'Some phrases bear repeating, and the warning of Levine et al in their landmark paper of 2017 that a 'strong' decline in count was the 'canary in the coalmine' holds true yet again in their latest update. The canary is still chirping its warning ?" but now with even greater force ?" in its implications for male reproductive and more general health. 'The group's first report of a significant decrease in sperm concentration and count was derived from studies published between 1981 and 2013 and based only on findings from men in North America, Europe and Australia. The latest analysis now extends the geography to include studies from South and Central America, Asia and Africa and thus presents a more complete picture of global trends in sperm count ?" and with data drawn from studies up to 2019.sperm count decrease depopulation agenda