If It Works ... Warming Male Testicles to Reduce Sperm Count

"There’s a reason that the testicles are outside a man’s body cavity.  The testicles need to be four degrees cooler than body temperature to make plenty of healthy sperm."

"The cremaster muscle contracts to pull the testicles closer to the body if they start to get too cold, and it relaxes to push them farther from the body to cool off if they get too warm."

"Prolonged exposure to a warmer temperature will make sperm die.  This will show up in a semen analysis as reduced motility [movement]."

Winfertility

 

In the late 1970s, Toulouse doctor and inventor Roger Mieusset theorized that applying mild heat to male testicles would succeed in diminishing the production of sperm. He tested underwear that lifts the testicles toward the body which had the effect of bringing heat to the testicles by two degrees. Sufficient, he discovered, to diminish the virility of fertility of a herd of rams, his test subjects. 

Male testicles must be dependent, hanging freely outside the body. Should those testicles be warmed to above 35C, sperm count realizes a dramatic drop. Any sperm count under one million sperm per millitre leads to infertility. It is, however, a temporary, reversible condition, to be used for no longer, it is recommended, than three years at a time. After which, given sufficient wait time, fertility levels should return to normal.

Dr. Mieusset himself prescribed his method -- with the use of a type of jockstrap he devised, lifting the testicles to rest against the body where they are gently warmed, instead of hanging loosely as nature designed them to for procreation and perpetuation of the species -- to a mere handful of men every year. His method, despite its success, was never funded for research trials, and thus failed to receive official recognition.

With the body in close contact to the testicles, heated by two degrees over what is considered normal, over three months when the warming underwear has been consistently worn for 15 hours daily, sterility is effected. In the current social consciousness of the unfairness of burdening women solely with the responsibility of ensuring unwanted pregnancy does not result from sexual congress, men are beginning to take some responsibility of their own; hence a return of the method.

French men are now assuming responsibility for birth control with the use of improvised jockstraps formulated to warm testicles to reduce their sperm count. The fact that no commercial options are yet available to men in the field of birth control, has led them to redress the gender imbalance with these contraceptive jockstraps. 

As a result, workshops have cropped up in cities like Toulouse, Paris and Nantes. The theory is that should a man determine it is time to discontinue use of the underwear, a return to normal can be affected following a few months of discarding use of the jockstrap. Effecting a reverse in the same time it took to diminish sperm count production.

Doctors' advice is that the devices not be worn regularly for over a three-year period, as a reflection of the lack of studies in the long-term impact of testicle-heating methods of contraception.

Aging Male Infertility

"We want to see fertility taught as part of the curriculum and have been successful in getting it included."
"Young men need to know they won't necessarily remain fertile their whole life, and are more likely to have problems as they age."
Professor Adam Balen, Fertility Education initiative, Leeds Teaching Hospitals NHS Trust 

"Online dating makes me nostalgic for the meat-market discos of my  youth. At least then you could eye each other up straight away and let hormones do the rest."
"I have been on so many dates with men who take to the hills when I said I wanted a serious relationship."
"It's such a waste of time and effort when my biological clock is ticking like a time-bomb."
Unnamed

A new study has revealed that the age of a man when he has a baby may have an effect on his child's social development later in life.

In 2013 the average age of men becoming new fathers was 32.9 as compared to the present where the average age is now 33.3. Ten percent of new fathers are in the age bracket between 40 and 44, while 5.1 percent are over age 45. Men over 40 are half as likely to see their partners pregnant as men under age 25, according to studies. The miscarriage rate tends to be higher with older male sperm, and there appear to be links between the age of a father and the increasing incidence of schizophrenia and autism.

Researchers in Israel and the United States presented data in 2017 revealing sperm counts in men living in the West had fallen in the last 40 years by 59.3 percent, attributable to smoking, stress, obesity, pollution and exposure to chemicals in plastics, in large part. Where sperm is present, it becomes less healthy as it ages; less motile, likelier to result in fetal abnormalities. The ageing male is just as likely to be responsible for elusive fertility as is a female, age 35 and beyond.

Data from the Human Fertilization and Embryology Authority whose function is to regulate treatment, discovered last year that the most common reason when a couple seek out treatment was attributable to male fertility problems. One issue for males postponing parenthood is economic insecurity, not surprisingly. Lack of job security, hindering a search for a home, has its impact.

In the current world of boy-meets-girl, all too frequently contact is made on line. There are countless dating sites. People 'meet' one another far more often through the Internet than they do now in person. Among some, there is a prevailing notion that no one takes these contacts really seriously; they're meant to arrange the typical one-night-stand, or casual relationships, an attitude not conducive to forming long-term bonds.

