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

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.

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).

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.

The panel provided statements on: (i) Prevalence and association between SDs and MI; (ii) Treatment of male SDs in men of infertile couples.

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.

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.

Sexual medicine. 2021 Jun 02 [Epub ahead of print]

Paolo Capogrosso, Christian Fuglesang S Jensen, Giulia Rastrelli, Josep Torremade, Giorgio I Russo, Amr Abdel Raheem, Anders Frey, Mikkel Fode, Mario Maggi, Yacov Reisman, Carlo Bettocchi, Giovanni Corona

Department of Urology, Circolo & Fondazione Macchi Hospital, University of Insubria, Varese, Italy. Electronic address: ., Department of Urology, Herlev and Gentofte Hopsital, University of Copenhagen., Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy., Hospital Universitari de Bellvitge, Barcelona, Spain., Urology section-University of Catania, Catania, Italy., Department of Andrology, The Institute of Urology, University College London Hospitals, London, UK., Department of Urology, University of Southern Denmark, Esbjerg, Odense., Department of Urology, Zealand University Hospital, Roskilde; Department of Clinical Medicine, University of Copenhagen., Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence., Men's Health Clinic, Amstelland Hospital, Amsterdam, The Netherlands., Division of Urology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy., Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy.