OBJECTIVETo investigate the impact of infertility on men's self-esteem, self-confidence, sexual satisfaction and overall relationship with their spouses.

METHODSUsing Self-Esteem and Relationship questionnaire (SEAR), we conducted an investigation among 253 infertile men and 52 fertile male controls. We divided the infertile men into four subgroups according to their perceived causes of infertility: male (M) factors, female (F) factors, both M and F factors, and unknown factors, and compared the SEAR scores among different groups.

RESULTSIn the infertile men, the total SEAR score was significantly higher in those with < 3 years than in those with > or = 3 years of infertility duration (75.50 +/- 17.05 vs 68.66 +/- 17.19, P < 0.05) and so was it in those with above-high-school than in those with high-school or lower education background (81.42 +/- 13.99 vs 67.61 +/- 17. 8, P < 0.01), but showed no significant difference between the > or = 30- and < 30-year-olds (71.77 +/- 17.42 vs 72.74 +/- 18.38, P > 0.05). The total SEAR scores in the M factor, M & F factor, unknown factor and F factor groups were 65.69 +/- 18.68, 68.52 +/- 17.68, 74.85 +/- 15.19 and 83.21 +/- 12.61, respectively, with significant differences between the first two and the latter two groups (P < 0.05), as well as between the unknown factor and F factor groups (P < 0.05). In the fertile male controls, the total SEAR score and subdomain scores on sexual relationship, self-confidence, self-esteem and overall relationship were 90.04 +/- 9.85, 88.40 +/- 10.74, 92.23 +/- 9.41, 91.95 +/- 10.67 and 90.38 +/- 14.14, respectively, all remarkably higher than in the M factor, M&F factor and unknown factor groups of the infertile men after adjustment of their infertility duration and education levels (P < 0.05).

CONCLUSIONInfertility reduces men's self-esteem, self-confidence, sexual satisfaction and relationship with their spouses, and the degree of its impact is correlated with the patients' infertility duration and education level.

Adult ; Erectile Dysfunction ; psychology ; Humans ; Infertility, Male ; psychology ; Male ; Personal Satisfaction ; Self Concept ; Surveys and Questionnaires

There has been increasing interest in the psycho-socio-relational and sexual disorders of infertility, as the risk of psychological burden among infertile men with sexual dysfunctions is significant. The purpose of this study was to develop and to validate a predictive model to estimate individual psychological burden among infertile men with sexual dysfunction and study the association between them. Comprehensive data were collected for infertile men (n = 480) who sought treatment for infertility in a reproductive medicine center between June 2012 and December 2013. Using independent predictors of psychological burden from the least absolute shrinkage and selection operator, univariable and multivariable analyses were developed into two models. Predictive accuracy was compared between the models. We explored the association between sexual dysfunction and psychological burden. A total of 480 patients were analyzed using 10-fold cross-validation. Independent predictors of psychological burden were incorporated into a model to measure anxiety (corrected-area under curve (AUC): 77.3%) and a model to measure depression (corrected-AUC: 70.2%). Anxiety and depression were both associated with erectile dysfunction (P < 0.05), with anxiety demonstrating the strongest association. Only anxiety was associated with premature ejaculation (P < 0.05). Premature ejaculation was not found to be associated with depression (P > 0.05). Predictive models for psychological burden among infertile men with sexual dysfunction are presented, and we found that there is an association between psychological burden and sexual dysfunction. According to the models, proper counseling and treatment of sexual dysfunction in infertile men may reduce the psychological burden, help attain natural pregnancy, and improve the quality of life.
Adolescent ; Adult ; Anxiety/psychology* ; Cross-Sectional Studies ; Depression/psychology* ; Erectile Dysfunction/psychology* ; Humans ; Infertility, Male/psychology* ; Male ; Quality of Life/psychology* ; Surveys and Questionnaires ; Young Adult

