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体外受精导致勃起和男性性功能障碍的高发:一项前瞻性病例对照研究。

In Vitro Fertilization Entails a High Prevalence of Erectile and Male Sexual Dysfunction: A Prospective Case-Control Study.

机构信息

Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel.

Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

J Urol. 2021 Oct;206(4):994-1000. doi: 10.1097/JU.0000000000001872. Epub 2021 May 25.

Abstract

PURPOSE

We evaluated the effect of in vitro fertilization (IVF) on sexual function in men, particularly for erectile dysfunction.

MATERIALS AND METHODS

A prospective case-control study at a tertiary medical center. The study group comprised men of infertile couples that required IVF to conceive. The control group comprised men of couples who conceived spontaneously. The effects of IVF on sexual and erectile function were assessed based on the International Index of Erectile Function (IIEF-15) and the Self-Esteem and Relationship (SEAR) questionnaires. Participants were followed up to 1 year postpartum.

RESULTS

Compared to the control group (378), for the IVF group (356), mean IIEF-15 scores were significantly lower: prior to pregnancy (31.7±4.5 vs 64.4±7.2, p <0.0001), at mid-pregnancy (37.3±5.1 vs 66.4±5.5, p <0.0001) and up to one year postpartum (42.3±4.9 vs 68.6±4.3, p <0.0001). Compared to the control group, in the IVF group, mean SEAR scores were significantly lower at these 3 respective time points (29.9±6.3 vs 66.5±8.3; 34.1±5.8 vs 66.9±7.2; and 40.9±6.7 vs 67.3±5.6; p <0.0001). At the 3 time points, for the IVF compared to the control group, the median monthly sexual intercourse rate was lower; and both the use of phosphodiesterase-5 inhibitor and psychologist/sexologist care were higher.

CONCLUSIONS

The prevalence of erectile dysfunction among men participating in IVF in order to conceive is significantly higher compared to couples that conceived spontaneously, thus leading to an extremely high rate of phosphodiesterase-5 inhibitor use.

摘要

目的

我们评估了体外受精(IVF)对男性性功能的影响,特别是对勃起功能障碍的影响。

材料与方法

这是一项在一家三级医疗中心进行的前瞻性病例对照研究。研究组由需要进行 IVF 才能受孕的不孕夫妇中的男性组成。对照组由自然受孕夫妇中的男性组成。根据国际勃起功能指数(IIEF-15)和自尊与关系(SEAR)问卷评估 IVF 对性功能和勃起功能的影响。对参与者进行了长达 1 年的产后随访。

结果

与对照组(378 例)相比,IVF 组(356 例)的平均 IIEF-15 评分明显更低:妊娠前(31.7±4.5 比 64.4±7.2,p<0.0001)、妊娠中期(37.3±5.1 比 66.4±5.5,p<0.0001)和产后 1 年(42.3±4.9 比 68.6±4.3,p<0.0001)。与对照组相比,在 IVF 组中,这 3 个时间点的平均 SEAR 评分均明显更低(29.9±6.3 比 66.5±8.3;34.1±5.8 比 66.9±7.2;和 40.9±6.7 比 67.3±5.6;p<0.0001)。在这 3 个时间点,与对照组相比,IVF 组每月性行为的中位数频率较低,并且使用磷酸二酯酶-5 抑制剂和心理医生/性治疗师的比例较高。

结论

与自然受孕的夫妇相比,参与 IVF 以受孕的男性勃起功能障碍的患病率明显更高,因此导致磷酸二酯酶-5 抑制剂的使用率极高。

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