Boxers vs. Briefs: Which is Better for Male Fertility?

Boxer shorts

Hello Doctor, I have a question: Before marriage, my husband preferred to wear briefs, but after learning about his infertility, the doctor advised him to wear boxers and take cold showers for better sperm health.
Since then, he has only worn boxers, but we have not achieved natural conception.
However, today a urologist in the newspaper stated that wearing boxers lacks support, which can cause the testicles to sag, and recommended wearing supportive briefs instead to prevent sagging of the scrotum.
I don't understand the doctor's advice, and my husband thinks ventilation is sufficient.
What do you think is the best approach? Thank you.

huanzhe, 30~39 year old female. Ask Date: 2013/09/23

Dr. Lin Wenbin reply Obstetrics and Gynecology

Please consult a physician in the urology department.
In my opinion, it is essential to regularly measure sperm count to assess the impact of lifestyle habits on sperm quality.

Reply Date: 2013/09/23

More Info

When it comes to male fertility, the choice between boxers and briefs has been a topic of discussion among medical professionals and couples trying to conceive. The concerns surrounding this choice primarily revolve around temperature regulation of the testicles and the support provided by the underwear type.

Temperature Regulation
The testicles are located outside the body for a reason: they need to be kept at a temperature slightly lower than the body's core temperature for optimal sperm production. Studies have shown that elevated temperatures can negatively affect sperm production and quality. Tight-fitting underwear, such as briefs, can trap heat and potentially lead to increased testicular temperature, which may impair spermatogenesis (the process of sperm production).
On the other hand, boxers provide more room and ventilation, which can help keep the testicles cooler. This is why many healthcare providers recommend wearing boxers or loose-fitting underwear to promote better fertility outcomes. However, the argument for briefs is that they provide better support, which some believe can be beneficial for sperm health by preventing excessive movement of the testicles.

Support vs. Temperature
The recent debate you've mentioned regarding the support provided by briefs versus the cooling effect of boxers is indeed a nuanced one. Some urologists argue that the support from briefs can prevent the testicles from hanging too low, which could theoretically reduce the risk of overheating. However, this is a point of contention, as the primary concern remains the temperature of the testicles.

Recommendations
1. Opt for Loose-Fitting Underwear: Generally, it is recommended that men trying to conceive wear loose-fitting underwear, such as boxers, to allow for better airflow and temperature regulation.

2. Avoid Hot Baths and Saunas: In addition to underwear choice, men should avoid activities that raise the temperature of the testicles, such as hot baths, saunas, and prolonged sitting.
3. Cold Showers: While cold showers can provide a temporary cooling effect, they are not a long-term solution for fertility issues. However, they can be refreshing and may help in reducing testicular temperature temporarily.

4. Consult a Specialist: If fertility issues persist despite making lifestyle changes, it is essential to consult a fertility specialist or a urologist. They can provide a comprehensive evaluation and recommend further tests to identify any underlying issues affecting fertility.

5. Lifestyle Factors: Beyond underwear choice, consider other lifestyle factors that can impact fertility, such as diet, exercise, smoking cessation, and alcohol consumption. Maintaining a healthy weight and managing stress are also crucial for optimal reproductive health.

Conclusion
In summary, while the debate between boxers and briefs continues, the prevailing advice is to prioritize temperature regulation by opting for looser-fitting underwear. However, individual comfort and support preferences should also be considered. If there are ongoing concerns about fertility, it is advisable to seek professional medical advice for a tailored approach that considers all factors affecting reproductive health.

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