Prevalence and associated factors of erectile dysfunction, psychological disorders, and sexual performance in primary vs. secondary infertility men

Abstract

Background Many infertile couples might experience erectile dysfunction (ED) and significant changes in the quality of sexual life and psychological state though information is limited in secondary infertile men in China. To determine whether primary or secondary infertility is associated with ED, psychological disorders, and sexual performance. Methods This was a cross-sectional survey conducted at the Dongzhimen Hospital of Beijing University of Chinese Medicine (06/2019-01/2020). The participants completed a questionnaire including general information, sexual life, simplified International Index of Erectile Function (IIEF-5), Patient Health Questionnaire-9 (PHQ-9), and 7-item Generalized Anxiety Disorder Scale (GAD-7). Multivariable logistic regression was used to identify the factors associated with ED, depression, and anxiety. Results ED was more frequent in secondary vs. primary infertility (46.5 % vs. 26.7 %, P < 0.001). Compared with men with primary infertility, those with secondary infertility showed lower IIEF-5 scores (P < 0.001), higher occurrence of TOIF (P = 0.001), had a higher awareness of partner’s ovulation when having ED (P = 0.001), lower GAD-7 scores (P = 0.016), lower libido (P = 0.005), fewer intercourses per month (P = 0.001) and a lower sexual satisfaction score (P = 0.027). In the multivariate analysis, primary infertility was found to be an independent risk factor of anxiety (OR: 1.812, 95 %CI: 1.015–3.236). Some overlap is observed in factors associated with ED, psychological disorders, and sexual performance between primary and secondary infertility, but some factors are distinct. Conclusions The prevalence of ED in secondary infertility men was higher than that of primary infertility men, and the quality of sexual life was decreased. Primary infertility is an independent risk factor of anxiety.

Association between generalized anxiety symptoms and semen quality in infertile men: A multicentre study in North China

“…Wu et al investigated the anxiety status of infertile patients and the influential factors; they reported an anxiety prevalence of 61.4% in 306 infertile patients from the central‐south region of China (Wu et al, 2015). Ma et al also conducted a cross‐sectional survey in China and the anxiety trait of the participants was assessed using the GAD‐7 scale; their study revealed that the overall prevalence rate of anxiety (including mild generalized anxiety symptoms) was 60.7% in infertile men (Ma et al, 2021). Therefore, the relatively high prevalence of anxiety among the infertile men in our study is consistent with that in previous studies.…”

Sexual dysfunction and disorders as a consequence of infertility: a systematic review and meta-analysis

“…In contrast, male IIEF overall scores were higher in primary vs. secondary infertility (2 studies, 297 primary vs. 160 secondary infertility; MD 1.93, 95% CI 1.09, 2.76, Supplementary Figure S1). Furthermore, the prevalence of ED was higher, while libido, intercourse frequency and sexual satisfaction were lower, in men with secondary infertility (Ma et al, 2021, Sahin et al, 2017.…”

Sperm quality impairment in males of couples with pregnancy loss is correlated with sexual dysfunction: a cross-sectional study

“…More importantly, there is a strong correlation between impaired semen quality and sexual dysfunction in the infertile population, with sexual dysfunction tending to be more severe the lower the sperm quality [ 5 , 6 ]. Many males of PL couples also experience a high level of psychological distress and emotional burden, and sexual dysfunction is increased among them [ 7 – 9 ].…”