autocratic model even spreading strain of aggressive nationalism worldwide. states - countries that like Turkey within liberal democracies.” He cited Still in the 1950s Trump’s “America First” mantra and attacks on institutions and Russia fall somewhere between Beijing’s close financial links to repres- Experts say that to address the basic unanswered such as the FBI, the judiciary and the free press are testing democracy and dictatorship. China’s sive regimes in countries such as clinical and scientific questions in andrology - the the democratic checks and balances in the US constitution. trajectory was always unknown, but Venezuela and Zimbabwe. —AFP study of male reproductive health - would require research ranging from large, ideally international, epidemiological studies to detailed lab work to decipher exactly how sperm cells function. Allan Pacey, a senior lecturer in andrology at Britain’s respect you,” said Kalachev. The US and Europe hit months, according to official polls, around 70 percent of Sheffield University, said even at a basic level - the Putin: Villain Russia with sanctions in 2014 over the annexation of those who are planning to vote say they will back the diagnosis of a possible male fertility problem - the Crimea and Moscow’s backing of rebels in Ukraine’s current president. His closest competitor, Communist science is lagging. The techniques of sperm analysis abroad, hero east. Since then Russia’s support of the Syrian regime in candidate Pavel Grudinin, is projected to garner less than - examining ejaculate under a microscope, counting a bloody civil war, allegations that Moscow interfered in eight percent of the vote. “(Putin) expertly exploits all the the sperm, assessing how well they swim, and seeing US presidential elections and the discovery of a state- fears and the complexes of the population,” Kalachev what they look like - were invented in the 1950s, he at home sponsored Olympic doping program have said, adding that the greatest fear was a said. “And we are still doing the same thing now.” further hurt the country’s reputation return to the instability of the 1990s. So while estimates suggest as many 1 in 20 young o the West he is public enemy number one: abroad. Putin often frames negative “People are afraid of losing what men now have sperm counts low enough to impair Snatching land from his neighbors, interfering foreign coverage of his leadership they already have...and this fear is fertility, that remains educated assumption, rather Tin foreign elections and unveiling weapons that as a sign that Russia is under especially strong in the provinces, than data from specific studies. “The quality of evi- he says render Washington’s missile defense systems attack from a West uncom- where it is hard, but still possi- dence we have got in this area falls way behind that obsolete. But despite - or because of - his reputation fortable with the country’s ble, to live,” he said. of other branches of medicine,” Pacey said. abroad, Vladimir Putin is still widely popular in Russia new global role. Despite Putin’s campaign Attracting funding for fundamental research into and is all but guaranteed to win a presidential elec- As he unveiled what he promises when he returned to possible environmental impacts on sperm counts - tion this week with a landslide. In part this is because called “invincible” new the Kremlin in 2012 after chemical exposure, for example, or smoking, obesity, over almost two decades in power he has cracked weapons in his state of the four years as prime minis- or sport and exercise - is tricky, partly because such down on dissent and consolidated Kremlin control nation address this month, ter, his last term was studies need vast numbers of people, take many over the media. he reminded the audience marked by recession and a years and may not give clear answers. The president’s most vocal opponent is also barred of the time in the early fall in living standards. “In the competitive world of grant funding, there is from appearing on the ballot on March 18 owing to a 2000s when “no one lis- Opposition leader Alexei a view that male infertility is a problem solved,” Sharpe criminal conviction. For millions of Russians, however, tened to us”. “Listen to us Navalny, who has called for a said. “We have ICSI. OK, this doesn’t fix the problem in Putin is the man who brought stability after the political now,” he said before playing boycott of the polls since he the affected men, but it treats the ‘symptoms’, and and economic chaos of the 1990s, as well as restoring video montages that dis- was barred from standing, that’s good enough. “So from an urgency and priority Moscow’s standing on the world stage following the played the weapons’ capa- rejects the idea that Putin perspective, it’s easy to downgrade when compared to humiliating collapse of the Soviet Union. “Putin is a mir- bilities. The Russian mod- retains real support in the cancer, obesity or cardiovascular disease.” ror and everyone can see in him what they want,” inde- erator of a televised dis- provinces. “They say there: well Comprehensive European or global data on pendent political analyst Konstantin Kalachev told AFP. cussion last year jok- alright, Putin, there’s nobody funding going to male fertility research are not “For some he is the man who got Russia back off its ingly told Putin he was apart from Putin, I’ll vote for him! available, but in Britain, for example, only around knees, got the army and defense back on track. For oth- the “pole of evil” around That’s the only reason why he gets 3.6 percent of the Medical Research Council ers he raised the quality of life and made sure pensions which Western powers any votes,” Navalny told AFP in a Populations and Systems panel budget was provid- were paid on time,” he said. “consolidate and mobi- recent interview. ed for male infertility research from 2014 to 2017. lize”. “Can you imagine At a recent campaign rally in Moscow, Pacey told Reuters he has “a filing cabinet full of ‘Pole of evil’ how they would manage supporters of the president expressed failed applications over the years” and Sharpe not- For those abroad, Putin - who in recent years has without you?” the modera- a similar sentiment. “I do not see ed that once research falls behind, future studies been variously portrayed as an octopus, The tor asked an appreciative another candidate who could be our have less to build on. “If you’re not producing sexy Terminator, Hitler and Batman’s nemesis The Joker on president. commander in chief,” Oscar-win- research that’s going to come up with a magic bul- the cover of Western news magazines - means some- ning director Nikita Mikhalkov let, then people are not going to give you the mon- thing else entirely. “But being the West’s main enemy No other option told the 100,000-strong crowd. ey,” he said. —Reuters is an acknowledgement that he is the number one While support for Putin in “He’s the only one. Putin is our politician. If they’re scared of you, it means they Russia has dipped slightly in recent president.” —AFP