agxАндрология и генитальная хирургияAndrology and Genital Surgery2070-97812412-890210.17650/2070-9781-2023-24-3-50-55agx-694Research ArticleОБЗОРНАЯ СТАТЬЯREVIEWСвязь ингибиторов фосфодиэстеразы 5-го типа и мужской фертильности: обзор литературыThe relationship of phosphodiesterase 5 inhibitors and male fertility: literature reviewhttps://orcid.org/0000-0003-1854-368XНаумовН. П.NaumovN. P.

Наумов Никита Петрович.

142611 Орехово-Зуево, ул. Барышникова, 13

Nikita P. Naumov.

13 Baryshnikova St., Orekhovo-Zuevo, Moscow Region 142600

naumovuro@mail.ruhttps://orcid.org/0000-0002-6082-1703ЩеплевП. А.ShcheplevP. A.

119435 Москва, ул. Малая Пироговская, 1а

1а, Malaya Pirogovskaya St., Moscow 119435

https://orcid.org/0000-0002-9367-6047ИпатенковВ. В.IpatenkovV. V.

119435 Москва, ул. Малая Пироговская, 1а

1а, Malaya Pirogovskaya St., Moscow 119435

СтолетовЯ. A.StoletovYa. A.

142611 Орехово-Зуево, ул. Барышникова, 13

13 Baryshnikova St., Orekhovo-Zuevo, Moscow Region 142600

https://orcid.org/0000-0002-7866-3168КонышевА. В.KonyshevA. V.

142611 Орехово-Зуево, ул. Барышникова, 13

13 Baryshnikova St., Orekhovo-Zuevo, Moscow Region 142600

БазуновД. С.BazunovD. S.

142611 Орехово-Зуево, ул. Барышникова, 13

13 Baryshnikova St., Orekhovo-Zuevo, Moscow Region 142600

ГБУЗ МО «Орехово-Зуевская областная больница»РоссияOrekhovo-Zuevo Central City HospitalRussian FederationПрофессиональная ассоциация андрологов РоссииРоссияProfessional Association of Andrologists of RussiaRussian Federation2023120920232435055Copyright © Наумов Н.П., Щеплев П.А., Ипатенков В.В., Столетов Я.A., Конышев А.В., Базунов Д.С., 20232023Наумов Н.П., Щеплев П.А., Ипатенков В.В., Столетов Я.A., Конышев А.В., Базунов Д.С.Naumov N.P., Shcheplev P.A., Ipatenkov V.V., Stoletov Y.A., Konyshev A.V., Bazunov D.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://agx.elpub.ru/jour/article/view/694

Цель данного обзора литературы – оценить роль ингибиторов фосфодиэстеразы 5-го типа в терапии не только эректильной дисфункции, но и мужского бесплодия.

Ингибиторы фосфодиэстеразы 5-го типа оказывают положительное влияние на секреторную функцию клеток Лейдига и Сертоли, биохимическую среду в семявыносящих протоках, сократительную способность белочной оболочки яичка и секреторную функцию предстательной железы. В нескольких исследованиях продемонстрирован положительный эффект от приема силденафила в отношении количественной и качественной подвижности сперматозоидов. Кроме того, некоторые исследования показывают, что ингибиторы фосфодиэстеразы 5-го типа положительно воздействуют на способность сперматозоидов подвергаться капацитации.

Отечественный препарат «Вилдегра» – единственный препарат силденафила с пролонгированным действием, при равной эффективности обладает лучшей переносимостью по сравнению с оригинальным препаратом.

The purpose of this literature review is to assess the role of phosphodiesterase 5 inhibitors not only in the treatment of erectile dysfunction, but also in the treatment of male infertility.

Phosphodiesterase 5 inhibitors has a positive effect on the secretory function of Leydig and Sertoli cells, the biochemical environment in the vas deferens, the contractility of the testicular protein membrane and the secretory function of the prostate gland. In several studies, the effect of taking sildenafil positively affected the quantitative and qualitative motility of spermatozoa. In addition, some studies show that phosphodiesterase 5 inhibitors has a positive effect on the ability of spermatozoa to undergo capacitation.

The “Vildegra” is the only sildenafil in a prolonged release form, with equal effectiveness, it has better tolerability compared to the original.

