R Matthew Coward1,2, Christy Stetter3, Allen Kunselman3, J C Trussell4, Mark C Lindgren5, Ruben R Alvero6, Peter Casson7, Gregory M Christman8, Christos Coutifaris9, Michael P Diamond10, Karl R Hansen11, Stephen A Krawetz12, Richard S Legro13, Randal D Robinson14, James F Smith15, Anne Z Steiner16, Robert A Wild11, Heping Zhang17, Nanette Santoro18. 1. Department of Urology, University of North Carolina School of Medicine , Chapel Hill , North Carolina. 2. University of North Carolina Fertility , Raleigh , North Carolina. 3. Department of Public Health Sciences, Penn State College of Medicine , Hershey , Pennsylvania. 4. Department of Urology, Upstate University Hospital , Syracuse , New York. 5. Department of Urology, University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma. 6. Department of Obstetrics and Gynecology, Warren Alpert School of Medicine at Brown University , Providence , Rhode Island. 7. Northeastern Reproductive Medicine , Colchester , Vermont. 8. Department of Obstetrics and Gynecology, University of Florida , Gainesville , Florida. 9. Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania , Philadelphia , Pennsylvania. 10. Department of Obstetrics and Gynecology, Augusta University , Augusta , Georgia. 11. Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma. 12. Department of Obstetrics and Gynecology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine , Detroit , Michigan. 13. Department of Obstetrics and Gynecology, Pennsylvania State University , Hershey , Pennsylvania. 14. Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio , San Antonio , Texas. 15. Department of Urology, University of California-San Francisco , San Francisco , California. 16. Department of Obstetrics and Gynecology, Duke University , Durham , North Carolina. 17. Department of Biostatistics, Yale University School of Public Health , New Haven , Connecticut. 18. Department of Obstetrics and Gynecology, University of Colorado School of Medicine , Aurora , Colorado.
Abstract
PURPOSE: We sought to determine whether lower fertility related quality of life or depression in men of couples with unexplained infertility is associated with low total testosterone levels, abnormal semen quality or erectile dysfunction. MATERIALS AND METHODS: This study is a secondary analysis of a large, multicenter, randomized controlled trial in couples with unexplained infertility. Male partners underwent baseline semen analysis with measurement of fasting total testosterone and gonadotropin. They also completed surveys, including the FertiQOL (Fertility Quality of Life), the PHQ-9 (Patient Health Questionnaire-9) and the IIEF (International Index of Erectile Function). The primary study outcomes were total testosterone with low total testosterone defined as less than 264 ng/dl, semen parameters and the IIEF score. We performed multivariable logistic regression analyses adjusted for patient age, race, body mass index, education, smoking, alcohol use, infertility duration and comorbidity. RESULTS: A total of 708 men with a mean ±SD age of 34.2 ± 5.6 were included in study. Of the men 59 (8.3%) had a PHQ-9 score of 5 or greater, which was consistent with depression, 99 (14.0%) had low total testosterone and 63 (9.0%) had mild or worse erectile dysfunction. Neither the FertiQOL score nor depression was associated with total testosterone or any semen parameter. The FertiQOL score was inversely associated with erectile dysfunction (for every 5-point score decline AOR 1.30, 95% CI 1.16-1.46). Depressed men were significantly more likely to have erectile dysfunction than nondepressed men (AOR 6.31, 95% CI 3.12-12.77). CONCLUSIONS: In men in couples with unexplained infertility lower fertility related quality of life and depression are strongly associated with erectile dysfunction. However, neither is associated with spermatogenesis or testosterone levels. Erectile dysfunction in infertile men merits longitudinal investigation in future studies.
RCT Entities:
PURPOSE: We sought to determine whether lower fertility related quality of life or depression in men of couples with unexplained infertility is associated with low total testosterone levels, abnormal semen quality or erectile dysfunction. MATERIALS AND METHODS: This study is a secondary analysis of a large, multicenter, randomized controlled trial in couples with unexplained infertility. Male partners underwent baseline semen analysis with measurement of fasting total testosterone and gonadotropin. They also completed surveys, including the FertiQOL (Fertility Quality of Life), the PHQ-9 (Patient Health Questionnaire-9) and the IIEF (International Index of Erectile Function). The primary study outcomes were total testosterone with low total testosterone defined as less than 264 ng/dl, semen parameters and the IIEF score. We performed multivariable logistic regression analyses adjusted for patient age, race, body mass index, education, smoking, alcohol use, infertility duration and comorbidity. RESULTS: A total of 708 men with a mean ± SD age of 34.2 ± 5.6 were included in study. Of the men 59 (8.3%) had a PHQ-9 score of 5 or greater, which was consistent with depression, 99 (14.0%) had low total testosterone and 63 (9.0%) had mild or worse erectile dysfunction. Neither the FertiQOL score nor depression was associated with total testosterone or any semen parameter. The FertiQOL score was inversely associated with erectile dysfunction (for every 5-point score decline AOR 1.30, 95% CI 1.16-1.46). Depressed men were significantly more likely to have erectile dysfunction than nondepressed men (AOR 6.31, 95% CI 3.12-12.77). CONCLUSIONS: In men in couples with unexplained infertility lower fertility related quality of life and depression are strongly associated with erectile dysfunction. However, neither is associated with spermatogenesis or testosterone levels. Erectile dysfunction in infertile men merits longitudinal investigation in future studies.
Entities:
Keywords:
erectile dysfunction; hypogonadism; infertility; male; penis; quality of life
Authors: Michael P Diamond; Mohamed Mitwally; Robert Casper; Joel Ager; Richard S Legro; Robert Brzyski; Peter Casson; Esther Eisenberg; Heping Zhang Journal: Contemp Clin Trials Date: 2011-07-20 Impact factor: 2.226
Authors: James F Smith; Thomas J Walsh; Alan W Shindel; Paul J Turek; Holly Wing; Lauri Pasch; Patricia P Katz Journal: J Sex Med Date: 2009-07-10 Impact factor: 3.802
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Doreen Koretz; Kathleen R Merikangas; A John Rush; Ellen E Walters; Philip S Wang Journal: JAMA Date: 2003-06-18 Impact factor: 56.272
Authors: Jennifer J Yland; Michael L Eisenberg; Elizabeth E Hatch; Kenneth J Rothman; Craig J McKinnon; Yael I Nillni; Greg J Sommer; Tanran R Wang; Lauren A Wise Journal: Fertil Steril Date: 2021-05-07 Impact factor: 7.490
Authors: 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 Journal: Sex Med Date: 2021-06-02 Impact factor: 2.491