Boxers or Briefs: Myths and Facts about Men's Infertility

Last Editorial Review: 1/30/2005

WebMD Feature

When a couple is diagnosed infertile, first thoughts often run to the woman. She's barren. She can't conceive. She's not a "complete" woman because she can't get pregnant. As nature would have it, problems with infertility are equally due to male and female conditions.

Infertility is the inability to get pregnant after one year of unprotected sexual intercourse. Statistics suggest that 35 to 40 percent of the problems are caused by male conditions, another 35 to 40 percent by female conditions, and the last 20 to 30 percent a combination of the two, plus a small percentage of unknown causes.

Men's part in fertilization is quite amazing. About 200 million sperm are mixed with semen to form ejaculate. In most men, 15 to 45 million of these sperm are healthy enough to fertilize an egg, although only 400 survive after a man ejaculates. Only 40 of those 400 reach the vicinity of the egg, surviving the toxic environment of the semen and the hostile environment of the vagina. After another process called capacitation (an explosion that allows the remaining sperm to drill a hole through the tough outer layer of the egg), only one lone sperm reaches the egg for fertilization and conception.

Top Causes of Male Infertility

  • Low sperm count
  • Slow sperm motility (movement)
  • Abnormal morphology (shape and size of sperm)
  • Problems with semen

Even though specialists know the causes of male infertility, what's not always known is the cause behind the cause. There are many factors -- lifestyle, genetics, physiology -- that might explain low sperm count, slow sperm mobility, abnormal sperm shape, and so on.

Recent developments in treatment have made fertility possible for many men. But before undergoing any complicated procedures, there are some simple lifestyle changes that can better the odds of a successful conception. (These tips are helpful for any couple trying to conceive, whether or not infertility has been diagnosed.)

  • Stop smoking cigarettes or marijuana. Smoking tobacco has been linked to low sperm counts and sluggish motility. Long-term use of marijuana can result in low sperm count and abnormally developed sperm.
  • Decrease your drinking. Alcohol can reduce the production of normally formed sperm needed for a successful pregnancy.
  • Watch your weight. Both overweight and underweight men can have fertility problems. With too much weight, there can be hormonal disturbances, and when a man's too lean, he can have decreased sperm count and functionality.
  • Exercise in moderation. Excessive exercise could lower your sperm count indirectly by lowering the amount of testosterone in your body. And as you might have guessed, stay off the steroids -- they can cause testicular shrinkage, resulting in infertility.
  • Value your vitamins. Low levels of vitamin C and zinc can cause sperm to clump together, so keep your numbers up. Vitamin E can counteract excess free-oxygen radicals, which can also affect sperm quality.
  • Turn your back on toxins. Landscapers, contractors, manufacturing workers, and men who have regular contact with environmental toxins or poisons (pesticides, insecticides, lead, radiation, or heavy metals) are all at risk of infertility.

Have you ever heard the debate about whether men should wear boxers or briefs? It goes something like this: Briefs are tighter, so it's possible that they can raise your body temperature above the norm for sperm to survive. So if a guy wants to be really fertile, boxers are the way to go. Truth is, this has yet to be scientifically proven. But if you're trying to get pregnant, there's no harm in wearing loose clothing and staying out of hot tubs and saunas.

Since infertility affects one in 25 men these days, maintaining a healthy lifestyle and a positive attitude is the way to go if you're considering becoming a father.

Additional Factors That May Inhibit Men's Fertility

  • Certain antibiotics
  • Narcotics (cocaine, speed, etc.)
  • Abstinence from sex (for more than a few days)
  • Variococeles (varicose veins in the testicles)
  • Untreated infections (sexually transmitted and otherwise)
  • Radiation and chemotherapy treatments
  • Fevers
  • Exposure to DES during your mother's pregnancy
  • Excessive stress
  • Testosterone deficiency

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