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Semen quality of fertile Japanese men: a cross-sectional population-based study of 792 men
  1. Teruaki Iwamoto1,2,
  2. Shiari Nozawa1,
  3. Miki Yoshiike1,
  4. Mikio Namiki3,
  5. Eitetsu Koh3,
  6. Jiro Kanaya3,
  7. Akihiko Okuyama4,
  8. Kiyomi Matsumiya4,
  9. Akira Tsujimura4,
  10. Kiyoshi Komatsu5,
  11. Taiji Tsukamoto6,
  12. Naoki Itoh6,
  13. Makiko Naka Mieno7,
  14. Matti Vierula8,
  15. Jorma Toppari8,
  16. Niels E Skakkebæk9,
  17. Niels Jørgensen9
  1. 1Department of Urology, St Marianna University School of Medicine, Kawasaki, Japan
  2. 2Division of Male Infertility, Centre for Infertility and IVF, International University of Health and Welfare Hospital, Nasushiobara, Japan
  3. 3Department of Urology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
  4. 4Department of Urology, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan
  5. 5Department of Urology, Harasanshinkai Hospital, Fukuoka, Japan
  6. 6Department of Urology, Sapporo Medical University, Sapporo, Japan
  7. 7Department of Medical Informatics, Centre for Information, Jichi Medical University, Shimotsuke, Japan
  8. 8Departments of Physiology and Paediatrics, University of Turku, Turku, Finland
  9. 9University Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Professor Teruaki Iwamoto; t4iwa{at}


Objectives To establish a base line for future studies on temporal trends, to describe potential geographical differences in semen quality and reference values for studies of men from the general population.

Design Cross-sectional study of fertile men from four areas in Japan. Inclusion criteria were: age 20–45 years at the time of invitation, and both the man and his mother had to be born in Japan. Additionally, the current pregnancy of the female partner had to be achieved by normal sexual relations without any fertility treatment.

Setting Four Japanese study centres at urban areas located in Sapporo, Osaka, Kanazawa and Fukuoka.

Participants 792 men, median age 31.4 years, included from 1999 to 2002.

Outcome measures Semen volume, sperm concentration, total sperm count, sperm motility and sperm morphology.

Results Semen volumes, percentages of motile spermatozoa and morphologically normal spermatozoa differed slightly between the four groups, whereas no differences in sperm concentrations or total sperm counts were found. In total, 1.2% of men had a sperm concentration below 5 million/ml, 2.1% below 10 million/ml, 3.5% below 15 million/ml and 16.3% below 40 million/ml. For morphology, 14.7% had less than 5% normal spermatozoa. Reproductive hormone levels varied significantly, however, only little from a biological point of view.

Conclusions This is the first cross-sectional study on semen quality covering fertile men from the major regions of Japan. It showed that semen quality of fertile Japanese men is comparable to that of the best in European regions. The results may serve as reference values for studies of men from the general population.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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