BERKELEY, CA (UroToday.com) -This a randomized, double-blind, placebo controlled, parallel group, multicenter study involving 200 men with or without erectile dysfunction. Men (25-64 years of age) did not have ejaculatory dysfunction. Subjects were randomized to daily treatment with vardenafil, sildenafil or placebo for 6 months. Baseline sperm concentrations were compared to specimens acquired after 6 months of placebo or treatment.

The authors concluded that that vardenafil had no adverse effects on sperm concentration, compared with sildenafil and placebo, when administered daily at the maximum recommended dose for 6 months. Further vardenafil did not impair sperm concentration, total sperm count, sperm morphology or motility.

Editorial Comments: Phosphodiesterase type 5 inhibitors widely utilized for erectile dysfunction. As our society ages, it is likely that more men who are interested in fertility will experience ED. Furthermore, young men may experience ED when attempting conception. "Fear of failure" can become daunting to the young man who must "rise to the occasion" when his partner is ovulating. This well designed study suggests that semen parameters are not adversely affected by phosphodiesterase inhibitors. It should be remembered that the primary outcome of this study was a 50% reduction in baseline sperm concentration and that too few patients with low baseline sperm counts were included in this study to draw any conclusions in this population in which a 50% reduction could be clinically significant. Of course this does not prove the safety of this exposure with regard to fertility or reproductive outcome. Nevertheless this study does provide comfort to the patient and physician.

Keith Jarvia, Eugene Dula, Margaret Drehobl, Jon Pryor, JoAnn Shapiro, Monica Seger

J.Urol. Volume 179, Issue 3, Pages 1060-1065 (March 2008)
doi: 10.1016/j.juro.2007.10.077

PubMed Abstract
PMID: 18206950

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Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

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