PURPOSE: The aim of this study was to evaluate the damage to the testicles caused by a varicocele over time with using an experimental varicocele rat model and by measuring the testicular weight, the status of oxidative stress, the hormonal changes and the degeneration of the tubules. MATERIALS AND METHODS: Thirty male Sprague-Dawley white rats, 10 weeks old, weighing 350-360g each, had experimentally induced left varicoceles; 30 rats of the same age were used as a control group. All rats in the varicocele and control groups were sacrificed at 2, 4 and 8 weeks after surgery. The testicular weight, the levels of serum reactive oxygen species, serum testosterone, LH and FSH, as well as the degenerative changes of the tubules were measured. Statistical analyses for comparisons between the two groups were performed using the Mann-Whitney U test; probability values of less than 0.05 were considered significant. RESULTS: Degenerative changes of the tubules on H-E stain and the testicular weight loss were observed 4 weeks after surgery. There was a significant difference in the serum ROS between the varicocele group and the control group at eight weeks after surgery. However, there were no significant differences found in the serum testosterone, LH or FSH. CONCLUSIONS: The results of this study with using a rat model showed that a varicocele may cause progression of the testicular damage that induced by the varicocele over time. If a further study shows that this damage can be reversed, then there may be a critical period for treatment of men before infertility develops.
Animals ; Critical Period (Psychology) ; Humans ; Infertility ; Infertility, Male ; Male ; Oxidative Stress ; Rats ; Reactive Oxygen Species ; Testis ; Testosterone ; Varicocele ; Weight Loss

OBJECTIVETo study the psychology of infertility patients from the perspective of economic sociology so as to prevent the patients from medical frauds in seeking medical treatment.

METHODWe investigated 902 infertility patients of the Third Hospital of Peking University from September 2005 to January 2006 using a randomized questionnaire.

RESULTSOf the total number, 84.4% had education below college level; the majority had a low monthly family income, 36.6% below Y1,000, 19.7% from Y1,000 to Y2,000, 16.5% from Y2,000 to Y3,000, 7.8% from Y3,000 to Y4,000 and 19.4% above Y4,000; 88.7% had a strong desire for a child; 60.3% were psychologically stressed. As for the advertisements for the treatment of infertility, 50.2% of the patients disbelieved them, 6.2% wanted to have a try and about 43.6% accepted them to be true. Regarding the treatment in individual hospitals, 55.2% disbelieved in it, 5.8% wanted to try it and about 39.0% believed in it.

CONCLUSIONInfertility patients of low economic status usually have a lower educational level but a higher desire for children, and therefore are more likely to be the victims of medical frauds and more psychologically stressed. It calls for our attention how to provide them with medical help.

Educational Status ; Health Knowledge, Attitudes, Practice ; Humans ; Infertility, Male ; economics ; psychology ; therapy ; Male ; Socioeconomic Factors ; Surveys and Questionnaires

OBJECTIVE: To investigate the factors influencing sterility in males undergoing routine sperm inspection by masturbation. METHODS: Scales for demographic data, self-compiled infertility questionnaire, Symptom Checklist-90 (SCL-90) , and sexual life subscale of Olson Marital Quality Questionnaire (ENRICH) were assessed in 220 cases of sterility in males who had undergone sperm examination after ejaculation. RESULTS: The total SCL-90 scores and the factor scores of anxiety, phobia, somatization, obsessive compulsive behavior, interpersonal-sensitivity, hostility, and depression were significantly higher than the norm (P<0.05). The total SCL-90 score of 69 males was higher than 160, implying that 31.36% of the sterile males had negative emotions. The total score was related to wife's attitude, semen collecting room, ejaculation situation, and the general state of sexual life. The ejaculation situation was subjected to a multivariate linear regression model. CONCLUSION About 1/3 of males with sterility problems undergoing routine semen examination by masturbation have negative emotions such as anxiety, phobia, somatization, and interpersonal sensitivities. The defective ejaculation may be the influential factor at the stage.
Adult ; Anxiety ; physiopathology ; Ejaculation ; Humans ; Infertility, Male ; psychology ; Male ; Masturbation ; Phobic Disorders ; physiopathology ; Sperm Count ; Sperm Motility ; Stress, Psychological

OBJECTIVETo study the mental health status of infertility patients with varicocele and its relationship with infertility.

