Improvement of semen quality by nocturnal scrotal cooling in oligozoospermic men with a history of testicular maldescent.

For infertile men with a history of testicular maldescent only few therapeutic options exist beside assisted reproduction. The aim of our study was to evaluate the influence of nocturnal scrotal cooling on semen quality in such patients presenting with oligozoospermia. Twenty infertile men with a history of testicular maldescent and oligozoospermia were included for nocturnal scrotal cooling over 12 weeks for every night. To increase nocturnal periscrotal air circulation we used a membrane pump connected via plastic tubes to receptacles placed in both groins. Semen analysis was performed at the beginning of the cooling period and at weeks 4, 8 and 12. Another 20 infertile patients with a history of testicular maldescent and oligozoospermia were followed without specific treatment and served as a retrospectively built control group. Scrotal cooling at night by means of a perigenital air stream resulted in a scrotal temperature drop by 0.8 degrees C (median). A significant increase in sperm concentration and total sperm count was achieved by nocturnal cooling after 8 weeks (p < 0.01; p < 0.05; respectively) and 12 weeks (p < 0.01; p < 0.01; respectively). The improvement of sperm motility and sperm morphology was statistically insignificant. The present study suggests nocturnal scrotal cooling as a therapeutic option to improve semen quality. In a further controlled prospective study the influence on pregnancy rates should be evaluated.