Antidepressant medications are commonly used in males of reproductive age for long‐term treatment of depression, as well as other disorders. Although antidepressants are known to be associated with sexual side‐effects, their effects on semen parameters and other markers of male fertility have been less thoroughly described. The majority of available studies have focused on selective serotonin reuptake inhibitors, which have been shown to negatively impact semen quality in in vitro, animal and human studies. Fluoxetine, in particular, has been the subject of multiple studies and has been associated with gonadotoxic effects, including decreased sperm concentration and motility, increased deoxyribonucleic acid fragmentation, and decreased reproductive organ weights. Studies of several other selective serotonin reuptake inhibitors have yielded similar results. Reassuringly, this effect does seem to be reversible. The data regarding serotonin–norepinephrine reuptake inhibitors, norepinephrine–dopamine reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors and atypical antidepressants are sparse, varied and conflicting. Given the widespread and often long‐term use of antidepressant medications, there is a clear need for further data regarding their impact on semen quality and male fertility.

We aimed to identify what information patients and partners are seeking on male infertility forums. Online discussion boards were identified. Posts were analysed in three steps: open coding, axial coding and selective coding, to determine common themes. A total of 1,118 posts were analysed. The majority of posts (20.2%) were related to "Questions about male fertility diagnosis and testing", with 47.8% asking for assistance interpreting semen analysis results. About 15.7% of posts were about "Feelings associated with male infertility", with 26.7% expressing anger or frustration, 26.1% encouraging hope, 21% seeking hope and 12.5% expressing fear. About 15.4% of posts were about "Lifestyle factors to improve male fertility", 24.4% of which were about vitamins and 6.4% about intercourse timing. About 15.4% of posts were about "Male infertility conditions", with 43% about semen parameters. Other themes included "Questions about male factor treatments", "Questions about assisted reproductive technologies (ART)", "Relationship issues", "Asking for advice", "Financial concerns" and "Information sharing". About 63.6% of posts were written by female partners [t(1,117) = 9.451, p < .001]. The most common posts posed questions about male fertility diagnosis and testing. Users discussed feelings involved in infertility, and counselling should be integrated. About 63.6% of posts were by partners, highlighting the importance of partners having access to infertility information. K E Y W O R D S discussion boards, male infertility, online

Introduction and objective Mycobacterium leprae has been identified in the testicular tissue of men with leprosy. We investigated the relationship between leprosy and male infertility and sexual function. Methods Male patients at the Los Angeles County + University of Southern California Medical Center Hansen's Disease Clinic were surveyed regarding sexual and reproductive history and sexual function via Sexual Health Inventory for Men (SHIM) scores. Survey topics included erectile dysfunction (ED), sexual function, libido, reproductive history before and after leprosy diagnosis, and SHIM scores. SHIM scores were compared with age matched controls without leprosy. Results Forty men with leprosy were interviewed, with a mean age of 53 years. The average age at leprosy diagnosis was 39 years. Thirteen (32.5%) men reported ED, 12 (30%) ejaculatory dysfunction, 6 (15%) impaired libido, and seven (17.5%) primary infertility post-leprosy diagnosis. SHIM scores consistent with mild to severe ED were found in 22/40 (55%) patients and were significantly lower in leprosy patients compared to age matched controls (20/25 versus 23/25, p < 0.001). Lower SHIM scores were also associated with the presence of other neurologic deficits (p = 0.029). Participants with SHIM scores suggestive of ED were no more likely to have had hormone analysis testing done than those with unimpaired SHIM scores.

OBJECTIVE: We sought to determine the effect of resident physician involvement in fertility surgical procedures on patient surgical outcomes and complications.DESIGN: A review of fertility-specific surgical procedures in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was performed, followed by statistical analyses.MATERIALS AND METHODS: The NSQIP database was reviewed for fertility surgical procedures from 2006 to 2012. The procedures included were: epididymectomy, spermatocelectomy, varicocelectomy +/-hernia repair, ejaculatory duct resection, vasovasostomy, vasoepididymostomy, and unlisted procedure male genital system (to capture sperm retrieval procedures).Patient factors analyzed were: patient age, race, body mass index (BMI), morbidity probability, mortality probability, American Society of Anesthesiologists physical status classification (ASA), smoker status, alcohol usage status, history of diabetes, chronic obstructive pulmonary disease, congestive heart failure, peripheral vascular disease, cerebrovascular accident, and/or steroid usage. Outcomes examined included operative time, length of hospital stay, superficial infection, deep wound infection, wound dehiscence, urinary tract infection (UTI), and reoperation rate. Resident and non-resident groups were compared by Wilcoxon rank sum tests, followed by logistic regression, univariate, and multivariate analyses.RESULTS: 924 cases were included: 309 with residents, and 615 without residents. The median post-graduate resident year was 3 (range: 0-10). There was no difference in baseline demographics between groups. On univariate analysis, mean operative time was longer with resident involvement, even after controlling for other covariates (76.2 vs 49.5 minutes, p¼0.00). Length of hospital stay was also longer in cases with resident involvement (0.41 vs 0.35 days, p¼0.02). There was no difference in superficial infections (p¼0.57) or UTIs (p¼1.00) with or without resident involvement.CONCLUSIONS: While resident physician involvement in fertility surgical procedures may lengthen operative time, there were no significant differences in length of hospital stay, superficial infections, deep wound infections, wound dehiscence, UTIs, and reoperation rates. This data is reassuring for attending physicians operating with residents.