Stay cool! Special underwear for cyclic cooling significantly decreases scrotal skin temperature.

Introduction Male reproductive health is rapidly declining during the past decades and it is well known that scrotal temperature is linked to male infertility. Material and methods We performed a prospective data evaluation within a counterfactual analysis study design. Scrotal cooling was performed using Snowballs™ underwear, scrotal temperature was monitored using a wireless temperature sensor (SensorPush, Brooklyn, NY, 11215). Results Overall, scrotal skin temperatures were monitored for 1008 hours. Median scrotal skin temperature was 34.6°C (IQR 33.1 to 35.3) and 35.3°C (IQR 34.4 to 35.9) in the experimental (SnowWedge™) period and control period, respectively, which was significantly different (P <0.001). Conclusions Cyclic scrotal skin cooling using specialized underwear is feasible and efficacious without impairing the activities of daily living and reduces median scrotal skin temperature significantly by 0.7°C. Given the proven association of scrotal skin temperature and semen quality, cyclic scrotal skin cooling by a device such as Snowballs™ underwear may eventually increase semen quality and fertility.