силденафилингибиторы фосфодиэстеразы 5-го типамужское бесплодиеэректильная дисфункцияВилдеграsildenafilphosphodiesterase 5 inhibitorsmale infertilityerectile dysfunctionVildegraReferencesDjøseland O., Gordeladze J.O., Høglo S. et al. Evidence for androgen-dependent phosphodiesterase activity in rat seminal vesicle and epididymis. Int J Androl 1980;3(1–6):363–6. DOI: 10.1111/j.1365-2605.1980.tb00125.xDjøseland O., Gordeladze J.O., Høglo S. et al. Evidence for androgen-dependent phosphodiesterase activity in rat seminal vesicle and epididymis. Int J Androl 1980;3(1–6):363–6. DOI: 10.1111/j.1365-2605.1980.tb00125.xBenau D., Szabo E.I., Terner C. Endogenous inhibitors of cyclic adenosine 3’,5’-monophosphate-phosphodiesterase in rat epididymis. Biol Reprod 1986;35(4):799–805. DOI: 10.1095/biolreprod35.4.799Benau D., Szabo E.I., Terner C. Endogenous inhibitors of cyclic adenosine 3’,5’-monophosphate-phosphodiesterase in rat epididymis. Biol Reprod 1986;35(4):799–805. DOI: 10.1095/biolreprod35.4.799Razzaboni B., Terner C. Cyclic adenosine 3’,5’-monophosphate-phosphodiesterases in epididymis and prostate of castrate and of aged rats. Mech Ageing Dev 1988;43(1):61–9. DOI: 10.1016/0047-6374(88)90097-8Razzaboni B., Terner C. Cyclic adenosine 3’,5’-monophosphate-phosphodiesterases in epididymis and prostate of castrate and of aged rats. Mech Ageing Dev 1988;43(1):61–9. DOI: 10.1016/0047-6374(88)90097-8Setchell B., Breed W. Anatomy, vasculature, and innervation of the male reproductive tract. In: Knobil and Neill’s Physiology of Reproduction. Ed. by J.D. Neill. 3rd edn. Elsevier, 2006. P. 771–825.Setchell B., Breed W. Anatomy, vasculature, and innervation of the male reproductive tract. In: Knobil and Neill’s Physiology of Reproduction. Ed. by J.D. Neill. 3rd edn. Elsevier, 2006. P. 771–825.Zhang C., Yeh S., Chen Y.T. et al. Oligozoospermia with normal fertility in male mice lacking the androgen receptor in testis peritubular myoid cells. Proc Natl Acad Sci U S A 2006;103(47):17718–123. DOI: 10.1073/pnas.0608556103Zhang C., Yeh S., Chen Y.T. et al. Oligozoospermia with normal fertility in male mice lacking the androgen receptor in testis peritubular myoid cells. Proc Natl Acad Sci U S A 2006;103(47):17718–123. DOI: 10.1073/pnas.0608556103Mewe M., Bauer C.K., Müller D., Middendorff R. Regulation of spontaneous contractile activity in the bovine epididymal duct by cyclic guanosine 5’-monophosphate-dependent pathways. Endocrinology 2006;147(4):2051–62. DOI: 10.1210/en.2005-1324Mewe M., Bauer C.K., Müller D., Middendorff R. Regulation of spontaneous contractile activity in the bovine epididymal duct by cyclic guanosine 5’-monophosphate-dependent pathways. Endocrinology 2006;147(4):2051–62. DOI: 10.1210/en.2005-1324Swinnen J.V., Joseph D.R., Conti M. Molecular cloning of rat homologues of the Drosophila melanogaster dunce cAMP phosphodiesterase: evidence for a family of genes. Proc Natl Acad Sci U S A 1989;86(14):5325–9. DOI: 10.1073/pnas.86.14.5325Swinnen J.V., Joseph D.R., Conti M. Molecular cloning of rat homologues of the Drosophila melanogaster dunce cAMP phosphodiesterase: evidence for a family of genes. Proc Natl Acad Sci U S A 1989;86(14):5325–9. DOI: 10.1073/pnas.86.14.5325Geremia R., Rossi P., Pezzotti R., Conti M. Cyclic nucleotide phosphodiesterase in developing rat testis identification of somatic and germ-cell forms. Mol Cell Endocrinol 