title: Twenty-four-hour monitoring of scrotal temperature in obese men and men with a varicocele as a mirror of spermatogenic function.
abstract: OBJECTIVE
  How do day and night scrotal temperatures, spermatogenesis parameters, sex hormones and intratesticular perfusion in obese men and men with a varicocele compare with healthy controls?
  
  
  CONCLUSIONS
  Compared with healthy controls, 24-h monitoring of scrotal temperature in men with a varicocele and obese men showed higher temperatures and this condition was related to a significant alteration of spermatogenesis and stasis of testicular perfusion.
  
  
  BACKGROUND
  Several studies have shown that increased scrotal temperature has dramatic effects on spermatogenesis. Scrotal hyperthermia by exposure to sauna is able to induce a significant alteration of sperm production.
  
  
  METHODS
  In a case-control study, data were collected over a period of 2 years from 60 subjects with risk factors for testicular heating and 20 healthy subjects who consecutively attended an andrology unit as participants in an infertility prevention program.
  
  
  METHODS
  Forty subjects with a left varicocele, 20 obese men and 20 healthy subjects who served as controls, were evaluated for testicular volumes, sex hormones, sperm parameters, sperm aneuploidies, mean transit time (MTT) of intratesticular blood and 24-h scrotal temperature monitoring by a cutaneous thermochip. Subjects with a varicocele were further subgrouped on the basis of normo or oligozoospermia (VN and VO). Student's t-test was used for statistical analysis.
  
  
  RESULTS
  We found a significant increase in 24-h mean scrotal temperature in obese men and men with a varicocele compared with controls (both P < 0.01). This increase in scrotal temperature was associated with impaired sperm parameters and higher FSH plasma levels compared with controls. Dynamic evaluation of scrotal temperatures showed wide fluctuations in controls, but little variation in obese men and men with a varicocele. Men with VO had left and right increase in scrotal temperatures (the right was increased also versus VN, P < 0.01) (both P < 0.001). Men with VN showed a left scrotal temperature higher than controls (P < 0.01) and a right scrotal temperature no different from controls (34.92 ± 0.53 and 34.66 ± 0.65, respectively). Mean MTT values recorded in men with VO were significantly higher than men with VN and obese men (both P < 0.001).
  
  
  CONCLUSIONS
  Different lifestyle, diet, occupation, stress level and environmental temperatures due to seasonal conditions are major limitations of this study.
  
  
  CONCLUSIONS
  Our data suggested for the first time that dynamic evaluation of scrotal temperatures seems to reflect alterations of testicular function and perfusion in obese men and men with a varicocele. In these clinical conditions, spermatogenic impairment and scrotal heating seem to be related to different mechanisms. The dynamic evaluation of scrotal temperature in subjects with risk factors for testicular heating could allow the identification of subjects needing treatment or a change in lifestyle.
  
  
  BACKGROUND
  No external funding was sought for this study, and the authors have no conflict of interest to declare.
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Garolla
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Torino
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy.
authors.forename: Paride
authors.initials: P
authors.lastname: Miola
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Caretta
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Pizzol
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Menegazzo
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bertoldo
authors.affiliation: Department of Molecular Medicine, Section of Clinical Pathology and Pathology of Human Reproduction Unit University of Padua, Via Gabelli 63, Padova 35121, Italy carlo.foresta@unipd.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Foresta
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001831:Body Temperature; D016022:Case-Control Studies; D002875:Chromosomes / Q000648:ultrastructure; D064368:Healthy Volunteers; D006728:Hormones / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D009845:Oligospermia / Q000503:physiopathology; D012307:Risk Factors; D012611:Scrotum / Q000000981:diagnostic imaging / Q000473:pathology*; D013091:Spermatogenesis; D013094:Spermatozoa / Q000473:pathology; D013737:Testis / Q000503:physiopathology; D014463:Ultrasonography; D014646:Varicocele / Q000175:diagnosis / Q000503:physiopathology*
chemical_list: D006728:Hormones
keywords: male infertility; obesity; spermatogenesis; testicular heating; varicocele