Semin Reprod Med. 2023 Nov;41(6):226-240. doi: 10.1055/s-0044-1782151. Epub 2024 Mar 18. ABSTRACT Since the end of the last century, several reports have suggested that semen quality is declining, especially in Western countries. Furthermore, cross-sectional studies using similar protocols have suggested regional differences in semen quality of young and fertile men.