Background: Men often report the concern that having a vasectomy will impair their future sexual function.

Objective: To determine in an objective and quantifiable manner if vasectomy leads to a decrease in sexual frequency.

Design: The authors analyzed data from the National Survey of Family Growth (NSFG), which is a large survey of American households.

Methods: Data were extracted from 2 cycles of the NSFG (2002 and 2006-2008) and analyzed. Men were included if they were previously sexually active and were aged >25 years. Female partners were also surveyed in the NSFG and were included if they were between 25 and 45 years of age. Sexual frequency was compared between men (or male partners of female respondents) who had a vasectomy and those who did not. The database captured sexual intercourse frequency over the preceding 4 weeks.

Results: A total of 5838 men met inclusion criteria, with 353 of these having a previous vasectomy. Men who had a vasectomy engaged in intercourse at a mean rate of 5.9 times per month compared to 4.9 times in men who had not had a vasectomy (P =0.0004). Additionally, men who had a vasectomy were less likely to have not engaged in any sexual intercourse in the preceding month. In the survey of female partners, 5211 women responded regarding their male partners, and 670 partners had a previous vasectomy. Again, men with a previous vasectomy had a higher frequency of sexual intercourse during the previous month (6.3 vs 6.0), although this difference was not statistically different (P =0.1341).

Conclusions: Vasectomy does not appear to negatively influence sexual frequency.

Reviewer’s Comments: The more invasive tubal ligation still outnumbers vasectomy among the options for permanent sterilization for couples. The rationale for this involves speculation, but male partner anxiety surrounding issues of sexual function have been proposed and are certainly evident when counseling males before vasectomy. Previous reports have investigated if vasectomy has any effect on sexual function and satisfaction, with most finding minimal to no effect on sexual function. In fact, some reports have demonstrated improved sexual function with improved sexual satisfaction, likely due to the loss of anxiety about unwanted pregnancy. The authors of this article demonstrate through objective survey results that sexual frequency does not decrease and may increase with vasectomy. While no explanation can be extracted from these data, the results are encouraging and can certainly be mentioned while counseling men before vasectomy.(Reviewer–Charles Welliver, MD).

Background: Saturated fat consumption has been correlated with some cancers and cardiovascular disease. Yet, whether saturated fat is correlated with abnormal sperm parameters needs more research.

Objective: To determine the impact of dietary fat on semen parameters among 701 young Danish men without azoospermia.

Design/Methods: This was a cross-sectional study of men recruited from their military fitness exam (2008 to 2010). Three-month recall-validated 136-item food frequency questionnaire, single semen sample, and physical examination were conducted for each participant. Median age was 19 years and median body mass index (BMI) was 22.5.

Results: Men with a high intake of saturated fat had lower total sperm counts. Men in the highest quartile of saturated fat intake had a 38% significantly lower concentration and a 41% significantly lower total sperm count compared to men in the lowest quartile. There were no other significant correlations found between semen parameters and other forms of dietary fat intake.

Conclusions: Diet may be a partial explanation for the reported greater abnormalities observed in sperm counts from other studies of the general population. Reducing the intake of saturated fat may improve reproductive and overall health parameters.

Reviewer’s Comments: This is part of a continuing series of studies that suggest you are what you consume in your diet regarding certain areas of health and – to some extent – fertility. Second, this is a cross-sectional study, whether it is a semen sample or dietary questionnaire is not level 1 evidence. In fact, the correlation between food frequency questionnaires and reality is still far apart. I do not remember what I ate yesterday, let alone months ago. Yet, the beauty of a large questionnaire and this study is that these snapshots might reveal a hidden general pattern or overall behavior that can provide some answers. I found it interesting that a higher percentage of men with a very low BMI were more likely to consume more saturated fat (seems counterintuitive, right?). Yet, men consuming more saturated fat were slightly more likely to smoke, drink more alcohol, report a sexually transmitted disease, consume more overall calories, eat more omega-6 fatty acids, and probably had less muscle mass. And, although the authors did adjust for most of these parameters in their study – which they believe makes the theory of saturated fat being a marker of unhealthy overall behavior less likely – I disagree (>30% of the saturated fat was coming from cheese and dairy products). There is a pattern of behavior to suggest a less healthy lifestyle in those who consume more saturated fat, which is similar to what has been found in many prostate cancer studies and cardiovascular reviews.(Reviewer–Mark Moyad, MD, MPH).