did not find a decreasing trend in relative frequency; however, they observed a significant decrease in the absolute number of spermatozoa, with averages falling from 34 million between 2001 and 2005 to 21 million between 2011 and 2015 4 .
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Total motile sperm count Regarding the total motile sperm count (TMSC) in the samples, we found a significant trend towards a decrease in median value over the years (reduction of 2.84 million progressive motile sperm each year) (Fig. 2A ).