Combined use of phosphodiesterase-5 inhibitors and selective serotonin reuptake inhibitors for temporary ejaculation failure in couple undergoing assisted reproductive technologies

Andrology Unit, Center For Reproductive Medicine, Provincial Hospital, Shandong University, Jinan, Shandong, People's Republic of China.
Fertility and sterility (Impact Factor: 4.59). 05/2008; 91(5):1806-8. DOI: 10.1016/j.fertnstert.2008.03.003
Source: PubMed


To explore the drug treatment for temporary ejaculation failure in couple undergoing assisted reproductive technologies (ART).
Case report.
Andrology unit, center for reproductive medicine. PATIENT (S): Five patients suffering from temporary ejaculation failure during ART.
Assisted reproductive technology. Semen samples were collected by masturbation. The combined use of phosphodiesterase-5 inhibitor (PDE5-I; vardenafil, 10 mg) and selective serotonin reuptake inhibitor (SSRI; sertraline, 50 mg) to treat patients who failed to collect semen on the day of egg retrieval.
Five patients with unexpected ejaculation failure during ART treatments were identified; two patients could not produce spermatozoa 3 h after taking PDE5-I (sildenafil, 50 mg), However, the use of PDE5-I (vardenafil, 10 mg) plus SSRI (sertraline, 50 mg) enabled them to provide spermatozoa successfully. It suggested that the combined protocol could be more efficient for temporary ejaculation failure than sildenafil alone. On the day of the egg retrieval, we directly prescribed vardenafil and sertraline for the other three patients and got sperm samples without difficulty 2 h later.
The results indicate that the combined protocol of vardenafil plus sertraline could resolve the unpredictable ejaculation failure during ART. We presume that it might be helpful for attenuating the patients' stress and anxiety.

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    • "Evidence also shows that SSRIs have a spermicidal effect in vitro (24). One group has actually described SSRIs as an acutely helpful therapy to improve increased ejaculate volume in men taking Sildenafil (25). While there have been several small trials that link SSRIs to semen abnormalities, the authors could not identify a large trial that definitively link SSRIs to MFI as defined by in ability to achieve pregnancy. "
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