The role of ejaculatory dysfunction on male infertility
V. 171 N. 6 (2020), Research article
V. 171 N. 6 (2020)

The role of ejaculatory dysfunction on male infertility: doi: 10.7417/CT.2020.2267

Research article
Pubblicato 2020-11-02
R. Mazzilli
Andrology Unit, Department of Clinical and Molecular Medicine, University of Rome “Sapienza”, Sant’Andrea Hospital, via di Grottarossa 1038, University of Rome ‘Sapienza’, Rome
G. Defeudis
Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
S. Olana
Andrology Unit, Department of Clinical and Molecular Medicine, University of Rome “Sapienza”, Sant’Andrea Hospital, via di Grottarossa 1038, University of Rome ‘Sapienza’, Rome
V. Zamponi
Andrology Unit, Department of Clinical and Molecular Medicine, University of Rome “Sapienza”, Sant’Andrea Hospital, via di Grottarossa 1038, University of Rome ‘Sapienza’, Rome
M. Macera
Andrology Unit, Department of Clinical and Molecular Medicine, University of Rome “Sapienza”, Sant’Andrea Hospital, via di Grottarossa 1038, University of Rome ‘Sapienza’, Rome
F. Mazzilli
Andrology Unit, Department of Clinical and Molecular Medicine, University of Rome “Sapienza”, Sant’Andrea Hospital, via di Grottarossa 1038, University of Rome ‘Sapienza’, Rome
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Parole chiave

ejaculatory dysfunction
premature ejaculation
anejaculation
retrograde ejaculation
infertility

Abstract

Background
The aim of this study was to evaluate: 1) the prevalence of male infertility due to ejaculatory dysfunction (premature ejaculation-PE, intravaginal ejaculatory dysfunction-IVEjD, anejaculation-AE, and retrograde ejaculation-RE); and 2) the hormonal profile and semen characteristics of such subjects.

Methods
N.3280 subjects who were referred to our andrology unit for infertility were studied. Exclusion criteria: the presence of known causes of male infertility and erectile dysfunction. In all subjects were performed: medical history and andrological physical examination; hormonal profile; semen analysis or centrifugation/resuspension of post-orgasmic urine; IIEF-5 questionnaire for the diagnosis of ED; PEDT questionnaire for the diagnosis of EP.

Results
The prevalence of ejaculatory dysfunctions in infertile males was 1.8% (59/3280). The causes were: a) absence of ejaculation in 37/3280 subjects (1.1%); among them, 23/3280 (0.7%) subjects showed a condition of RE and 14/3280 (0.4%) of AE; b) PE in 16/3280 subjects (0.5%); and c) IVEjD in 6/3280 subjects (0.2%). Hormonal values and seminal parameters (when semen analysis was possible) were within the normal ranges in all the cases. In subjects with RE, sperm recovery was possible in 69.9% (16/23) subjects after centrifugation and resuspension of post-orgasmic urine.

Conclusions
The prevalence of male infertility due to ejaculatory dysfunctions is overall just under 2%. The main cause is retrograde ejaculation; psychogenic origins could also have an important role. It is important to identify the cause of ejaculatory dysfunction in order to decide upon correct management (PE treatment, centrifugation and resuspension of post-orgasmic urine, penile vibratory stimulation, and psychological counselling)

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