Jianxiong Ma1,2,3, Yingying Zhang1, Binghao Bao2, Wangqiang Chen4, Haisong Li5, Bin Wang6. 1. The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China. 2. Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. 3. Key Laboratory of Integrative Chinese and Western Medicine for Prevention and Treatment of Sexual Dysfunction of Zhejiang Province, Hangzhou, China. 4. Department of Reproductive Medicine, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital, Hangzhou, China. 5. Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. lihs369@sina.com. 6. Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. dayiwangbin@sina.com.
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.
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 infertilemen 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 infertilitymen was higher than that of primary infertilitymen, and the quality of sexual life was decreased. Primary infertility is an independent risk factor of anxiety.