While it is true that some cases of infertility are secondary, at least in part, to sexual disorders, they are more often the consequence than the cause of infertility.

Psychosexual problems responsible for infertility

The man

Male sexual dysfunctions are responsible for couple infertility in only about 5% of cases, on the other hand, infertility and its management may be associated with the appearance of male sexual dysfunction. You can visit this site now.

Congenital malformations

The micropenis defined, according to the authors, as a penis not exceeding 7.5 to 9cm in erection, can reduce the capacity for insemination.

• The congenital curvature, by hypoplasia of one of the two cavernous bodies or ventral chord, can make penetration impossible.
• Hypospadias can compromise procreation, in case of penoscrotal form. Operated hypospadias with diverticula or urethroplasty-related strictures can also be a cause of dysejaculation.
• Epispadias and complex forms associated with bladder extrophy.

Acquired morphological abnormalities

The curvatures of the erect penis from Peyronie’s disease and the sequelae of trauma to the penis can affect a couple’s fertility by compromising the quality of sperm deposition in the cervical uterine region.

Erectile dysfunction

The prevalence of erectile dysfunction is twice as high in the population of infertile men (15 to 22%) compared to men of the same age (7 to 9%). Severe erectile dysfunction (ED) can be a cause of male infertility but it is rare in young men and must be the subject of comprehensive management because it can be a sign of denial of paternity or serious psychological disorders. Of infertile men, 15-20% show signs of moderate or severe depression.

• Permanence of ED, defined by persistence of the disorder regardless of circumstances and partners, is a sign of seriousness.

In this context, psychogenic factors are to be sought in the same way as organic factors:

individual factors: neuroses, performance anxiety, ignorance of sexuality, depressive syndrome, personality factors, factors linked to gender identity, phobias and fears, and organic comorbidities (diabetes, hypertension, dyslipidemia, hypogonadism);

Relational factors: conflict between spouses, resigned attitude and guilt of one of the partners, aggressive and protesting attitude (s), extramarital relationship (s), widowhood syndrome, break-up;

Cultural and social factors: situation (s) or condition (s) of life making the expression of sexuality difficult or fatherhood generating anxiety (unemployment, risk of dishonor, fertility / erection assimilation, age difference).

Ejaculation disorders

Premature ejaculation

Premature ejaculation does not interfere with fertilization provided that there is regular penetration and intravaginal ejaculation. The permanent anteportas ejaculation can be a cause of male infertility. Among men consulting for infertility as a couple, 50 to 66% say they ejaculate faster than they would like and 50% of women say they are frustrated by the speed of their partner’s ejaculation. 

If premature ejaculation alters the quality of the relationship between the two partners measured by the SEAR score, it does not appear that this parameter is associated with an increase in sexual disorders in the partners measured by the FSFI score.The high prevalence of premature ejaculation is therefore more likely a consequence than a cause of infertility and certainly a sign of suboptimal communication in matters of sexuality in infertile couples.