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Management of Male Infertility with Coexisting Sexual Dysfunction: A Consensus Statement and Clinical Recommendations from the Asia-Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men's Health and Aging (ASMHA)

Chung E 1 , Hui J 2 , Xin ZC 3 , Kim SW 4 , Moon DG 5 , Yuan Y 6 Show all authors , Nagao K 7 , Hakim L 8 , Chang HC 9 , Mak SK 10 , Duarsa GWK 11 , Dai Y 12 , Yao B 13 , Son H 14 , Huang W 15 , Lin H 2 , Nguyen Q 16 , Mai DBT 17 , Park K 18 , Lee J 19 , Tantiwongse K 20 , Sato Y 21 , Jiann BP 22 , Ho C 23 , Park HJ 24

Affiliations 

  • 1 Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
  • 2 Department of Urology, Peking University Third Hospital, Beijing, China
  • 3 Male Reproductive and Sexual Medicine, Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
  • 4 Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
  • 5 Department of Urology, Korea University Guro Hospital, Seoul, Korea
  • 6 Andrology Centre, Peking University First Hospital, Peking University, Beijing, China
  • 7 Department of Urology, Toho University, Tokyo, Japan
  • 8 Department of Urology, Universitas Airlangga Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
  • 9 Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
  • 10 Department of Surgery, Union Hospital, Hong Kong, China
  • 11 Faculty of Medicine Udayana University, Bali, Indonesia
  • 12 The Department of Andrology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
  • 13 Department of Urology, Affiliated Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
  • 14 Department of Urology, Seoul National University College of Medicine, Seoul, Korea
  • 15 Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
  • 16 Centre of Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
  • 17 Department of Urology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
  • 18 Department of Urology, Chonnam National University Medical School, Gwangju, Korea
  • 19 Department of Urology, National University Hospital, Singapore
  • 20 Department of Urology, Chulalongkorn University Hospital, Bangkok, Thailand
  • 21 Department of Urology, Sanjukai Hospital, Sapporo, Japan
  • 22 Department of Urology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  • 23 School of Medicine, Taylor's University, Subang, Selangor, Malaysia
  • 24 Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
World J Mens Health, 2024 Jul;42(3):471-486.
PMID: 37853539 DOI: 10.5534/wjmh.230180

Abstract

Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients' factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men's Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: "low libido", "erectile dysfunction", "ejaculatory dysfunction", "premature ejaculation", "retrograde ejaculation", "delayed ejaculation", "anejaculation", and "orgasmic dysfunction" between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socio-economic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient's individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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