Sexual Dysfunction in Infertile Men: A Systematic Review and Meta-Analysis

Background: According to previous studies of male infertility, we found that the association between sexual dysfunction and male infertility was reported rarely and controversially. Aim: We carried out this 1meta-analysis to evaluate the prevalence of sexual dysfunction and the International Index of Erectile Function (IIEF) score in infertile men. Methods: A systematic search of the target literature was conducted using PubMed, EMBASE, and Cochrane Library. Data were analyzed using Review Manager 5.4 software. Standardized mean differences (SMD) with the corresponding 95% confidence intervals (95% CIs) were implemented in 6 controlled studies as a measure of effect size to assess the relationship between sexual dysfunction and male infertility and Odds Ratio (OR) were performed for the morbidity between infertility group and fertility group. Outcomes: Men in infertile group were found with higher prevalence of sexual dysfunction and lower IIEF values than in controls. Results: A meta-analysis of morbidity was performed in 8 of 10 controlled studies. Meta-analysis of the 8 studies found remarkable higher prevalence of sexual dysfunction in men with infertility than in controls (OR = 2.66, 95% confidence interval = 1.69-4.19, P < .0001; I2 = 67%, P for heterogeneity = 0.004). Another meta-analysis of evidence suggested that IIEF in infertile men was lower than controls (SMD = -0.47, 95% confidence interval = -0.63 to -0.31, P < .00001; I2 = 64%, p for heterogeneity = 0.02). Clinical Implications: We recommend further research based on the relevant criteria of region, sample size, rigorous statistical analysis, and research design. Strengths & limitations: This systematic review is the first to evaluate the prevalence of sexual dysfunction and the score of sexual dysfunction in male infertility. Investigation on the topic is scarce, and only few studies used Conclusions: Male infertility was associated with an increase in the prevalence of sexual dysfunction. The areas most affected by sexual function were erectile function, orgasm and sexual desire. Liu Y, Wang Y, Dong C, et al. Sexual Dysfunction in Infertile Men: A Systematic Review and Meta-Analysis. Sex Med 2022;XX: XXXXXX.