title: A study of the effect of the FertilMate™ Scrotum Cooling Patch on male fertility. SCOP trial (scrotal cooling patch) - study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Male infertility is a significant contributor to the need for fertility treatment. Treatment currently involves correcting any identifiable adverse lifestyle factors in men with suboptimal sperm parameters, and if these measures are unsuccessful, assisted conception is offered, which can be quite expensive. Raised scrotal temperature is one of the least studied but easily corrected risk factors for male infertility. In a recent review of the literature, sperm count, motility and morphology improved with scrotal cooling devices. The devices used to achieve testicular cooling were, however, not practical for day-to-day use. A potentially more practical device for scrotal cooling has recently been developed. The Babystart® FertilMate™ Scrotum Cooling Patch is a hydrogel pad which allows for comfortable application. The aims of this study were to investigate whether exposing the scrotum to lower temperatures by means of these new patches could improve semen parameters, thereby improving fertility, and to assess the feasibility of a clinical trial.
  
  
  METHODS
  This is a randomised controlled trial set in a university teaching hospital in the United Kingdom. The proposed sample size was 40 men with mild, moderate or severe oligoasthenospermia, of whom 20 would be randomised to wearing the scrotum cooling patch for 90 days and 20 men would be acting as controls and not wearing the patches. The primary outcome measure was the change in sperm concentration. Secondary outcome measures included the change in sperm volume, motility and morphology; endocrine parameters; metabolomic biomarkers; testicular volume and blood flow. Reasons for dropping out and non-compliance were also going to be noted and reported.
  
  
  CONCLUSIONS
  The study started recruiting in October 2011 and as of November 2011 four men had been consented and were participating in the study. No operational challenges had been encountered at the time of the submission of this manuscript. Although the study also aimed to evaluate the feasibility of a definitive study, the change in sperm count after 90 days of wearing the scrotal cooling patches was made the primary outcome measure because a statistically significant improvement in sperm parameters with the scrotal patches would in itself be a definitive finding.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN94041896.
authors.affiliation: Department of Obstetrics and Gynaecology, Nottingham University Hospital Queen’s Medical Centre Campus, Derby Road, Nottingham, NG7 2UH, UK.
authors.forename: M Waseem
authors.initials: MW
authors.lastname: Osman
authors.forename: Llias
authors.initials: L
authors.lastname: Nikolopoulos
authors.forename: Zeina
authors.initials: Z
authors.lastname: Haoula
authors.forename: Jayaprakasan
authors.initials: J
authors.lastname: Kannamannadiar
authors.forename: William
authors.initials: W
authors.lastname: Atiomo
mesh_terms: D053627:Asthenozoospermia / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D001833:Body Temperature Regulation; D004739:England; D004867:Equipment Design; D006785:Hospitals, University; D006801:Humans; D020100:Hydrogels; D007036:Hypothermia, Induced / Q000295:instrumentation*; D008297:Male; D009845:Oligospermia / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D012107:Research Design; D012611:Scrotum / Q000503:physiopathology*; D012720:Severity of Illness Index; D013076:Sperm Count; D013081:Sperm Motility; D013091:Spermatogenesis; D013094:Spermatozoa / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D020100:Hydrogels