When we think about our plastic overconsumption, we generally think about its detrimental environmental impact. With a steep rise in plastic production worldwide – from two billion tons in 1950, to over eight billion tons in 2017, and an estimated 34 billion tons by 2050 – it’s no surprise that the plastic crisis is damaging our planet. But is it also damaging our health, and more specifically, our fertility?

THE WHY’s 2021 documentary film, We, the Guinea Pigs, seeks to investigate the potential correlation between hazardous chemicals found in various everyday plastics, a sharp decline in semen quality and a consequent increase in fertility issues. Alongside this, the film also investigates how plastic may be linked to a number of different health issues, diseases, and disorders, including breast cancer, early onset puberty, reproductive development, and neurodevelopmental disorders such as attention deficit/hyperactivity disorder and autism.

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Chemicals in Our Environment

We are constantly exposed to harmful plastic chemicals in our daily home environment through storage containers, fabrics, medical and electronic devices, and even children’s toys. These have been named endocrine disrupting chemicals (EDCs). These chemicals have the ability to resemble our natural hormones to such an extent that they can mimic – or completely alter – them and take their place in our body. As such, they have the capability to disrupt our entire endocrine system; a vital system for brain development, metabolic regulation, and anatomic function as early as foetal development in the uterus.

The film follows two couples struggling with infertility – Preben Jensen and Cecilia Rebild, and Emil Broo Holm and Katrine Larsson Zachariassen. Both couples have gone through fertility treatments including sperm donors, egg donors, immunosuppressant medication, and in vitro fertilisation. When Emil and Katrine started fertility treatments, the focus was solely on the quality of Emil’s sperm. 

Katrine says “Emil had dramatically reduced semen quality, so we got treatment for that. There wasn’t a focus on me at the time,” highlighting the struggles with receiving equity of treatment by fertility doctors. Both couples have tried to conceive for years, both naturally and with treatment, without success. Even though the cause of their infertility may lie beyond their control, the couples can’t help but place the blame on themselves. Emil says, “why can’t we have kids? Why did nature choose that for us?” Katrine adds, “I can’t help but think: ‘am I doing something wrong?’”

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The Male Fertility Crisis

The World Health Organisation recently reported that approximately one in six couples worldwide experience infertility. They describe infertility as a disease of the reproductive system defined by the failure to achieve pregnancy after 12 or more months of actively trying to conceive. For many years, the blame has been directed at women for the couple’s infertility, with a quarter of men still believing that infertility is most likely to affect women, despite male infertility contributing to about 50% of cases. Research has found that sperm counts among healthy men have more than halved in the last 40 years. Unfortunately, comparatively men are less likely to seek professional help for fertility issues. 

The film follows doctors and specialists at Denmark’s Rigshospitalet, where scientists had discovered that something was wrong with the quality of men’s semen. Endocrinology specialist Niels Jørgensen highlights that with the rapid decline in sperm counts “it’s not because of a change in our genome but must be due to our environmental factors and our lifestyle.” Jørgensen and his team set out to test the severity of the situation. They completed two large population studies. Both studies came to the same result, from which they were able to conclude that there is an evident male fertility crisis.

Inspired by new insight into EDCs, Jørgensen and his team launched a comprehensive research project, stating:

‍“we have a focus on endocrine disruptors as one possible explanation, and in regard to semen quality, the development of the testicles in the foetus is the alpha and omega. That is when the quality of men’s semen is determined.”

The study revealed a connection between the level of EDCs in pregnant women and the development of their sons’ testicles, meaning fertility may be predetermined prior to birth and will only continue to wane throughout the life cycle.

Environmental and reproductive epidemiology professor Shanna Swan has devoted her academic life to studying the effects of EDCs. In recent years, traces of these harmful chemicals have been found in breast milk, placental tissue, urine, blood, and semen. In 2017, Swan and her team completed a major study that found that sperm levels among men in Western counties had plummeted over the past four decades. 

They found that reproductive development is shifting rapidly, for both men and women, most deteriorating at the rate of 1% per year. In 2022, they updated their analysis and found that sperm count has been declining at more than twice that rate since 2000. At this rate, Swan predicts that the world population is on pace to become an infertile one. While she wouldn’t go as far as fearing for a future Gileadean society, she is growing more despondent as the time for warnings is running out.

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Identifying the Research Gap

For successful conception, both partners’ reproductive systems must be well-functioning; however, with heavy focus on male fertility, little research has been conducted into female fertility. Jodi Flaws, professor of comparative biosciences, stated:

“although we finally recognise that environmental chemicals impact women's health, most studies have focused on men’s reproductive health and very few studies have looked at how these chemicals affect women.”

Flaws conducted an experiment on female mice to test the extent to which women’s fertility may be directly affected by EDCs. By exposing the rats to phthalates for 10 days, they found that it disrupted their reproductive cycles, reducing their ability to become pregnant for up to nine months afterwards.

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A Toxic Soup of Chemicals

Similarly, in the film, Hannah Johansson, research scientist in reproductive toxicology, set out to examine how a ‘toxic cocktail’ of hazardous chemicals that we’re exposed to on a daily basis potentially affects the female reproductive system. Johansson says, “girls are born with a specific number of eggs, and that’s the number they have for the duration of their life.” Due to this, Johansson and her team wanted to see how these chemicals might affect egg production. Testing on female rats during their gestation period and when they nurse, the researchers were interested in how the offspring were affected. The results showed that the rats’ ovaries were drastically underdeveloped in size, as well as containing fewer eggs, which is concerning when we know this deposit should last them a lifetime.

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Treating the Problem, Ignoring the Root Cause

While research suggests the dangers of EDCs generated through excessive plastic consumption, little has been done to address the root cause of the problem. Jørgensen says, “we have reached a point where 10% of a generation is conceived through a fertility clinic. Imagine a disease that struck 10%. You’d go: ‘wow, that’s a big number’… but we don’t solve the problem.”

Instead, infertile couples are given fertility treatments to aid in conception, but this is only an expedient solution to a growing problem. Swan states that “If you look at the curve on sperm count and project it forward… it reaches zero in 2045,” essentially meaning the average man would have no viable sperm, and thus “most couples may have to use assisted reproduction.”

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As part of THE WHY’s vision of providing free access to information, once a month we release one of our favourite documentaries onto our YouTube Channel, labelled as Film of the Month.

If you would like to suggest a WHY film that you would like to watch, or simply want more information surrounding this month’s pick, then reach out at info@thewhy.dk.