Erectile dysfunction is often accompanied by a significant change in the quality of a man’s life. As a rule, this problem, like impaired fertility, can have common underlying causes. Planning for self-conception in the presence of erectile dysfunction is simply impossible. These problems are episodic and have psychological and physiological factors. Let’s consider each of them in more detail. The psychological causes of erectile dysfunction include:
- excessive fatigue,
Physiological factors include:
- · pathological changes in the blood filling of the penis;
- · impaired nerve sensitivity of the penis ;
- · change in the blood level of sex hormones.
In the case of psychogenic erectile dysfunction, the quality of work of other organs and parts of the body is not observed, therefore infertility in such men is a rare thing. In other cases, erectile dysfunction is not a direct cause of infertility, and occurs due to age-related reasons.
Depending on the degree of erectile dysfunction and its pathology, therapeutic tactics may differ:
- · In the absence of other sexual dysfunctions and normal spermogram indicators, an erection can be restored with the use of certain drugs (for several hours after taking the pill), and a man will be able to conceive a child naturally.
- · In the case of hypogonadism or age-related androgenic deficiency, testosterone preparations are recommended – most often in an injectable form. This therapy contributes to the normalization of hormonal levels in the blood, as well as the restoration of erection and the quality of semen.
- · In the case of absence of dynamics from the use of drugs to normalize an erection, but with a high quality of semen, sexual intercourse can be facilitated through the introduction of intracavernous injections or with the help of LOD therapy.
Sperm in the IVF protocol using the ICSI method
It should be noted that cases of infertility with erectile dysfunction at a young age, with good spermogram readings, are extremely rare. Most often, the onset of this problem is associated with age-related changes that affect both the physiology and the quality of semen. In such cases, conception with the use of reproductive technologies is very effective.
Sexual impairment and infertility
With a decrease in libido, a man can have sexual intercourse, provided that an erection is maintained. Another question is that most often the suppression of libido is a consequence of a decrease in the level of androgens. That affects not only the libido, but also significantly impairs the quality of the seminal fluid. This change falls under the definition of endocrine infertility. To eliminate this problem, testosterone replacement therapy is used.
Other causes of decreased sex drive include:
- · hyperprolactinemia;
- · hypothyroidism;
- · obesity of 2-3 degrees;
- · diabetes mellitus;
- · severe somatic pathology.
After undergoing therapy, libido is most often restored. If this does not happen, IVF is indicated.
Violation of orgasm and infertility
Any painful sensations during orgasm. In the second case, most often the rejection of sexual intercourse is caused by the fear of discomfort. With a not timely solution to the problem, this factor only increases, which can lead to psychogenic erectile dysfunction and a decrease in libido.
Retrograde ejaculation and infertility
Retrograde ejaculation is a condition when the semen of a man during ejaculation enters his own bladder, and not outside (for example, in the partner’s vagina).
Causes of this phenomenon include:
- · Obstruction of the vas deferens.
- · Inadequate contraction of the bladder neck during orgasm.
Obstruction of the vas deferens – occurs as a result of previous surgical interventions, an inflammatory process or a congenital defect in development.
Violation of the contraction of the bladder neck develops as a complication from surgery, when taking medications, as well as in consequence of diabetes.
Most often, surgical treatment is prescribed, which can restore the ejaculation process. However, men are often not ready for this type of treatment because of fears or unwillingness to experience discomfort associated with the operation and the rehabilitation period. In such cases, it is recommended to resort to assisted reproductive technologies for conception.