We observed four men who had temporary erectile dysfunction during procedures related to in vitro fertilization (IVF). One of the patients was 36 years old. He and his 32-year-old partner were recommended IVF after a failure to stimulate ovulation and intrauterine insemination (WMO), conducted for secondary infertility, unspecified in the course of 3 years. Earlier, in three cycles of the WMO, the man had no problems with ejaculation if necessary. However, on the day of sampling the egg, he had a temporary erectile dysfunction, lasting 12 hours. She was associated with the stress that he felt in connection with IVF.
After exhausting attempts to sperm, we came to the conclusion that, perhaps, sildenafil will help to solve this problem for a man. After 1 hour and 10 hours after taking 50 mg of sildenafil, the patient was able to pass two samples of sperm with a total number of mobile spermatozoons of 70 × 106. The woman was taken 6 eggs, which were fertilized, according to the standard IVF protocol. After 18 hours we observed two pronucleus in four ovules, but the subsequent fragmentation of the egg did not occur,so the embryo was not transplanted. The patient was not asked to take two samples of sperm. Probably, he did it on his own initiative for security.
We assumed that earlier the use of sildenafil in this case could prevent the delay in fertilization and the loss of fertility in this cycle. Therefore, we found among our patients those who had a history of erectile dysfunction during artificial insemination, which could benefit from the early use of the drug in the cycle of IVF.
The second patient was aged 41 years. The previous time I was able to take a sperm sample with WMO only after five hours of attempts. A third patient, a 45-year-old man, could not sperm in the morning with the previous nine fences of the egg. Successful attempts occurred only the evening before, so until the morning the sperm was stored in a special environment. Once he was given a testicular extraction of spermatozoa because of the inability to pass the sperm for IVF. The third patient of 35 years could pass the sample of sperm only after two hours of attempts. Each of these patients was assigned sildenafil at a dosage of 50 mg per hour before attempting to sperm for IVF or WMO.
The second and third patient after the application of sildenafil passed the sperm without problems. The fourth patient did not need the drug, because, thanks to the offered help, he was able to cope with the excitement and was able to pass the sperm without taking the drug.
In the absence of contraindications sildenafil with temporary erectile dysfunction during ART, it seems a simple and pharmacoeconomically beneficial solution for assisting in the sperm delivery, if necessary. In most cases, it eliminates the need to apply surgical methods.