Myth busting on male infertility

February 11, 2009 12:00:00 AM PST
Educating yourself on your man's health, so you can educate him on it. When it comes to male infertility, what is myth and what is fact? Dr. Paul Turek heps break it down.

Male health myths:

MYTH: Infertility is almost always a woman's problem

False. Among reproductive age couples in the US, 10-15% will have trouble conceiving, making this problem almost as common as diabetes. The infertility "issue" or "factor" can be attributed to women about 50% of the time. The other 50% involves male factors, either as an isolated issue (30%) or along with a female issue (20%). This is why it is just as important to have men evaluated for a couple's infertility along with the female partner.

MYTH: Hot tubs and hot baths can cause infertility in men.

True. This has thought to be true for 50 years. In the early 1950's, a Swiss doctor in India worked with male volunteers for 10 years and reported using hot baths as a contraceptive for men. She had them sit in a hot bath (116o F) for 45 minutes daily for 3 weeks and 6 months of infertility resulted from this exposure. Dr. Turek published the first and only research on hot tub and bath exposure among infertile men in 2007 and demonstrated that half of exposed men had a 400%+ increase in sperm counts after discontinuing this exposure. The mechanism of elevated temperature is also likely the reason for decreased fertility with fevers from flus or other illnesses as well as possibly the issues observed with laptop computers.

MYTH: Tight underwear can cause male infertility. Boxer shorts are safer.

False. More than any other influence, urologists have made boxers a fashion statement. For 55 years, it has been touted that loose underwear keeps scrotal temperature down and maintains fertility: wear boxer shorts instead of jockeys as underwear. However, 10 years ago a study was published by urologists that involved 97 male volunteers and showed that there was no difference in scrotal temperatures (taken from 3 areas!) in men wearing boxers and jockey shorts, even when they switched from one type of underwear to the other. Although fertility was not measured in this study, the evidence clearly shows that scrotal temperature does not correlate with the type of underwear that men wear.

Ref: Turek PJ. Journal of Urology. Vol 160, p. 1337, 1998.

MYTH: Unlike with women, a man's fertility does not change with age.

False. Semen quality does decline with age in men, but this occurs slowly, decreasing 1% annually after the age 30 years. The most dramatic change occurs with sperm motility. Of course, as men reach the 7th and 8th decades, they progress through "andropause" a process that is associated with hormonal changes similar in caliber to menopause in women. Sperm production will cease during this time. Advancing male age has also been associated with increased time to conception, and a higher occurrence of certain diseases, including schizophrenia and autism, in children. This is likely due to aging of the quality control processes in the genetic machinery that governs sperm production.

MYTH: Sexual position during intercourse correlates with the ability to conceive or with the sex of the child.

False. Methods for improving the chances of conceiving or for determining baby gender are ancient, even prehistoric, and range from astrological, to dietary to sexual position. You may have heard that positions that deposit the sperm closest to the cervix - such as the missionary position (man on top) - are more promising for conceiving boys than other positions. However, there is no real evidence that any particular sexual position is more likely to lead to conception of a boy or girl. Realize though, that it has definitely been shown that the timing of intercourse during the menstrual cycle is important for conception.

Whether sexual position during intercourse can influence the gender of the baby is also controversial and unsubstantiated. The Shettle Method of gender selection is based upon this idea and suggests that to increase the odds of conceiving a girl baby, that intercourse be attempted regularly and well in advance of ovulation. Theoretically, this will favors the slower but larger and more resilient X-chromosome sperm (girls) rather than the smaller, less resilient Y chromosome (boy) sperm. To conceive a boy, it is recommended that intercourse occur nearer to ovulation, as the less "durable" Y-chromosome sperm have a better chance in this situation. Importantly, The Shettle Method has never been demonstrated to be scientifically valid for gender selection.

About Dr. Paul Turek:
Dr. Paul Turek, who is a leading surgeon and former endowed chair professor at UCSF, is leading the charge to make men aware of the importance of paying attention to their reproductive health. Research has shown (some of which is Dr. Turek's research at UCSF) that reproductive dysfunctions in men are early indicators of severe life threatening health issues like cancer and cardiovascular disease. Dr. Truek wants to make sure men are checked by a men's health specialist when they are having symptoms.

About The Turek Clinic:
The Turek Clinic in San Francisco is a next-generation men's healthcare medical practice specializing issues facing reproductive age men. The practice was founded by Dr. Paul Turek, a leading surgeon and former endowed chair professor at the University of California San Francisco in May, 2008. Dr. Turek's work combines innovative and cutting edge techniques, with the wisdom of old-world medicine to treat and the problems of men ages 21 to 55 years of age.

For more information, visit www.theturekclinic.com or call 415-392-3200.


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