When dating potentials take place online a personal element is missing, and it may seem to many as though the 'many fish in the sea' syndrome prevails; so many choices and so many opportunities to look around, greet and meet, and keep on looking. For men in particular a prevailing attitude of moving on as a compelling option should a woman they've chosen for a casual relationship convey her wishes for a deeper commitment.

According to the Office for National Statistics in the U.S., the proportion of childless women has, in a single generation doubled; close to one in five women will remain childless. Women generally now give birth to their first baby at 28.8 years, with more becoming new mothers in their 40s than their 20s. Concurrently, the incidence of single-person families has grown exponentially.

• It takes longer: If a man is over and the woman is under 25, it can take about two years to get pregnant. On the other hand, if both partners are under 25, it takes just over 4.5 months, on average.
• In vitro fertilization (IVF) becomes more challenging: The risk of not having a baby after IVF is more than five times higher if the male partner is 41 years old or older.
• Semen volume decreases with age: The amount of semen a man produces, as well as the sperm's ability to move towards an egg, decreases continually starting at the age of 20.
• There's a higher risk of miscarriage: Believe it or not, a father's age can even impact the likelihood of the baby surviving in the womb. The risk of the woman having a miscarriage is twice as high with a male partner over the age of 45 as it is with a male partner under 25.
• Autism risk increases: Children fathered by men older than 40 are more than five times as likely to have an autism spectrum disorder than those fathered by men under 30.             Source: verywellhealth

With a Grain of Cannabis

"These findings are not consistent with a deleterious role of marijuana smoking on testicular function as initially hypothesized."
"Whether these findings are reflective of the previously described role of the endocannabinoid system in spermatogenesis or a spurious association requires confirmation in further studies."
New study on pot smoking and testosterone, Harvard University

"We know a lot less than we think we know. These unexpected findings highlight how little we know about the reproductive health effects of marijuana, and in fact of the health effects of marijuana in general."
"[This paper] does not mean that using more marijuana is going to increase sperm counts, or testosterone or your masculinity."
"But who knows -- it may turn out that marijuana is actually positive for sperm production, and we've been getting the answer wrong [up to the present]."
"The problem is we can't tell which of those two interpretations is the correct one."
"Our results need to be interpreted with caution and they highlight the need to further study the health effects of marijuana use."
Dr. Jorge Chavarro, associate professor of nutrition and epidemiology, Harvard University

Photo: Getty

The results of a study undertaken by Dr. Chavarro and his colleagues surprisingly points to a tentative conclusion, that men who have smoked marijuana were imbued with notably elevated sperm concentrations and counts, along with higher testosterone levels, challenging expectations to the contrary, given previous studies' opposite conclusions and generally accepted as fact. Not only did he study conclude that men who had never smoked weed had inferior sperm concentrations and counts, but marijuana users' sperm appears to be of superior grade.

Hitherto studies, most of them with laboratory rats yet several with human males, have posited a link with heavy pot use and a slump in sperm production. Dr. Chavarro's study links casual, light use of marijuana with upgraded sperm count, however. Men smoked, on average, two joints a week with the new study. Dr. Chavarro, in attempting to rationalize his team's findings hypothesizes that males with higher circulating testosterone concentrations might be more likely to smoke pot, along with other "risk-taking behaviours".

On the other hand, indulging minimally in pot might result in sperm production being boosted, skewing the finding that high pot use depresses sperm production to give a green light to random, lesser use of marijuana as a potential bonus. A corollary can be found in alcohol consumption, considered mildly beneficial in small amounts, and hugely detrimental when taken in large proportions.

A widely regarded study that took place in 2014 of close to 2,000 British men found that under age 30 males with fewer than four percent normal sperm almost twice as likely to have used cannabis in the previous three months. This study represented the largest done to date in exploring how common factors in lifestyle can influence sperm morphology.  Researchers found as well that sperm size and shape was degraded in samples taken during summer months.

Overall, the sperm of past and current marijuana users seemed to be of superior quality. Getty Images

In the new study recently published in the  journal Human Reproduction, 1,143 semen samples collected from 662 men enrolled at the Massachusetts General Hospital fertility centre were studied along with blood samples collected from 317 of the men and analyzed for reproductive hormones. On average 36 years of age and mostly Caucasian university educated, just over half reported smoking some marijuana at some time. Of this number, 44 percent were past smokers, and 11 percent current smokers.