1982;28(1):37–53. DOI: 10.1016/0303-7207(82)90039-9Geremia R., Rossi P., Pezzotti R., Conti M. Cyclic nucleotide phosphodiesterase in developing rat testis identification of somatic and germ-cell forms. Mol Cell Endocrinol 1982;28(1):37–53. DOI: 10.1016/0303-7207(82)90039-9Morena A.R. Boitani C., de Grossi S. et al. Stage and cell-specific expression of the adenosine 3’,5’ monophosphate-phosphodiesterase genes in the rat seminiferous epithelium. Endocrinology 1995;136(2):687–95. DOI: 10.1210/endo.136.2.7835302Morena A.R. Boitani C., de Grossi S. et al. Stage and cell-specific expression of the adenosine 3’,5’ monophosphate-phosphodiesterase genes in the rat seminiferous epithelium. Endocrinology 1995;136(2):687–95. DOI: 10.1210/endo.136.2.7835302Fujishige K., Kotera J., Michibata H. et al. Cloning and characterization of a novel human phosphodiesterase that hydrolyzes both cAMP and cGMP (PDE10A). J Biol Chem 1999;274(26):18438–45. DOI: 10.1074/jbc.274.26.18438Fujishige K., Kotera J., Michibata H. et al. Cloning and characterization of a novel human phosphodiesterase that hydrolyzes both cAMP and cGMP (PDE10A). J Biol Chem 1999;274(26):18438–45. DOI: 10.1074/jbc.274.26.18438Soderling S.H., Bayuga S.J., Beavo J.A. Cloning and characterization of a cAMP-specific cyclic nucleotide phosphodiesterase. Proc Natl Acad Sci U S A 1998;95(15):8991–6. DOI: 10.1073/pnas.95.15.8991Soderling S.H., Bayuga S.J., Beavo J.A. Cloning and characterization of a cAMP-specific cyclic nucleotide phosphodiesterase. Proc Natl Acad Sci U S A 1998;95(15):8991–6. DOI: 10.1073/pnas.95.15.8991Siuciak J.A., McCarthy S.A., Chapin D.S. et al. Genetic deletion of the striatum-enriched phosphodiesterase PDE10A: evidence for altered striatal function. Neuropharmacology 2006;51(2):374–85. DOI: 10.1016/j.neuropharm.2006.01.012Siuciak J.A., McCarthy S.A., Chapin D.S. et al. Genetic deletion of the striatum-enriched phosphodiesterase PDE10A: evidence for altered striatal function. Neuropharmacology 2006;51(2):374–85. DOI: 10.1016/j.neuropharm.2006.01.012Baxendale R.W., Fraser L.R. Mammalian sperm phosphodiesterases and their involvement in receptor-mediated cell signaling important for capacitation. Mol Reprod Dev 2005;71(4):495–508. DOI: 10.1002/mrd.20265Baxendale R.W., Fraser L.R. Mammalian sperm phosphodiesterases and their involvement in receptor-mediated cell signaling important for capacitation. Mol Reprod Dev 2005;71(4):495–508. DOI: 10.1002/mrd.20265Francis S.H. Phosphodiesterase 11 (PDE11): is it a player in human testicular function? Int J Impot Res 2005;17(5):467–8. DOI: 10.1038/sj.ijir.3901377Francis S.H. Phosphodiesterase 11 (PDE11): is it a player in human testicular function? Int J Impot Res 2005;17(5):467–8. DOI: 10.1038/sj.ijir.3901377Wayman C., Phillips S., Lunny C. et al. Phosphodiesterase 11 (PDE11) regulation of spermatozoa physiology. Int J Impot Res 2005;17(3): 216–23. DOI: 10.1038/sj.ijir.3901307Wayman C., Phillips S., Lunny C. et al. Phosphodiesterase 11 (PDE11) regulation of spermatozoa physiology. Int J Impot Res 2005;17(3): 216–23. DOI: 10.1038/sj.ijir.3901307Tzortzis V., Mitrakas L., Gravas S. et al. Oral phosphodiesterase type 5 inhibitors alleviate recurrent priapism complicating thalassemia intermedia: a case report. J Sex Med 2009;6(7):2068–71. DOI: 10.1111/j.1743-6109.2009.01285.xTzortzis V., Mitrakas L., Gravas S. et al. Oral phosphodiesterase