Male Sexual Dysfunctions in the Infertile Couple–Recommendations From the European Society of Sexual Medicine (ESSM)

Abstract

Introduction Sexual dysfunctions (SDs) have been frequently reported among male partners of infertile couples due to psychogenic, relational and/or organic issues related with the inability to conceive. Likewise, male infertility (MI) could be a consequence of sexual dysfunctions. Aim To review the evidence on the prevalence and treatment of male SDs in men of infertile couples and provide clinical recommendations on behalf of the European Society of Sexual Medicine (ESSM). Methods The MEDLINE database was searched in September 2019 for randomized clinical trials (RCTs), meta-analyses and open-label prospective or retrospective studies investigating the presence of erectile dysfunction (ED) and/or ejaculatory dysfunctions (EjDs) and/or low sexual desire (LSD) in conjunction with infertility. Main Outcome Measure The panel provided statements on: (i) Prevalence and association between SDs and MI; (ii) Treatment of male SDs in men of infertile couples. Results ED has been reported in 9% to 62% of male partners of infertile couples, with severe impairment observed in only 1% to 3% of ED cases. Moreover, worse semen parameters have been associated with greater ED severity. Phosphodiesterase type 5 inhibitors (PDE5is) can be safely used to treat ED among patients seeking fatherhood. Male partners of infertile couples are at higher risk of premature ejaculation (PE). Retrograde ejaculation (RE) and anejaculation are a cause of MI and can be managed with electroejaculation (EEJ) or penile vibratory stimulation (PVS) or, alternatively, with oral treatments, however the latter with limited documented success. Low sexual desire has been reported by one third of men of infertile couples. Conclusion ED could significantly affect male partners of infertile couple; PDE5is should be suggested to ensure an effective and satisfactory sexual relationship of the couple. Anejaculation and RE should be considered as a possible cause of MI and treated accordingly. Low sexual desire is frequently reported among men of infertile couple and could be a symptom of other systemic conditions or psychological distress. Capogrosso P, Jensen CFS, Rastrelli G, et al. Male Sexual Dysfunctions in the Infertile Couple–Recommendations From the European Society of Sexual Medicine (ESSM). J Sex Med 2021;9:100377.

Hemangioma of the prostate with retrograde ejaculation - a case report

“…The total number of sperm was only 8.1 million (the normal value is 39 million or more). A large amount of sperm was found in the urine during the first urination after ejaculation, which was in consistent with his chief complaint [6] . The urinary sperm count after ejaculation was 128,000/mL.…”

“…Retrograde ejaculation is the main cause of 1.2% cases of infertility [10] . The benefit from treatments that include electroejaculation [11] , [12] , penile vibratory stimulation [13] and oral medication is controversial [6] . Therefore, assisted reproductive technology might be the recourse for the patient in our case.…”

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“…perturbations ( Yafi et al, 2016 ). Additionally, ED may lead to a dramatically reduced frequency of intercourse among infertile men, which definitely has a negative impact on fertility ( Capogrosso et al, 2021 ). Furthermore, Li et al found that the prevalence of ED among Chinese infertile men reached 57%, and most of them were mild ED.…”

Sexual Dysfunctions in Men with Infertility in Marriage, Which is Caused by Tubal Peritoneal Pathology in Women. The Effectiveness of the Combined Use of Dietary Supplements

“…Негативний вплив безпліддя на інтимне життя подружжя не тільки поглиблює розлади в сім'ї, а й провокує розвиток певних сексуальних дисфункцій, які часто виникають як у жінок, так і у чоловіків [7,20].…”

“…За даними різних досліджень, сексуальні порушення, як наслідок неможливості зачати дитину, у разі безпліддя спостерігаються у 43-90% жінок та у 48-56% чоловіків [20]. Здебільшого їх проявами у чоловіків є низький статевий потяг, еректильна дисфункція, передчасна еякуляція і сексуальна незадоволеність [6,7,13,19,20]. Порушення сексуальних функцій і особливо проблеми з ерекцією та еякуляцією викликають у чоловіків психологічний стрес, що нерідко призводить до порушень генеративної здатності [7,18].…”