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Quality assessment for bias of analytical studies was conducted using the ToxRtool for in-vitro studies and was assessed by two reviewers (RM and PB) independently. Each study was screened by title and abstract based on predefined eligibility criteria (Table 1). We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA) statement . To further determine the proportions of fake AAS found on the black market, we conducted a systematic literature review and meta-analysis of analytical test results for those substances within the published literature. In this Modern Wisdom episode, Dr. Michael Eisenberg addresses the significant decline in global sperm counts over the past 40 years and explores potential causes, including environmental factors, lifestyle choices, and rising obesity rates. 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