Sperm counts low; infertility bill prefiled
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Sperm counts low; infertility bill prefiled

Date: December 17, 2008
By: Emily Coleman
State Capitol Bureau
Links: House Bill 50

JEFFERSON CITY - With Missouri recording abnormally low sperm counts, one Missouri legislator is proposing a bill that would require health insurance to pay for infertility treatments.

Rep. Steve Hodges, D-East Prairie, recently prefiled a bill that would require health insurance coverage for the diagnosis and treatment of infertility.

"We spend millions upon millions of dollars trying to assist people even in terminal situations with cancer with a lot of different things," Hodges said. "To me, this is a very positive medical procedure. Nothing but good things could come out of it, and I know everything has its cost, whether it's good or bad."

The bill had been filed in the House of Representatives last session and assigned to a committee but never made it to a hearing.

"Men that have concerns about their fertility don't always know where to turn," Dr. Erma Drobnis said. "And actually having a semen analysis at a fertility clinic is very simple, very noninvasive and not terribly expensive."

Hodges said he was unsure if the bill would include infertility treatment for both men and women.

"It would be good if infertility could be covered like any other illness or disease that people have," Drobnis said.

A study recently linked poor semen quality to pesticides in drinking water.

No bills have been prefiled that deal with water quality in general or as a root cause of infertility.

"(Looking into the root causes of infertility) is an obligation of the Health Department," Hodges said. "Whether or not there's mass amounts of money for that, I don't know."

The study, which compared urban cities with one farming town, Columbia, was conducted by Drobnis of Columbia Regional Hospital and Dr. Shanna Swan of New York and designed to parallel a similar study conducted in Europe.

The European study showed the low sperm quality among men in urban areas in comparison to a rural town. In contrast, the rural town studied in Missouri exhibited a lower sperm count than its urban counterparts.

While cities like New York and Los Angeles had sperm counts of 102.9 million and 80.8 million per milliliter, respectively, Columbia's sperm count was almost half of those at 58.7, according to an initial study.

"We actually expected to have semen quality higher in Columbia, Mo. than in the urban sites," Drobnis said. "It was very surprising results."

A second study done by Drobnis said pesticides in drinking water could be a contributor.

Obesity, smoking and alcohol abuse are other causes of low sperm counts. Other specialists say that semen quality is a mostly hereditary issue.

The rural site in Finland that was used in the European study was not an farming town. It was this difference that led researchers to pesticides in water.

A subsequent study narrowed it down to two herbicides, atrazine and alachor, and one insecticide, diazinon.

Gale Carlson, a public health epidemiologist who critiqued the study for the Missouri Health Department, said the link between semen and water quality was questionable.

"There was no relationship determined between (sperm counts) and actual pesticides in the water they were drinking because there was no study of even where they drank the water," Carlson said. "It was just a general statement that certain areas of the country, the Midwest, where there was more agricultural work going on, that there was more pesticides used, and therefore, it would be logical that some of that pesticide could be getting into drinking water."

All the men in Drobnis' study were still fertile, just exhibiting lower than average sperm counts.