It must be considered that there is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. Machiavelli: The Prince (1513) These are the Proceedings of a Conference on Temperature and Environmental Factors and the Testis which took place at New York University School of Medicine, December 8th and 9th, 1989. There is good reason to believe that this was the first of its kind to address, exclusively, the implications of temperature for this highly thermosensitive organ and its precious genetic cargo. The organizers of the Conference hoped to stimulate interest in this area which, paradoxically, has a considerable literature but which has received scant attention and sometimes outright opposition from clinicians expert in male infertility. There have been studies of the relationship of temperature to reproduction starting in the mid-18th Century with observations of the relationship of water temperature to spawning of fish. There is also a vast literature on the deleterious effects of externally applied heat upon spermatogenesis but little study of the possibility that intrinsic heat may be an important etiologic factor in subfertile semen. Today, fertility research has largely ignored this in favor of research in areas which have not produced successes, in terms of live births, comparable to what can be obtained by varicocelectomy (when appropriate) or scrotal hypothermia: viz. 1. Concentration upon the endocrine aspects of testicular function and its relation to spermatogenesis.
Table of ContentsViews of Testicular Function from Antiquity to the Present.- 1 Testis Thermoregulation: An Overview.- Thermoregulation of the Scrotum and Testis: Studies in Animals and Significance for Man.- Effects of Elevated Temperature on the Epididymis and Testis: Experimental Studies.- Effects of Temperature on the Biochemistry of the Testis.- Epidemiologic Aspects of the Relationship between Temperature and Male Reproduction.- 2 Environmental Factors.- Seasonal Patterns of Births and Conception throughout the World.- Temperature and the Seasonality of Births.- Seasonal Variation in Human Semen Quality.- 3 Testis Thermometry.- Theoretical and Practical Considerations in Scrotal Temperature Measurement.- Non-Invasive Scrotal Thermometry.- Deep Body Intrascrotal Thermometer: Theory and Methodology.- 4 Temperature Pathophysiology Of The Testis.- A Theoretical Model for Testis Thermoregulation.- The Multi-Level Compartmentation of the Simulation Models of the Counter-Current Heat Exchange (CCHE) Mechanism of the Testis.- The Physiology of Testicular Thermoregulation in the Light of New Anatomical and Pathological Aspects.- Effect of Local Heating on Scrotal Temperature.- Is Testicular Function in Immature Rats Increased rather than Decreased by a Moderate Increase in Temperature?.- The Effect of Intermittent Scrotal Hyperthermia on the Sprague-Dawley Rat Testicle.- Human Scrotal Temperature during Heat Exposure Associated with Passive Leg Heating.- Effect of Medullary Lesions on Scrotal Thermoregulation: A Preliminary Study.- 5 Intrinsic Heat Effects.- Intrinsic Testicular Temperature Elevation and Subfertile Semen.- Scrotal Hyperthermia: Frequency in an Infertile Population and Associated Alterations in Testicular Function.- Scrotal Hyperthermia; Etiologic Factors: Facts and Hypotheses.- Testicular Hyperthermia: Physiopathology, Diagnostic and Therapeutical Concepts.- Hypothesis to Explain Subfertile Semen.- 6 Therapeutic Uses of Heat Transfer.- Chronic Scrotal Hypothermia.- Heat Induced Inhibition of Spermatogenesis in Man.- 7 Varicocele: Diagnosis, Pathogenesis And Treatment.- Scrotal Hyperthermia and Varicocele.- The Significance of Elevated Scrotal Temperature in an Adolescent with a Varicocele.- Deep Body Temperature Measurement for the Noninvasive Diagnosis of Varicocele.- A Comparative Study of the Diagnostic Value of Telethermography and Contact Thermography in the Diagnosis of Varicocele.- Scrotal Thermography in Varicocele.- The ROCC Analysis of Five Different Methods in the Diagnosis of Varicocele.- The Pathogenesis of Epididymo-Testicular Dysfunction in Varicocele: Factors other than Temperature.- Varicocelectomy: Effect on Fertility.- Participants.