Average sperm concentrations of 62.7 million sperm per millilitre of ejaculate linked with men who had smoked pot, in comparison to 45.4 million/mL for men who had never used marijuana. No significant differential in sperm concentration was noted between the two streams, however, and a similar pattern was expressed for total sperm count. Sperm concentration below 15 million/mL reflects a mere five percent of marijuana smokers, the WHO's threshold for "normal" levels, compared with 12 percent of men who had never smoked pot.

Quartz

"As the authors point out, men with higher sperm concentrations are likely to have more testosterone in their bodies and thus may be more likely to smoke marijuana because simply they are willing to take more risks."
"In conclusion, I am not convinced that this paper moves us any further forward in this debate.

"Moreover, nor does it give support to any apparent fertility benefits of smoking marijuana."
"In my opinion, this should be avoided at all costs in any couples trying to start a family."
Allan Pacey , Professor of Andrology,  University of Sheffield, Great Britain

Patronizing Mature Women

"[,,,Many women who desire sterilization at a young age experience barriers from physicians who decline to facilitate the request."
"...A woman who is child-free and wishes to remain so is less likely to regret sterilization than a mother who wants no additional children."
Drs. Dustin Costescu and Dylan Ehman, McMaster University Medical Centre, Hamilton

"It's unclear if this [chafing against the universal belief that women are meant to be mothers] is more women choosing to be child-free, or increased comfort in advocating [for sterilization]."
"Often these women have other role models in their life who are also child-free. They may be aunts or people in senior positions in their workplace -- role models who demonstrate they can meet all of their other life goals without having children."
Dr. Dustin Costescu, Family planning specialist

"I personally have zero worries about the risk of regret. I actually don't remember a time when I've had a parental instinct [other than with animals]."
"[I have experienced] the typical comments about how I'll change my mind, and that I'm 'too young to know what I want'. I've had doctors, all men, simply laugh off the situation and my concerns and tell me I'm not ready to make that decision [even though I have medical issues with my uterus and cervix]."
Anonymous 26-year-old woman awaiting tubal ligation at McMaster University Medical Centre

National Post

Certainly the observations made by the two doctors who co-authored a paper published in the Journal of Obstetrics and Gynaecology of Canada know of what they speak when they refer to the 'paternalistic attitude' of male doctors confronted with requests by young women for sterilization, explaining to them that they will regret their decision at some time in the future, refusing to perform the procedure on the basis that 'doctor knows best'. But then Dr. Costescu falls into the same trap himself when he speaks of role models as leading young women into such decisions.

The fact being that by the age of majority women in their 20s and 30s should be regarded as sufficiently mature to have of their own agency reached their own conclusions about whether they foresee childbearing in their future as a choice for them personally. To his great credit, however, Dr. Costescu will not refuse such requests, basing his position on the fact that he believes women approaching him to take advantage of his professional capabilities as a doctor, have every right for their requests to be honoured.

He and his colleague, Dr. Ehman, wrote their article in response to what they see as their professional colleagues in refusing to conduct sterilization procedures on women who request them with full consideration respecting the fall-out are doing these women an injustice. Those women who have convinced themselves for whatever reason that motherhood is not and never will be a goal that appeals to them have the right to due consideration, as far as these two doctors are concerned.

And Dr. Costescu, as a family planning specialist and assistant professor, states without equivocation that any woman seeking to permanently prevent pregnancy and with no contraindications or medical reasons that might complicate sterilization should be -- as he does himself -- considered an appropriate candidate for the procedure of sterilization.

Professional guidelines, in fact, clearly state that well-informed, mentally competent women knowledgeable of birth control options and the resulting "permanency of the procedure", should be respected in their wish for sterilization, irrespective of age or birth history. The two doctors reviewed medical records of 29 women under age 30 on a wait-list for sterilization at Dr. Costescu's clinic to find that most had reported their experience in previously seeking the process elsewhere as demeaning.

Illustration, Mikey Burton. Chatelaine

Doctors consistently refused to perform the requested procedure, or would not refer the women to someone else in the profession who would provide sterilization for them. Among the women were some who related they were recommended the services of a psychiatrist to evaluate their requests, the implication being it is "pathological" to wish voluntarily to close out motherhood prospects for the future.

The surgery itself uses clips placed across the Fallopian tubes through laparocopic (minimally-invasive) laser surgery; alternately cutting away a part, or all of the tubes in their entirety, preventing the potential of a mature egg reaching the uterus to become fertilized. Fallopian tubes can be reopened, untied or reconnected with the traditional form of "tubal" ligation, though a reversal is no guarantee that pregnancy will ensue.

