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Boxers vs. Briefs: Is One Better For Sperm Count?

In this video, we visit Dr.Kasraeian on the daily dose as he explains how the different underwear men wear has an impact on sperm count.


Andy: To be or not to be, who said that? Shakespeare was wrong. To be or not to be is not the question. Boxers or briefs, while the decision is all about personal preference, many people believe that one may be better than the other when it comes to sperm count, so we're going to get the answers here because Dr. Kasraeian's joining us for the Weekly Dose. Dr. Kasraeian, you're a urologist — so you're the best person to ask about this. Hearing this question as a guy, since you were a teenager, is it true?

Ali Kasraeian: It is true. It is true.

Andy: Oh no.

Ali Kasraeian: And I know you're very upset by this.

Andy: But I just had a kid, and I've been wearing what I would consider briefs, compression shorts.

Ali Kasraeian: Again, this isn't a steadfast rule that everyone that wears briefs is not going to be able to have children.

Andy: Clearly.

Ali Kasraeian: Yeah, absolutely. Success.

Andy: Exhibit A.

Ali Kasraeian: The reason to think about, and this isn't new information, it's just a bigger study kind of verifying it — so it seems to be the official commentary to settle the debate. The way the scrotum is designed, your testicles are actually outside the body. They're at a lower temperature than the rest of the body because the process of spermatogenesis, the creation of sperm, needs a cooler process. The body's actually designed in a great way with its own internal refrigerator system. Your artery that brings blood from the body to the testicles is surrounded by what's called the pampiniform plexus. It's a plexus of veins that now is bringing the cooler temperature up — so it kind of cools the blood that's going to the testicle, creating a little bit of a refrigerator system. The idea with boxers is that you are wearing something that's not as compressive, as form-fitting — so the testicles can be a bit further away and maintain that temperature. That's the idea of the physiology of why this would be potentially true.

Andy: All right.

Ali Kasraeian: Are you okay?

Andy: I think I'm all right, because like I said, I just had a child a few weeks ago.

Ali Kasraeian: Congratulations.

Andy: And I think maybe the reason is because compression shorts and giving everybody all the information in the world, don't look below the table, but they're dry fit — so they breathe well.

Ali Kasraeian: Sure. For athletics, if someone is dealing with fertility issues, and that's one thing with the study, it was more than 650 patients followed over a 17-year period up at Harvard — Harvard's where the study was done — who were coming in for fertility issues. Again, half the time, it's a male issue, half the time it's a female issue. That's one thing about the study to take with a grain of salt. There's a lot of patients followed for a long period of time. If someone's having this issue, this is good information to have. The people that wore boxers had a better sperm concentration, meaning the amount of sperm per ejaculate, they had a higher sperm count by 25% and 17%, respectively. They also had a lower FSH, follicle-stimulating hormone, which is a hormone.

Andy: What's that?

Ali Kasraeian: It basically is a hormone that helps with the production of sperm. People that wore briefs, their numbers were about 14% higher, meaning their bodies are trying to rile things up to get more sperm.

Andy: It's having to work harder.

Ali Kasraeian: Right. One thing that you could do, if you're concerned about this is wear boxers in any nonathletic event that you're doing and then during the time that you're doing something athletic or doing something that you feel like you need a bit more support, wear something more like a brief or a sports underwear during that period of time.
Andy: With fertility issues, people talk about it, the count is one thing, the number of sperm we've heard that one before but the health of the sperm?

Ali Kasraeian: The health of the sperm is something to think about. Again here, the thing they found was that it affect mostly the count of the sperm from that standpoint. There weren't any statistically significant differences in what's called the morphology of the sperm. That's different. And all these guys came in, they had a sperm analysis, they had blood work done, and they also had a question that they answered regarding what kind of underwear they wore. It's interesting information to take from that standpoint. Right now, 52% lower sperm counts and sperm rates in the world between 1973 and 2011, so anything we can do to kind of up the amount would be a good thing. And if people are worried about this stuff, this is a simple, easy thing to try.

Andy: Worldwide since 1972?

