JEFFERSON CITY — With Missouri men recording low sperm counts, one Missouri legislator is proposing a bill that would require health insurance companies to pay for infertility diagnosis and treatments.
"We spend millions upon millions of dollars trying to assist people, even in terminal situations with cancer, with a lot of different things," said the bill's sponsor, Rep. Steve Hodges, D-East Prairie. "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."
Hodges filed a similar bill last year, but it never received a hearing.
Hodges said he was unsure if the bill would include infertility treatment for men.
"Men that have concerns about their fertility don't always know where to turn," said Erma Drobnis, an andrologist at Columbia Regional Hospital. "And actually having a semen analysis at a fertility clinic is very simple, very noninvasive and not terribly expensive."
"It would be good if infertility could be covered like any other illness or disease that people have," Drobnis said.
Drobnis was a researcher on a study released in 2003 that compared semen quality in three urban cities and one rural town, Columbia. It was designed to parallel a European study that found men in urban areas had lower sperm quality than those in rural towns. In contrast, Columbia men had a lower sperm count than their 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 58.7, according to the 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 subsequent study by the researchers said pesticides in drinking water could be a contributor. It identified two herbicides, atrazine and alachor, and one insecticide, diazinon, that were found in men with low sperm quality.
Obesity, smoking and alcohol abuse are other causes of low sperm counts. Other specialists say semen quality is a mostly hereditary issue.
The rural site in Finland used in the European study was not a farming town. It was this difference that led researchers to suspect pesticides in water.
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.
No bills have been prefiled that deal with water quality in general or water 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."