Sildenafil has had a dramatic influence on the field of sexual medicine over the past 20 years. Not only have phosphodiesterase-5 (PDE5) inhibitors improved the treatment of erectile dysfunction (ED), they have indirectly contributed to the treatment of male factor infertility. A review of the literature between 1998 - 2018 was performed using PubMed with regards to sildenafil and male infertility. Numerous studies have demonstrated sildenafil’s safety and efficacy for treating ED. Sildenafil does not alter semen parameters, and, in fact, may positively affect semen parameters. Sildenafil is helpful for treating ED caused by the psychological stress of infertility treatments. Sildenafil has improved the treatment of ED and may have a benefit on semen parameters. This has aided in the management of male factor infertility, and has contributed to hundreds of thousands of pregnancies that would have been more difficult, as it was before its advent.
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Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker. Sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med. 1998;338:1397–404.
Shah J. Erectile dysfunction through the ages. BJU Int. 2002;90:433–41.
Tan P, Liu L, Wei S, Tang Z, Yang L, Wei Q. The effect of oral phosphodiesterase-5 inhibitors on sperm parameters: a meta-analysis and systematic review. Urology. 2017;105:54–61.
Wincze JP. Psychosocial aspects of ejaculatory dysfunction and male reproduction. Fertil Steril. 2015;104:1089–94.
Dehghani Firouzabadi R, Davar R, Hojjat F, Mahdavi M. Effect of sildenafil citrate on endometrial preparation and outcome of frozen–thawed embryo transfer cycles: a randomized clinical trial. Iran J Reprod Med. 2013;11:151–8.
Burger M, Sikka SC, Bivalacqua TJ, Lamb DJ, Hellstrom WJ. The effect of sildenafil on human sperm motion and function from normal and infertile men. Int J Impot Res. 2000;12:229–34.
du Plessis SS, de Jongh PS, Franken DR. Effect of acute in vivo sildenafil citrate and in vitro 8-bromo-cGMP treatments on semen parameters and sperm function. Fertil Steril. 2004;81:1026–33.
Sher G, Fisch JD. Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. Fertil Steril. 2002;78:1073–6.
Goldstein I, Tseng LJ, Creanga D, Stecher V, Kaminetsky JC. Efficacy and safety of sildenafil by age in men with erectile dysfunction. J Sex Med. 2016;13:852–9.
Yang B, Xu P, Shi Y, Xu J, Zheng L, Li H, et al. Erectile dysfunction and associated risk factors in Chinese males of infertile couples. J Sex Med. 2018;15:671–7.
Pan BC, Xing X, Li P, Guo RH, Du Q, Liang X, et al. [Impact of perceived male infertility factors on penile erectile function]. Zhonghua Nan Ke Xue. 2013;19:1087–90.
Perlis N, Lo KC, Grober ED, Spencer L, Jarvi K. Coital frequency and infertility: which male factors predict less frequent coitus among infertile couples? Fertil Steril. 2013;100:511–5.
Boorjian S, Hopps CV, Ghaly SW, Parker M, Mulhall JP. The utility of sildenafil citrate for infertile men with sexual dysfunction: a pilot study. BJU Int. 2007;100:603–6.
Althof SE, Berner MM, Goldstein I, Claes HI, Cappelleri JC, Bushmakin AG, et al. Interrelationship of sildenafil treatment effects on the physiological and psychosocial aspects of erectile dysfunction of mixed or organic etiology. J Sex Med. 2010;7:3170–8.
Tan HM, Tong SF, Ho CC. Men’s health: sexual dysfunction, physical, and psychological health—is there a link? J Sex Med. 2012;9:663–71.
Miner M, Nehra A, Jackson G, Bhasin S, Billups K, Burnett AL, et al. All men with vasculogenic erectile dysfunction require a cardiovascular workup. Am J Med. 2014;127:174–82.
McCabe MP, Althof SE. A systematic review of the psychosocial outcomes associated with erectile dysfunction: does the impact of erectile dysfunction extend beyond a man’s inability to have sex? J Sex Med. 2014;11:347–63.
Sadovsky R. Integrating erectile dysfunction treatment into primary care practice. Am J Med. 2000;109:22–8.
Conflict of interest
WJGH is a consultant/advisor for Pfizer. The other authors declare that they have no conflict of interest.
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Scherzer, N.D., Le, T.V. & Hellstrom, W.J.G. Sildenafil’s impact on male infertility: what has changed in 20 years?. Int J Impot Res 31, 71–73 (2019). https://doi.org/10.1038/s41443-018-0067-x