A 37-year-old man reports that he has had recurrent epididymitis and external hemorrhoidal bleeding for the past three years. Recently, he was told that he suffers from oligospermia. Otherwise, he has always been in excellent physical and mental health. He does not take any medication or smoke. His alcohol intake is limited to an occasional glass of wine each week. Further questioning, including a sexual history, uncovered nothing remarkable. The patient commented that he drives a car with heated seats. Are there any studies that would link my patient’s complaints with his car seats?—LOUIS A. KATZ, MD, New York City

Superstitions abound regarding activities that might elevate intra­scrotal temperature and thereby cause oligospermia. These range from wearing jockey shorts to taking frequent saunas. I have not heard of risk associated with heated seats. In one study, 21 healthy male volunteers wore polyester-lined athletic supports (single layer, double layer, or double layer impregnated with aluminum) throughout the day for 52 weeks (Fertil Steril. 1997;68:334-339). In all three groups, despite increased scrotal temperature, sperm motility, morphology, mean sperm concentration, and viability were unaffected. This would seem to dispel the myth that external heat contributes to oligospermia.—David T. Noyes, MD (144-6)