September 16, 2019/Urinary & Kidney Health

Are You Unknowingly Lowering Your Sperm Count? When to Worry

A urologist explains male infertility myths and facts

Man pointing to test results on a tablet

There’s ample information — and misinformation — out there about the causes of male infertility, or the inability to father a child.


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It’s true that regular exposure to highly elevated temperatures in the testicles can lower sperm counts. But not all of the suspected culprits are actually supported by research. Here urologist Sarah Vij, MD, sorts out what men need to know.

Tight underwear

Many men worry whether they should switch from briefs to boxers. The fear is that the tighter briefs keep the testicles closer to the body. The result: warmer testicles and infertility.

“Studies show that it probably doesn’t matter,” Dr. Vij says. “We tell our patients to wear what is comfortable.”


Portable computer designers made laptops convenient enough to place directly in your lap. They generate heat, though, so they can raise the temperature of the testicles over time.

Some laptop pads shield the testicles from the heat, but only for a short period of time. Dr. Vij recommends using your laptop on a desk or table.

Saunas and hot tubs

Even in a hot sauna, the testicles — because of their structure — may be able to remain slightly cooler.

Hot tubs, though, are problematic because the testicles are completely submerged in the hot water and have no way to cool off. Instead, they warm up to a higher level than doctors consider safe for healthy fertility, Dr. Vij says.

If you’re worried about infertility, it’s best to skip the hot tub, Dr. Vij says.


Cell phones

The effect of cell phones on sperm counts is highly debated. The bottom line is the jury is still out whether it has an effect, Dr. Vij says.

While there are a variety of factors involved — where you keep your phone and what kind you have, for instance — the goal is to minimize things that impair fertility.

There are several studies on cell phones and sperm counts,” Dr. Vij says. “In studies where we directly exposed sperm to cell phone radiation, it did damage the sperm but this is still controversial.”


Certain drugs — legal and illegal — can have a negative effect on a man’s fertility. If you have concerns about your fertility, talk to your doctor before starting a new medication or treatment.


If you smoke, kicking the habit can improve your fertility.

Semen analysis of smokers reveals trace elements from tobacco. These chemicals lower sperm count and sperm’s ability to move spontaneously and actively. Tobacco also appears to fragment the DNA in the sperm, which damages genetic material.

Dr. Vij strongly encourages her patients to quit smoking forever, if possible. But smokers need to quit at least during the time they are trying to conceive.


Much of the research done on marijuana shows it can alter fertility substantially. It affects the motion of the sperm and lowers testosterone levels.


It’s best to avoid marijuana, especially during the time a man and his partner are trying to conceive, Dr. Vij says.

Anabolic steroids

Some people think that if a man uses anabolic steroids, the synthetic hormone will increase testosterone and improve fertility. Actually, it does just the opposite.

The testicles sense there is enough testosterone in the body, so they can completely shut down.

Discuss the use of steroids with your physician, especially if you are trying to conceive, Dr. Vij says.

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