Men with depression, low fertility-related QOL more likely to have erectile dysfunction
Lower fertility-related quality of life (QOL) and depression show a robust association with erectile dysfunction in men of couples with unexplained infertility, but neither of these is associated with spermatogenesis or testosterone levels, according to a study.
This secondary analysis of a large, multicentre, randomized controlled trial in couples with unexplained fertility included 708 men (mean age, 34.2 years), who underwent baseline semen analysis with measurement of fasting total testosterone and gonadotropin. Participants also completed surveys, including the Fertility Quality of Life (FertiQOL), the Patient Health Questionnaire-9 (PHQ-9) and the International Index of Erectile Function (IIEF).
Total testosterone, with low total testosterone defined as <264 ng/dl, semen parameters and the IIEF score were the primary outcomes. Multivariable logistic regression analyses were performed, adjusting for age, race, body mass index, education, smoking, alcohol use, infertility duration and comorbidity.
Fifty-nine men (8.3 percent) had a PHQ-9 score of ≥5, which was consistent with depression, while 99 (14.0 percent) had low total cholesterol, and 63 (9.0 percent) had mild or worse erectile dysfunction.
The FertiQOL score and depression did not show any association with total cholesterol or any semen parameter, but the FertiQOL score inversely correlated with erectile dysfunction (for every 5-point score decline; adjusted odds ratio [aOR], 1.30, 95 percent CI, 1.16–1.46).
Furthermore, erectile dysfunction was significantly more likely to manifest in men with vs without depression (aOR, 6.31, 3.12–12.77).
“Erectile dysfunction in infertile men merits longitudinal investigation in future studies,” the investigators said.