29 Furthermore, a significant trend of decline in sperm concentration and total sperm count for increasing quartiles of metabolite concentration was reported.
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The environmental and occupational influence of pesticides on male fertility: A systematic review of human studies.
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De Jager et al., 63 dividing subjects according to lipid‐adjusted p,pʹ‐DDE plasma concentration, noted an increasing trend in the log‐transformed DFI coefficients as the serum level of this metabolite increased, with a significant difference between the lowest quartile group and third and fourth quartile groups ( p < 0.05).
Indeed, although stratifying cases according to p,pʹ‐DDE serum concentrations, a negative trend of impaired semen parameters occurred, 23 and some papers did not report any relationship, showing that these pesticides are safe than other POPs, such as polychlorinated biphenyls (PCBs). 22 — 25 In any case, almost all human studies have a low level of evidence, and further studies with adequate quality are necessary for definitive evidence.