Ali Kasraeian: 1973 to 2011, when they're studying, there's about a 50% plummeting of the sperm rates.

Andy: Worldwide.

Ali Kasraeian: Worldwide. Mystery because the reasons are unknown.

Andy: Thanks Fruit of the Loom. Well, now that my wife is probably hitting Amazon for a bunch of briefs to send to our house.

Ali Kasraeian: Andy, you're not alone, 53% of people wore boxers everyone else wore something else.

Andy: Actually, she's probably going boxers. She wants four more kids.

Ali Kasraeian: Okay, so boxers.

Andy: We're going to be okay, babe. Don't worry.

Ali Kasraeian: He'll be fine.

Andy: Another topic that this time of year with the summer mosquitoes that can get people panicked when they hear West Nile Virus and mosquitoes.

Ali Kasraeian: Absolutely.

Andy: Is this something we seriously go to worry about in Jacksonville?

Ali Kasraeian: Well, and Jacksonville was one of the places, actually there's some cases reported. All over the country, the West Nile Virus has been seen and it's basically from mosquito bites. The thing to take away from this is the best way to avoid the West Nile Virus is to prevent mosquito bites. Simple things you can think about, insect repellent. You can go to the CDC site at and find out what are the appropriate EPA approved, the Environment Protection Agency approved, registered insect repellents to use. Follow the instructions, be mindful of how to give them to children. You don't want to use them in children less than two months of age. That's something to keep in mind. Wear clothes that are covering your skin as much as possible. If you're in a place, especially if you're in a place that you're worried about it.

And with children, be mindful. Mosquito nets are things to keep in mind on cribs and strollers and baby carriers, and make sure they're covered as well. Empty out standing water. That's something that we don't think about. If you have a pot, if you have a tire, if you have a standing kind of plastic pool or inflatable pool, make sure that the water isn't sitting around for long periods of time, at least once a week, make sure you empty things out because mosquitoes, they lay their eggs and they breed. It's a fertile ground for breeding in standing bodies of water.

Andy: But the West Nile, I lived in Egypt for years  —so I know that the Nile is a river. And so it's called West Nile. Why are we worried about it in mosquitoes here in Jacksonville?

Ali Kasraeian: Because specific mosquitoes carry different types of bugs. And so with this particular virus has been shown in bugs, in the United States and in Florida they have seen them. Fortunately, most people they get infected with the West Nile Virus have no symptoms. However, one out of five infected people develop very nonspecific symptoms, fever, they get body aches, they get joint pain, they can get some nausea and vomiting, diarrhea, and then you can get a rash. However, it can progress for some people, and one out of 150, get a more severe effect on their central nervous system, brain, spinal cord, and that can be much more serious in terms of having very high fevers. People can get seizures. They can feel disoriented.

Andy: Pay attention to mosquito bites if you get them.

Ali Kasraeian: If you get a high fever, if you get neck pain, really, really be mindful for going in there. Can cause vision loss or can be some paralysis issues.

Andy: You're starting to scare me.

Ali Kasraeian: No, no. Be mindful of it because and again, the thing for this is something we can prevent. It's preventable but be mindful. If you start noticing any of these nonspecific symptoms, go talk to your doctor.

Andy: All right. As we finish up here, I'm going to ask you, doctors always ask patients pain level or concern level on a scale of 1 to 10. Concern level on West Nile in Jacksonville, just so our viewers can rest easy. Concern level 1 to 10.

Ali Kasraeian: I would say probably an eight.

Andy: Dang it.

Ali Kasraeian: Because it's something preventable.

Andy: Dang it.

Ali Kasraeian: And the thing to think about in terms of that number, if you get it, it's something serious. If not, it's something that you can usually most of the time prevent. The other thing, our heart goes out to Aretha Franklin. One of the cool things about her, she's most proud of her job as a mom.

Andy: Very cool. Appreciate doc, always learned stuff with you. More information on Dr. Kasraeian, you can head to Dr. Kasraeian's website, which is or you can listen to him live and call into his radio show, The Conversation. It's on WOKV and airs every Saturday, starting at 5:00 PM.