Abstract

BackgroundMale 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/designThis 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.DiscussionThe 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.Trial registrationCurrent Controlled Trials ISRCTN94041896

Highlights

  • Male infertility is a significant contributor to the need for fertility treatment

  • The study 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

  • Male infertility is a significant contributor to the need for fertility treatment in the UK and approximately onethird of in vitro fertilisation cases are due to male factor infertility

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Summary

Discussion

This study addresses an important but insufficiently explored area of male fertility. We have used the opportunity to investigate whether changes in endocrine levels and serum metabolomic profiles, which are possible surrogate markers of male fertility, occur as a result using the scrotal cooling patches. Assessing compliance was considered to be an important issue to address as there were no valid biological variables identified for measuring compliance to the scrotal cooling patches. One challenge is determining whether or not any differences or improvements identified in this study could translate into improved live birth rates, which is the primary outcome measure of interest in couples presenting to the fertility clinic. Doi:10.1186/1745-6215-13-47 Cite this article as: Osman et al.: A study of the effect of the FertilMateTM scrotum cooling patch on male fertility. SCOP trial (scrotal cooling patch) - study protocol for a randomised controlled trial.

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