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Effect of induced intrascrotal hyperthermia on testicular function in man

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      Abstract

      In order to determine the influence of intrascrotal hyperthermia on testicular function, studies were carried out on human males with the following results:
      • 1.
        1. The mean scrotal-rectal temperature differential (S-R differential) of 36 normal men in the supine position at room temperature was 2.38°C. Changes in posture affected this gradient to some extent. Age apparently had no effect.
      • 2.
        2. The mean S-R differential of 1.75° C. in 21 euspermic individuals, 1.93° C. in 37 oligospermics, and 2.0° C. in 8 men with varicoceles must await interpretation pending the accumulation of sufficient data to warrant statistical evaluation.
      • 3.
        3. Infraclavicular immersion of 8 euspermic subjects in hot baths (38 to 43° C.) resulted in a shift of the median S-R differential from −1.6° C. to +1.2° C., i.e., an inversion of the S-R ratio from 36.1:37.7 to 40.5:39.3, or from 0.96 to 1.03.
      • 4.
        4. In 6 euspermic individuals wearing insulating underwear almost constantly for about 6 weeks, and in a seventh subject who wore the insulating clothing for approximately 14 weeks, the sperm count began to decrease at about the third week after the start of insulation, reaching its lowest point between the fifth to the ninth week. With one exception, the men remained oligospermic for 3 to 8 weeks after omitting insulation and then gradually returned to their characteristic preinsulation sperm output. This was reached, at the latest, by the twelfth postinsulation week in all subjects.
        No effect on volume of semen was observed. Nor was there any change in the morphology of spermatozoa, with the single exception of the subject who wore the insulation for as long as 14 weeks.
        A lowering of the mean S-R temperature differential by 1° C. accompanied the suppression of spermatogenesis.
      • 5.
        5. In 20 oligospermic individuals, application of wet heat (43 to 45° C.) to the scrotum for half an hour on 6 alternate days resulted in a decrease in sperm count within 11 to 112 days. In 9 of the men, the drop was followed later by a rebound to levels higher than had prevailed prior to treatment. The wives of 6 of the men conceived within 5 months of start of therapy. All pregnancies were normal.
      Modification of spermatogenesis by induced intrascrotal hyperthermia may have practical application not only as a means of controlling fertility, but also as a therapeutic tool in certain cases of oligospermia. These studies are being continued with the aim of elucidating the exact mechanism whereby heat effects such changes in testicular function.
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