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Boxers or briefs?

Male fertility is linked to lots of things, not just underwear

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(Baptist Health)

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Admit it. It's a conversation you've had before, if only a very private one inside your head.

Which is better, boxers or briefs? The debate has long raged, and men come down on either side of it for reasons of style, comfort, sexiness, and even fertility.

But do boxers really win over briefs when it comes to fertility? There's medical research that suggests they do.

A study published last summer in the journal Human Reproduction found men who wore boxers instead of briefs had a higher sperm count and lower FSH levels. FSH is a hormone that kicks in to produce more sperm. It's something that's needed in higher doses when sperm is being damaged by say, semen-hostile underwear.

Wearing boxers to improve your chances of conceiving may sound like superstition. But Jonathan Gonzalez, MD, a family doctor with Baptist Primary Care, said it's an idea that's been around for a while. 

"There were a couple of studies a long time ago where researchers thought tight briefs created infertility issues because they elevated the testicles and changed their temperature one or two degrees," he said.

The theory being, testicles warm up when held tight to the body. When allowed a little more space, they cool. That could matter because a too-high temperature can hurt sperm.

But there are lots of things that can elevate temperature or damage sperm.

Marijuana, drugs and alcohol are all causes Dr. Gonzalez has talked with patients about. Tighty whities? Not so much.

"I've never sat with a couple where somebody out there had told them the tightness of their underwear caused infertility," he said. "It's kind of far fetched."

So, when it comes to male infertility, what kinds of things do doctors look at?

Diabetes, hypertension and high cholesterol are all considered because these conditions affect the blood flow. They're more common later in life, but with today's obesity epidemic, they sometimes appear in patients during their reproductive years.

Anabolic steroids are another big culprit.

"Sometimes guys in college do steroids for a year or two, and it gets them behind when they try to have a kid later on in life," Dr. Gonzalez said. "It drops their testosterone, and so they don't produce as much sperm."

Though he doubts tight underwear is at the root of infertility, for couples who are trying for a baby, it doesn't hurt to think about it, Dr. Gonzalez said.

"You want to optimize everything," he said. "It's like—when you put a cake in the oven, you want the perfect temperature. You want the perfect non-stick pan. You want everything to be perfect."

So, if you're trying to have a baby, go for it. Do anything that could help. At the end of the day, it's not hard to simply buy another pair of underwear.

For more answers about fertility, contact your Baptist Health primary care physician, who may refer you to a specialist if needed. If you don’t have a primary care provider, call 904-202-4YOU or visit Baptist Primary Care to find a doctor near you.