The study revealed that some of the women presented with medical conditions that could be risky for pregnancies while others had carried pregnancies to fruition and with children felt their families were complete and had no wish for additional offspring, while a third of the women studied had never gone through a pregnancy. Surgical risks in this generally safe and effective procedure include excess bleeding and infection with a complication rate of under two percent. Considered a minor surgery, it is performed under full anaesthetic.

A previous review undertaken in the United States involved over 11,000 women who'd received permanent sterilization in the 1970s and 80s, finding that fourteen years later the risk of regret was 20 percent in those 30 or younger at sterilization, and 6 percent for women over age 30. For women who had never had a child, compared with women who'd borne at least one, regret was lower.

As for the woman quoted above whose identity was not revealed on request, her partner is fully in support of her decision not to bear children. New Canadian guidelines recommend no restrictions on the basis of age, while according to Dr. Costescu, who had a hand in authoring the new guidelines, other doctors inform women in his practice they must await age 30 before they will be accommodated.

Sex Roulette

"Oftentimes, people don't realize they have a gap in their knowledge. People don't know what they don't know."
"I don't think we can call that [2006 survey questioning Canadian women where 64 percent reported an unintended pregnancy, with 61 percent reporting in 2017] much of [a] change."
Dr. Jennifer Blake, chief executive, Society of Obstetricians and Gynaecologists of Canada

"A person who is using withdrawal as a contraceptive method is someone who has not planned for contraception, period. They haven't thought about the need to practice contraception. A significant proportion of Canadian women are essentially making a spontaneous decision in the absence of any planning for sexual activity."
"It's fair to say a wide swath of the sexually active adult population in Canada is not taking care of their sexual and reproductive health."
"We sometimes make the assumption that as teenagers grow into young adults and then into full adulthood, they become naturally more responsible. But we know condom use declines with age. I don't see anything that shows people get better at protecting sexual and reproductive health as they get older."
Alex MacKay, executive director, Sex Information and Education Council of Canada

Condoms are one of the favoured forms of contraception, according to a survey of more than 3,200 Canadian women. WPpost image

A recent survey undertaken by the Society of Obstetricians and Gynaecologists of Canada revealed some interesting, somewhat surprising and most certainly disappointing realities. One of the survey's major findings was that women no longer seek contraceptive information from doctors; instead they look online for their options, even though many of the women responding to the survey stated that they don't necessarily trust online information.

The fact that women, who at one time saw their doctors on a yearly basis for an annual Pap smear, and that routine has been placed on a back burner, with women seeking out their family doctor less frequently may explain in part the situation. What was also revealed was that one in four women has no idea how to proceed when they miss taking a birth control pill, or other hormonal contraception.

IN response to this situation the SOGC is preparing to release a new online source they have named S.O.S., meant to guide women through that scenario and what their response should be. The website SexandU.ca has also been relaunched, with plans to publicize a media campaign later in the year. An online program will expose women to the best forms of contraception from among an array of options, based on age and circumstances.

What the results of the survey revealed that turned out to be the most surprising element relating to contraceptive methods was the identification of one of the most favoured contraception methods; withdrawal. Women in the survey placed withdrawal in third place, following birth control pills and condoms, out of a menu of various contraceptive options.

While Dr. Blake doesn't mind acknowledging that withdrawal can be recognized as a type of contraception, she emphasizes that this cannot be considered a sound pregnancy prevention method, in particular for younger people. Let alone the concerns surrounding the contact and spread of sexually-transmitted infections.

That, added to the fact that most women appeared unaware of many of the contraceptive options that currently exist, surprised the researchers. That many women knew nothing of intrauterine devices (IUDs) as representative of one of the most effective contraceptives available, points to a severe lack of responsibility on the part of women of child-bearing age who are sexually active. A mere 3.7 percent of women in the survey reported having used a copper IUD, while 7.1 percent only had used an intrauterine system or hormonal IUD.

The survey results appear to confirm previous research findings that birth control pills and condoms overwhelmingly represent the most popular forms of birth control. Yet the frequency with which women cite withdrawal as a contraceptive method has the researchers concerned. Withdrawal was used by close to 29 percent of women between the ages of 15 and 19 who responded to the SOGC survey.

In comparison, 45 percent of women between 20 and 29 and 42.7 percent of women between 30 and 50 also made contraceptive use of withdrawal; age demographics that the medical profession might imagine would know better. Concern was also raised over the fact that greater numbers of young women between the ages of 20 to 29 used withdrawal than did teens.

That old adage that "We get too soon old and too late smart" appears to have undergone a strangely unaccountable reversal.