METHODSUsing Hospital Anxiety and Depression scale (HAD), we assessed the psychological status of 110 infertility patients with varicocele, identified the risk factors of anxiety and depression in these patients, and analyzed the correlation among psychological and other relevant factors. Meanwhile, we recruited 61 age-matched normal fertile men as controls for comparative analysis. We also conducted logistic regression analysis on the mental health status of the 106 infertility patients with varicocele.

RESULTSThe prevalence rates of anxiety were 61.32% and 13.79%, while those of depression 37.73% and 6.90% in the infertile patients and normal fertile controls, respectively, significantly higher in the former than in the latter (P < 0.05). Logistic regression analysis showed that the main risk factors of anxiety and depression of the infertile patients were the number of times they sought medical care and the severity of their testis disorders.

CONCLUSIONInfertility patients with varicocele have psychological disorders, which are particularly associated with the frequency of the patients' clinic visit and the severity of their testis disorders.

Adult ; Anxiety Disorders ; epidemiology ; Case-Control Studies ; Depression ; epidemiology ; Humans ; Infertility, Male ; complications ; epidemiology ; psychology ; Male ; Middle Aged ; Surveys and Questionnaires ; Varicocele ; complications ; epidemiology ; psychology ; Young Adult

ObjectiveTo investigate the impact of infertility-related psychological stress (IRPS) on the quality of life (QOL) of azoospermia patients and the correlation between IRPS and QOL.

METHODSUsing the Fertility Problem Inventory and Fertility-Related QOL (FertiQOL) questionnaire, we carried out a cross-sectional study among 503 azoospermia patients treated in our center from January to July 2017, all subjected to testicular biopsy for identification of the causes. We analyzed the IRPS and QOL of the patients and explored their correlation.

RESULTSThe total score of the azoospermia patients for IRPS was 153.60 ± 27.21 and that for QOL was 64.22 ± 14.68. Multivariate linear regression analysis showed that the main factors influencing the patients' QOL included IRPS ( β = －0.298, P< 0.05), education ( β = －0.093, P< 0.05), and age ( β = 0.099, P< 0.05). Pearson correlation analysis revealed a negative correlation of the total QOL score with all the factors for IRPS (P <0.01).

CONCLUSIONSIRPS is an important factor affecting azoospermia patients' QOL, the higher the IRPS, the worse the QOL. Therefore, sufficient attention and effective intervention measures are needed for the improvement of their QOL.

Azoospermia ; psychology ; Cross-Sectional Studies ; Humans ; Infertility, Male ; psychology ; Male ; Quality of Life ; Regression Analysis ; Sertoli Cell-Only Syndrome ; Stress, Psychological ; Surveys and Questionnaires

Objective: To investigate the relationship of erectile dysfunction (ED) with psychological factors in male patients with infertility. METHODS: We conducted a questionnaire investigation among 252 male patients with infertility, which involved the general condition, results of semen routine examination, sexual life, and scores in IIEF-5, self-reported 9-item patient health questionnaire (PHQ-9) and 7-item generalized anxiety disorder scale (GAD-7). We analyzed the prevalence of ED, depression, and anxiety and their correlations among the patients in comparison with 100 fertile male controls. RESULTS: In 245 of the infertility patients, the most common symptoms of depression and anxiety were "feeling tired or no vitality" and "easily getting worried or impatient", 20.4% of them with depression disorder and 42.9% with anxiety disorder. The PHQ-9 and GAD-7 scores were significantly higher in the infertile males than in the normal fertile controls (P <0.05), and so was the incidence of ED (28.6% vs 12.4%, P <0.05), while the IIEF-5 scores were markedly lower in the former than in the latter group (P <0.01), and so were sex frequency and sexual satisfaction (P <0.05). The PHQ-9 and GAD-7 scores were remarkably higher in the infertility patients with ED than in those without (P <0.01). Logistic regression analysis showed that the level of libido and results of semen routine examination were the risk factors for depression disorder, while age, education level, disease course and experience of assisted reproduction were those for anxiety disorder. CONCLUSIONS Male infertility patients have a poorer mental health and a higher incidence of ED than normal fertile men, and there is some interaction between psychological status and ED prevalence.
Anxiety ; epidemiology ; Depression ; epidemiology ; Erectile Dysfunction ; epidemiology ; psychology ; Humans ; Infertility, Male ; psychology ; Libido ; Male ; Patient Health Questionnaire ; Prevalence ; Risk Factors ; Semen Analysis ; Sexual Behavior

