Boxers or briefs?

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 because of style, comfort and everything in between.

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

Heat can impact sperm health

According to Donald Tice, DO, a family doctor with Baptist Primary Care, several studies have found that men who wore boxers instead of briefs had higher sperm count and lower follicle-stimulating hormone (FSH) levels. FSH helps produce more sperm and is needed in higher doses when sperm is being damaged by say, semen-hostile underwear.

“Many articles mention a temperature rise in the scrotum between 0.9 and 3.6 degrees Fahrenheit when wearing briefs rather than boxers,” said Dr. Tice. “That could be enough to decrease sperm count and motility [ability to move], and adversely affect the shape of the sperm.”

The theory as to why this could stifle your swimmers is that 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.

However, Dr. Tice said that before men go blaming their underwear for infertility problems, there are a variety of other things to consider.

“When a couple is having difficulty getting pregnant, the first thing for a man to do is to get a sperm count and motility analysis in which a sample is taken at a lab and the sperm is examined under a microscope. If there's a low sperm count or poor motility, then scrotal temperature or other influences may be a factor.”

But there are lots of things besides underwear choice that can elevate temperature or damage sperm. Dr. Tice explained that frequent hot tub usage or sauna sessions will temporarily decrease sperm count and motility, and may do DNA damage.

Other causes of male fertility issues

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

Diabetes, hypertension (high blood pressure) 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.

Lifestyle choices are another big culprit.

“Other situations that have been linked to lower sperm count include smoking, excessive alcohol intake, recreational drugs such as marijuana and cocaine, obesity, stress and STDs, to name a few,” said Dr. Tice.

So, if you’re trying to have a baby, a simple swap may be worth it. Do anything that could help improve your chances. At the end of the day, it’s not hard to buy a different pair of underwear.