PDE5 inhibitors and male reproduction: Is there a place for PDE5 inhibitors in infertility clinics or andrology laboratories?

Dimitriadis, Fotios; Kaltsas, Aris; Zachariou, Athanasios; Mamoulakis, Charalampos; Tsiampali, Chara; Giannakis, I.; Paschopoulos, Minas; Papatsoris, Athanasios; Loutradis, Dimitrios; Tsounapi, Panagiota; Takenaka, Atsushi; Sofikitis, Nikolaos

doi:10.1111/iju.15046

Cited by 4 publications

(3 citation statements)

References 126 publications

(322 reference statements)

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“…Urologists can prescribe a range of medications to address these issues. For erectile dysfunction, treatments may include phosphodiesterase type 5 inhibitors (PDE5is) like sildenafil and vardenafil, which enhance the effects of nitric oxide, a natural chemical the body produces to relax penis muscles and increase blood flow [149,150].…”

Section: Addressing Erectile Dysfunction and Premature Ejaculation Fo...mentioning

confidence: 99%

“…Their research revealed that PDE5is had a positive impact on the secretory function of Leydig and Sertoli cells and were linked to the regulation of contractility in the tunica albuginea of the testes and epididymis. Moreover, PDE5is have been shown to enhance sperm motility by augmenting prostatic secretory activity and to play a pivotal role in the regulation of sperm capacitation [150].…”

Section: Addressing Erectile Dysfunction and Premature Ejaculation Fo...mentioning

confidence: 99%

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From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology

Kaltsas,

Dimitriadis,

Zachariou

et al. 2023

Medicina

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Infertility is a global health concern, with male factors playing an especially large role. Unfortunately, however, the contributions made by reproductive urologists in managing male infertility under assisted reproductive technology (ART) often go undervalued. This narrative review highlights the important role played by reproductive urologists in diagnosing and treating male infertility as well as any barriers they face when providing services. This manuscript presents a comprehensive review of reproductive urologists’ role in managing male infertility, outlining their expertise in diagnosing and managing male infertility as well as reversible causes and performing surgical techniques such as sperm retrieval. This manuscript investigates the barriers limiting urologist involvement such as limited availability, awareness among healthcare professionals, and financial constraints. This study highlights a decrease in male fertility due to lifestyle factors like sedentary behavior, obesity, and substance abuse. It stresses the significance of conducting an evaluation process involving both male and female partners to identify any underlying factors contributing to infertility and to identify patients who do not require any interventions beyond ART. We conclude that engaging urologists more effectively in infertility management is key to optimizing fertility outcomes among couples undergoing assisted reproductive technology treatments and requires greater education among healthcare providers regarding the role urologists and lifestyle factors that could have an effect on male fertility.

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Section: Addressing Erectile Dysfunction and Premature Ejaculation Fo...mentioning

confidence: 99%

Section: Addressing Erectile Dysfunction and Premature Ejaculation Fo...mentioning

confidence: 99%

From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology

Kaltsas,

Dimitriadis,

Zachariou

et al. 2023

Medicina

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“…In this context, male infertility occurs in 30–50% of cases [ 3 ]. Varicocele, smoking, radiation, urinary tract infection, nutritional deficiencies, oxidative stress, and environmental factors are some reasons for male factors [ 4 , 5 , 6 ] but seem not to be completely understood in all aspects. Oxidative stress (OS) may play an increasingly important role in environmental factors when the production of reactive oxygen species (ROS) exceeds the body’s natural antioxidant neutralizing capacity [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Antioxidant Supplementation on Male Fertility—A Systematic Review

et al. 2023

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Our aim was to review the current literature regarding the effect of antioxidant supplementation (AS) on male fertility parameters, as AS is commonly used to treat male infertility due to the availability and affordability of antioxidants in many parts of the world. Materials and methods: PubMed, Medline, and Cochrane electronic bibliographies were searched using the modified Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate studies on the benefit of antioxidant therapy on infertile men. Results were analyzed regarding the following aspects: (a) ingredient and dose; (b) potential mechanism of action and rationale for use; and (c) effect on various reported outcomes. Results: Thus, 29 studies found a substantial positive effect of AS on outcomes of assisted reproductive therapy (ART), WHO semen parameters, and live-birth rate. Carnitines, Vitamin E and C, N-acetyl cysteine, coenzyme Q10, selenium, zinc, folic acid, and lycopene were beneficial ingredients. Nevertheless, some studies did not show a substantial change in one or more factors. Conclusion: AS seems to have a positive effect on male fertility. Environmental factors may play an increasing role in fertility. Further studies are needed to determine the optimal AS combination and the influence of environmental factors.

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Oral phosphodiesterase type 5 inhibitors and male reproductive potential: an overview

Mostafa

Alghobary

Hanafy³

et al. 2023

Sexual Medicine Reviews

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Background Phosphodiesterase type 5 inhibitors (PDE5Is), due to their efficacy and tolerable profile for more than 2 decades,are considered a good addition to the available treatments in patients with erectile dysfunction (ED). Aim We sought to assess the possible influence of oral PDE5Is on male human reproduction. Methods A literature review was performed in several databases, including the PubMed/Medline database, Scopus, Cochrane Library, EMBASE, Academic Search Complete, and Egyptian Knowledge Bank databases. The keywords/search terms were “PDE5Is,” “sildenafil,” “vardenafil,” “tadalafil,” or “avanafil,” combining and crossing them with “male infertility,” “semen,” “reproductive hormones,” or “sperm.” Results Overall, 101 articles were selected. After removal of duplicates and animal studies, 75 articles were finally subjected to review covering the different items related to male human reproduction, including effects of PDE5Is on different parameters of semen or reproductive hormones, as uses of PDE5Is in cases related to distinctive male factor infertility, such as ED, temporary ED, or ejaculatory failure alongside assisted reproduction (AR) procedures, and ejaculatory dysfunction in spinal cord lesions. We found 26 articles that addressed the direct effects of PDE5Is on semen and reproductive hormonal profiles, 16 in vivo studies and 10 in vitro studies. Oral PDE5Is have in general a stimulatory effect on sperm motility, while other semen parameters and reproductive hormonal profiles showed varied outcomes. Such effects are more pronounced with a long-term daily regimen than with an on-demand regimen. However, it seems that the best-controlled studies suggested no change in the sperm quality of male reproductive potential. Conclusion Oral PDE5Is have in general stimulatory effects on sperm motility, while other semen parameters and hormone profiles showed varied results. In addition, oral PDE5Is have played a useful role in conditions related to distinctive male factor infertility, such as ED, temporary ED, ejaculatory failure alongside AR, and ejaculatory dysfunction in spinal cord lesions.

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PDE5 inhibitors and male reproduction: Is there a place for PDE5 inhibitors in infertility clinics or andrology laboratories?

Cited by 4 publications

References 126 publications

From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology

From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology

Antioxidant Supplementation on Male Fertility—A Systematic Review

Oral phosphodiesterase type 5 inhibitors and male reproductive potential: an overview

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