OBJECTIVE: To figure out the more optimal method for freezing and thawing the sperm, we compared with the sperm motility after handling of the sperm based on the different types of freezing and thawing methods. METHODS:Twenty four adult males who visited our infertility clinic from Aug 2004 to Feb 2005 were enrolled. We applied two kinds of freezing method to normal sperm according to WHO standard criteria; automatic slow freezing method (Auto) and manual vapor freezing method (Manu). We also use two different methods of thawing; a 37 degreesC warm water bath (37 degreesC) and 22 degreesC room temperature thawing (22 degreesC). Mean motile percent (MMP) was compared by the freezing methods and thawing methods respectively. We also evaluated the motility in four different ways of freezing and thawing combination. A written informed consent was obtained from each client. This study was approved by IRB. RESULTS: MMP by the freezing method was 56% in Auto group and 52% in Manu group. It was significantly different (P=0.037). In thawing method, it was 59% in 37 degreesC group and 49% in 22 degreesC group (P=0.000). Each of freezing and thawing methods was joined to make four different types of freezing and thawing combinations. In MMP there were 63% in Auto/37 degreesC, 50% in Auto/22 degreesC, 56% in Manu/37 degreesC and 48% in Manu/22 degreesC (P>0.05). CONCLUSION: The automatic method in freezing and room temperature in thawing showed respectively the highest MMP. In four different types of freezing and thawing combinations, Auto/37 degreesC MMP was the highest. There was no statistical difference. This means that all four types of freezing and thawing methods might be used clinically. If further study of larger population or comparison of fertility is done, we would have a better result.
Adult ; Baths ; Ethics Committees, Research ; Fertility ; Freezing ; Handling (Psychology) ; Humans ; Infertility ; Informed Consent ; Male ; Sperm Motility ; Spermatozoa ; Water

OBJECTIVE: To figure out the more optimal method for freezing and thawing the sperm, we compared with the sperm motility after handling of the sperm based on the different types of freezing and thawing methods. METHODS:Twenty four adult males who visited our infertility clinic from Aug 2004 to Feb 2005 were enrolled. We applied two kinds of freezing method to normal sperm according to WHO standard criteria; automatic slow freezing method (Auto) and manual vapor freezing method (Manu). We also use two different methods of thawing; a 37 degreesC warm water bath (37 degreesC) and 22 degreesC room temperature thawing (22 degreesC). Mean motile percent (MMP) was compared by the freezing methods and thawing methods respectively. We also evaluated the motility in four different ways of freezing and thawing combination. A written informed consent was obtained from each client. This study was approved by IRB. RESULTS: MMP by the freezing method was 56% in Auto group and 52% in Manu group. It was significantly different (P=0.037). In thawing method, it was 59% in 37 degreesC group and 49% in 22 degreesC group (P=0.000). Each of freezing and thawing methods was joined to make four different types of freezing and thawing combinations. In MMP there were 63% in Auto/37 degreesC, 50% in Auto/22 degreesC, 56% in Manu/37 degreesC and 48% in Manu/22 degreesC (P>0.05). CONCLUSION: The automatic method in freezing and room temperature in thawing showed respectively the highest MMP. In four different types of freezing and thawing combinations, Auto/37 degreesC MMP was the highest. There was no statistical difference. This means that all four types of freezing and thawing methods might be used clinically. If further study of larger population or comparison of fertility is done, we would have a better result.
Adult ; Baths ; Ethics Committees, Research ; Fertility ; Freezing ; Handling (Psychology) ; Humans ; Infertility ; Informed Consent ; Male ; Sperm Motility ; Spermatozoa ; Water