The debate over the decline in sperm count has been ongoing, with recent reanalyses of data from Carlsen et al. (2) and Swan et al. (1) suggesting a worldwide decline over the past 50 years. However, these studies are subject to significant methodological biases, including geographical and temporal variations, and the potential impact of confounding factors such as regional, racial, and ethnic differences. Other studies have found no decline in sperm count in specific regions, while some have detected a decline in certain areas. The authors emphasize the need for innovative, prospective studies with high-quality data to address this issue, highlighting the risk of generalizing trends globally. They also acknowledge the regional variation and the importance of ongoing international research to provide reliable estimates of between-region differences in semen quality.The debate over the decline in sperm count has been ongoing, with recent reanalyses of data from Carlsen et al. (2) and Swan et al. (1) suggesting a worldwide decline over the past 50 years. However, these studies are subject to significant methodological biases, including geographical and temporal variations, and the potential impact of confounding factors such as regional, racial, and ethnic differences. Other studies have found no decline in sperm count in specific regions, while some have detected a decline in certain areas. The authors emphasize the need for innovative, prospective studies with high-quality data to address this issue, highlighting the risk of generalizing trends globally. They also acknowledge the regional variation and the importance of ongoing international research to provide reliable estimates of between-region differences in semen quality.