type 5 inhibitors alleviate recurrent priapism complicating thalassemia intermedia: a case report. J Sex Med 2009;6(7):2068–71. DOI: 10.1111/j.1743-6109.2009.01285.xGeorgiadis G., Zisis I.E., Docea A.O. et al. Current concepts on the reno-protective effects of phosphodiesterase 5 inhibitors in acute kidney injury: systematic search and review. J Clin Med 2020;9(5):1284. DOI: 10.3390/jcm9051284Georgiadis G., Zisis I.E., Docea A.O. et al. Current concepts on the reno-protective effects of phosphodiesterase 5 inhibitors in acute kidney injury: systematic search and review. J Clin Med 2020;9(5):1284. DOI: 10.3390/jcm9051284Iordache A.M., Buga A.M., Albulescu D. et al. Phosphodiesterase-5 inhibitors ameliorate structural kidney damage in a rat model of contrast-induced nephropathy. Food Chem Toxicol 2020;143:111535. DOI: 10.1016/j.fct.2020.111535Iordache A.M., Buga A.M., Albulescu D. et al. Phosphodiesterase-5 inhibitors ameliorate structural kidney damage in a rat model of contrast-induced nephropathy. Food Chem Toxicol 2020;143:111535. DOI: 10.1016/j.fct.2020.111535Mamoulakis C., Tsarouhas K., Fragkiadoulaki I. et al. Contrast-induced nephropathy: basic concepts, pathophysiological implications and prevention strategies. Pharmacol Ther 2017;180:99–112. DOI: 10.1016/j.pharmthera.2017.06.009Mamoulakis C., Tsarouhas K., Fragkiadoulaki I. et al. Contrast-induced nephropathy: basic concepts, pathophysiological implications and prevention strategies. Pharmacol Ther 2017;180:99–112. DOI: 10.1016/j.pharmthera.2017.06.009Fisch J.D., Behr B., Conti M. Enhancement of motility and acrosome reaction in human spermatozoa: differential activation by type-specific phosphodiesterase inhibitors. Hum Reprod 1998;13(5):1248–54. DOI: 10.1093/humrep/13.5.1248Fisch J.D., Behr B., Conti M. Enhancement of motility and acrosome reaction in human spermatozoa: differential activation by type-specific phosphodiesterase inhibitors. Hum Reprod 1998;13(5):1248–54. DOI: 10.1093/humrep/13.5.1248Sikka S.C., Hellstrom W.J. The application of pentoxifylline in the stimulation of sperm motion in men undergoing electroejaculation. J Androl 1991;12(3):165–70.Sikka S.C., Hellstrom W.J. The application of pentoxifylline in the stimulation of sperm motion in men undergoing electroejaculation. J Androl 1991;12(3):165–70.Tesariki J., Thébault A., Testart J. Effect of pentoxifylline on sperm movement characteristics in normozoospermic and asthenozoospermic specimens. Hum Reprod 1992;7(9):1257–63. DOI: 10.1093/oxfordjournals.humrep.a137837Tesariki J., Thébault A., Testart J. Effect of pentoxifylline on sperm movement characteristics in normozoospermic and asthenozoospermic specimens. Hum Reprod 1992;7(9):1257–63. DOI: 10.1093/oxfordjournals.humrep.a137837Tournaye H., Devroey P., Camus M. et al. Use of pentoxifylline in assisted reproductive technology. Hum Reprod 1995;10(suppl 1): 72–9. DOI: 10.1093/humrep/10.suppl_1.72Tournaye H., Devroey P., Camus M. et al. Use of pentoxifylline in assisted reproductive technology. Hum Reprod 1995;10(suppl 1): 72–9. DOI: 10.1093/humrep/10.suppl_1.72Haesungcharern A., Chulavatnatol M. Stimulation of human spermatozoal motility by caffeine. Fertil Steril 1973;24(9):662–5. DOI: 10.1016/s0015-0282(16)39909-5Haesungcharern A., Chulavatnatol M. Stimulation of human spermatozoal motility by caffeine. Fertil Steril 1973;24(9):662–5. DOI: 10.1016/s0015-0282(16)39909-5Schill