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

Objective

To explore the drug treatment for temporary ejaculation failure in couple undergoing assisted reproductive technologies (ART).

Design

Case report.

Setting

Andrology unit, center for reproductive medicine.

Patient (s)

Five patients suffering from temporary ejaculation failure during ART.

Intervention(s)

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.

Result(s)

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.

Conclusion(s)

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.

Key Words: Phosphodiesterase-5 inhibitor, selective serotonin reuptake inhibitor, assisted reproductive technologies, temporary ejaculation failure, anxiety