Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Dermatology, Andrology & STIs, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Sex Med Rev. 2023 Jun 27;11(3):240-252. doi: 10.1093/sxmrev/qead010.
Phosphodiesterase type 5 inhibitors (PDE5Is), due to their efficacy and tolerable profile for more than 2 decades,are considered a good addition to the available treatments in patients with erectile dysfunction (ED).
We sought to assess the possible influence of oral PDE5Is on male human reproduction.
A literature review was performed in several databases, including the PubMed/Medline database, Scopus, Cochrane Library, EMBASE, Academic Search Complete, and Egyptian Knowledge Bank databases. The keywords/search terms were "PDE5Is," "sildenafil," "vardenafil," "tadalafil," or "avanafil," combining and crossing them with "male infertility," "semen," "reproductive hormones," or "sperm."
Overall, 101 articles were selected. After removal of duplicates and animal studies, 75 articles were finally subjected to review covering the different items related to male human reproduction, including effects of PDE5Is on different parameters of semen or reproductive hormones, as uses of PDE5Is in cases related to distinctive male factor infertility, such as ED, temporary ED, or ejaculatory failure alongside assisted reproduction (AR) procedures, and ejaculatory dysfunction in spinal cord lesions. We found 26 articles that addressed the direct effects of PDE5Is on semen and reproductive hormonal profiles, 16 in vivo studies and 10 in vitro studies. Oral PDE5Is have in general a stimulatory effect on sperm motility, while other semen parameters and reproductive hormonal profiles showed varied outcomes. Such effects are more pronounced with a long-term daily regimen than with an on-demand regimen. However, it seems that the best-controlled studies suggested no change in the sperm quality of male reproductive potential.
Oral PDE5Is have in general stimulatory effects on sperm motility, while other semen parameters and hormone profiles showed varied results. In addition, oral PDE5Is have played a useful role in conditions related to distinctive male factor infertility, such as ED, temporary ED, ejaculatory failure alongside AR, and ejaculatory dysfunction in spinal cord lesions.
磷酸二酯酶 5 型抑制剂（PDE5Is）因其 20 多年来的疗效和可耐受的特点，被认为是治疗勃起功能障碍（ED）患者的有效治疗方法之一。
我们旨在评估口服 PDE5Is 对男性生殖功能的可能影响。
我们在多个数据库中进行了文献回顾，包括 PubMed/Medline 数据库、Scopus、Cochrane 图书馆、EMBASE、Academic Search Complete 和埃及知识库数据库。关键词/搜索词为“PDE5Is”、“西地那非”、“伐地那非”、“他达拉非”或“阿伐那非”，并将它们与“男性不育”、“精液”、“生殖激素”或“精子”相结合和交叉。
共选择了 101 篇文章。去除重复和动物研究后，最终有 75 篇文章进行了综述，涵盖了与男性人类生殖相关的不同项目，包括 PDE5Is 对精液或生殖激素不同参数的影响，以及 PDE5Is 在与男性因素相关的特殊不育症（如 ED、暂时性 ED 或射精失败与辅助生殖（AR）程序以及脊髓损伤的射精功能障碍）中的应用。我们发现 26 篇文章直接探讨了 PDE5Is 对精液和生殖激素谱的影响，其中 16 篇为体内研究，10 篇为体外研究。口服 PDE5Is 通常对精子运动有刺激作用，而其他精液参数和生殖激素谱则显示出不同的结果。与按需方案相比，长期每日方案的效果更为明显。然而，似乎控制最好的研究表明，男性生殖潜能的精子质量没有变化。
口服 PDE5Is 通常对精子运动有刺激作用，而其他精液参数和激素谱则显示出不同的结果。此外，口服 PDE5Is 在与男性因素相关的特殊不育症相关的情况下发挥了有用的作用，如 ED、暂时性 ED、射精失败与 AR 以及脊髓损伤的射精功能障碍。
