Sexual dysfunction in men undergoing infertility evaluation: a cohort observational study.

OBJECTIVE To study psychosexual problems in men undergoing infertility evaluation. DESIGN A cohort observational study. SETTING Male infertility diagnostic center. PATIENT(S) Four hundred twelve men undergoing infertility evaluation between 1999 and 2001. INTERVENTION(S) Baseline and follow-up data on sexual functions. Semen analysis for samples collected by masturbation. A second analysis was requested in 2 weeks upon finding an abnormality of semen parameters. Penile vibratory stimulation to help men who failed to collect semen on their second or subsequent appointments. MAIN OUTCOME MEASURE(S) Sexual functions (erection and orgasm) during the time of infertility evaluation. RESULT(S) Seven of 412 men were excluded from the analysis due to a past history of sexual dysfunction. Of the remaining 405 men, 46 (11%) failed to collect semen by masturbation for a second semen analysis after repeated (2-4 times) attempts at 2- to 3-day intervals. Nine of these men (20%) were able to collect semen using vibratory stimulation. All 46 men experienced problems with erection or orgasm and had severe anxiety during attempts to masturbate and during sexual contact with their partners. CONCLUSION(S) Our study indicates that some men may experience sexual dysfunction of a psychogenic nature in response to the diagnosis of infertility.