Ejaculation failure on the day of oocyte retrieval for IVF: A report of five cases

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

BACKGROUND

Sexuality has a key impact on quality of life and on reproductive health. Infertility often results in sexual dysfunction. Despite this close association, addressing sexuality is not a standard component of infertility counselling, especially since in most countries sexual medicine is not a core element of specialist training. Even today, many doctors and patients consider discussing sexuality to be more challenging than other aspects of reproductive medicine. The present review addresses the complex consequences of infertility on sexuality.

OBJECTIVE AND RATIONALE

Our goals were: (i) to identify the prevalence of sexual problems resulting from infertility, (ii) to evaluate characteristics of sexual difficulties and disorders resulting from infertility and (iii) to analyse factors involved in the complex association between sexual problems and infertility.

SEARCH METHODS

A systematic search for publications containing keywords related to sexual disorders and infertility was performed via PubMed, Web of Science and Psyndex. A total of 170 manuscripts published between January 1966 and April 2021 were identified after verification of inclusion and exclusion criteria. The reference lists in these manuscripts were searched for further relevant literature. Studies were reviewed for quality-related methodological details.

OUTCOMES

Couples diagnosed with infertility have an increased risk of sexual disorders. Loss of sexual desire and erectile dysfunction are among the most frequent sexual disorders resulting from infertility. Currently available literature reflects only fragmentarily the complexity of the diverse interactions. Sexuality plays out against the backdrop of interactions among personal, cultural, infertility-related and sexuality-related factors. Considering this complexity, it is crucial to evaluate individual profiles as well as partnership interactions to avoid a negative impact of infertility on a couple's sexual life.

WIDER IMPLICATIONS

Identifying sexual disorders as relevant considerations in the context of infertility and exploring their impact during the entire course of diagnosis and treatment constitute an important contribution to comprehensively care for the couples concerned. Counselling should focus on preventing the onset and aggravation of sexual disorders. As sexuality represents a major component of quality of life and of partnership, such support may improve not only the current overall wellbeing but also the chances of a satisfactory long-term partnership and family life.

Management of transient ejaculation failure due to erectile difficulties encountered on the oocyte retrieval day

INTRODUCTION

Transient ejaculation failure can be seen on the oocyte retrieval day which might cause the cancelation of oocyte retrieval procedure. The aim of this study was to evaluate the management of these patients and to assess the clinical outcome of intracytoplasmic sperm injection (ICSI) using spermatozoa obtained from them.

METHODS

The records of the oocyte pick-up (OPU) procedures between November 2014 and January 2017 were reviewed, the management and ICSI outcomes of 26 patients with transient ejaculation failure due to erectile difficulties on the oocyte retrieval day were evaluated.

RESULTS

Intracavernosal injection (ICI), percutaneous sperm aspiration (PESA) and microdissection testicular sperm extraction (micro-TESE) were performed to 15, 6 and 5 patients, respectively. The sperm retrieval rate (SRR) and live birth rate (LBR) of ICI, PESA and micro-TESE were 26%, 63.6% and 100% and 40%, 16.7%, 38.4% respectively.

CONCLUSIONS

Although a limited number of cases were evaluated in this study, micro-TESE appears to be the preferable approach when assessed both in terms of sperm retrieval method success and ICSI results.