Jung A, Schuppe H-C
Center of Dermatology and Andrology, Justus Liebig University, Giessen, Germany.
Andrologia. 2007 Dec;39(6):203-15. doi: 10.1111/j.1439-0272.2007.00794.x.
The concept that an elevation of testicular temperature results in impairment of spermatogenesis is widely accepted. Here, current knowledge concerning genital heat stress and its consequences in men is reviewed. Duration of sitting during work positively correlates with daytime scrotal temperatures and daytime scrotal temperature negatively correlates with semen quality. However, the assumed negative correlation between duration of sitting and semen quality could not be shown in the available studies. Fertility parameters of professional drivers with long periods of sitting in vehicles were impaired; however, for predominantly affected drivers of vans, trucks or industrial heavy machinery potential confounders have to be considered. Wearing tight fitting compared with loose-fitting underwear is associated with significantly higher scrotal temperatures. However, available observations suggesting a link between tight-fitting underwear or trousers and impaired semen quality are not convincing. Studies addressing professional exposure to high temperatures delivered conflicting results concerning fertility parameters. The postulated negative impact of sauna visits on semen quality is not sufficiently underlined by the available studies. Oligozoospermic men with a varicocele have significantly higher scrotal temperatures than normozoospermic men, and according to several studies varicocelectomy normalises scrotal temperatures. A further link has been reported between fever and deteriorated semen quality. Contraception via genital heat stress has been demonstrated using hot sitting baths or insulating suspensors. However, down-regulation of spermatogenesis is inconsistent and unsafe. On the other hand, scrotal and consecutively testicular cooling is able to improve semen quality.
睾丸温度升高会导致精子发生受损这一概念已被广泛接受。在此，我们综述了目前关于男性生殖器热应激及其后果的相关知识。工作时坐着的时长与白天阴囊温度呈正相关，而白天阴囊温度与精液质量呈负相关。然而，在现有研究中未能证实久坐时长与精液质量之间存在假定的负相关关系。长时间坐在车内的职业司机的生育参数受损；然而，对于主要受影响的货车、卡车或工业重型机械司机，必须考虑潜在的混杂因素。与穿着宽松内裤相比，穿着紧身内裤会使阴囊温度显著升高。然而，现有观察结果表明紧身内裤或裤子与精液质量受损之间存在关联，这并不令人信服。针对职业性高温暴露的研究在生育参数方面得出了相互矛盾的结果。现有研究并未充分证实桑拿对精液质量的假定负面影响。患有精索静脉曲张的少精子症男性的阴囊温度显著高于正常精子症男性，并且根据多项研究，精索静脉结扎术可使阴囊温度恢复正常。发热与精液质量恶化之间也有进一步的关联报道。通过热坐浴或隔热悬带已证实可通过生殖器热应激进行避孕。然而，精子发生的下调并不一致且不安全。另一方面，阴囊以及随之而来的睾丸降温能够改善精液质量。
