Case: Xiao Wang is 28 years old and found out that he had a right inguinal hernia five years ago, but he has been putting off the surgery because he is busy with his work and love. However, some people say that hernia has an effect on fertility, while others say that hernia surgery may have an effect on fertility. Xiao Wang looked up the information on the Internet and found that hernia must be operated to cure this point very consistent, but the impact on fertility was not concluded even after half a day of research, which left Xiao Wang in a dilemma. The doctor told Wang that this is the most common problem for young inguinal hernia patients and men with fertility requirements, and gave him a clear answer. First of all, inguinal hernia has an indirect effect on fertility, especially a large hernia that enters the scrotum. There are two reasons for this: first, the normal temperature of the scrotal testes is 35 degrees and the normal temperature in the abdominal cavity is 37-37.5 degrees. The contents of the hernia come from the abdominal cavity and larger hernia contents entering the scrotum will lead to an increase in scrotal temperature; second, larger hernias tend to cause varicose veins in the spermatic cord and affect the blood supply to the testes. Therefore, inguinal hernia has an impact on fertility, and the larger the hernia the greater the impact. In addition, inguinal hernias in young people may still have acute complications – entrapment – because of the small hernia ring, so young men with clearly diagnosed inguinal hernias should still undergo surgery as soon as possible. The question of whether surgery has an impact on fertility is more complex than the first one and it is not possible to say that there is a 100% certainty. The first aspect is that inguinal hernia surgery requires the separation of the hernia sac from the spermatic cord, an operation that can cause some trauma to the spermatic cord, which cannot be completely avoided as long as the surgery is performed. The second aspect is the possible effect of the surgical repair material on the spermatic cord. The current method of inguinal hernia repair is a tension-free repair using patches. The effect of synthetic patches on fertility is debated, as animal studies have found that inflammatory stimulation of the patch can affect the vas deferens and even cause occlusion, but human clinical studies have found no significant effect of synthetic patches on fertility. If you are still concerned, there are now non-synthetic, naturally sourced biological patches that do not form adhesions with the vas deferens, but may not be as strong as synthetic patches in terms of repair fastness. Therefore, for men who have not yet had children or are considering having more children, the hernia specialist will discuss the options with the patient and weigh the pros and cons. A laparoscopic approach is recommended to reduce the damage to the spermatic cord compared to open surgery, thus further reducing the impact on fertility.