W.B. Caffeine- and kallikrein-induced stimulation of human sperm motility: a comparative study. Andrologia 2009;7(3):229–36. DOI: 10.1111/j.1439-0272.1975.tb00933.xSchill W.B. Caffeine- and kallikrein-induced stimulation of human sperm motility: a comparative study. Andrologia 2009;7(3):229–36. DOI: 10.1111/j.1439-0272.1975.tb00933.xDe Turner E.A., Aparicio N.J., Turner D., Schwarzstein L. Effect of two phosphodiesterase inhibitors, cyclic adenosine 3’:5’-monophosphate, and a β-blocking agent on human sperm motility. Fertil Steril 1978;29(3):328–31. DOI: 10.1016/s0015-0282(16)43161-4De Turner E.A., Aparicio N.J., Turner D., Schwarzstein L. Effect of two phosphodiesterase inhibitors, cyclic adenosine 3’:5’-monophosphate, and a β-blocking agent on human sperm motility. Fertil Steril 1978;29(3):328–31. DOI: 10.1016/s0015-0282(16)43161-4Schill W.B., Pritsch W., Preissler G. Effect of caffeine and kallikrein on cryo-preserved human spermatozoa. Int J Fertil 1979;24(1):27–32.Schill W.B., Pritsch W., Preissler G. Effect of caffeine and kallikrein on cryo-preserved human spermatozoa. Int J Fertil 1979;24(1):27–32.Marrama P., Baraghini G.F., Carani C. et al. Further studies on the effects of pentoxifylline on sperm count and sperm motility in patients with idiopathic oligo-asthenozoospermia. Andrologia 2009;17(6):612–6. DOI: 10.1111/j.1439-0272.1985.tb01728.xMarrama P., Baraghini G.F., Carani C. et al. Further studies on the effects of pentoxifylline on sperm count and sperm motility in patients with idiopathic oligo-asthenozoospermia. Andrologia 2009;17(6):612–6. DOI: 10.1111/j.1439-0272.1985.tb01728.xYovich J.M., Edirisinghe W.R., Cummins J.M., Yovich J.L. Influence of pentoxifylline in severe male factor infertility. Fertil Steril 1990;53(4):715–22. DOI: 10.1016/s0015-0282(16)53470-0Yovich J.M., Edirisinghe W.R., Cummins J.M., Yovich J.L. Influence of pentoxifylline in severe male factor infertility. Fertil Steril 1990;53(4):715–22. DOI: 10.1016/s0015-0282(16)53470-0Shen M., Chiang P.H., Yang R.C. et al. Pentoxifylline stimulates human sperm motility both in vitro and after oral therapy. Br J Clin Pharmacol 1991;31(6):711–4. DOI: 10.1111/j.1365-2125.1991.tb05600.xShen M., Chiang P.H., Yang R.C. et al. Pentoxifylline stimulates human sperm motility both in vitro and after oral therapy. Br J Clin Pharmacol 1991;31(6):711–4. DOI: 10.1111/j.1365-2125.1991.tb05600.xFuse H., Sakamoto M., Ohta S., Katayama T. Effect of pentoxifylline on sperm motion. Arch Androl 1993;31(1):9–15. DOI: 10.3109/01485019308988374Fuse H., Sakamoto M., Ohta S., Katayama T. Effect of pentoxifylline on sperm motion. Arch Androl 1993;31(1):9–15. DOI: 10.3109/01485019308988374Pang S.C., Chan P.J., Lu A. Effects of pentoxifylline on sperm motility and hyperactivation in normozoospermic and normokinetic semen. Fertil Steril 1993;60(2):336–43. DOI: 10.1016/s0015-0282(16)56108-1Pang S.C., Chan P.J., Lu A. Effects of pentoxifylline on sperm motility and hyperactivation in normozoospermic and normokinetic semen. Fertil Steril 1993;60(2):336–43. DOI: 10.1016/s0015-0282(16)56108-1Tasdemir M., Tasdemir I., Kodama H., Tanaka T. Andrology: Pentoxifylline-enhanced acrosome reaction correlates with fertilization in vitro. Hum Reprod 1993;8(12):2102–7. DOI: 10.1093/oxfordjournals.humrep.a137990Tasdemir M., Tasdemir I., Kodama H., Tanaka T. Andrology: Pentoxifylline-enhanced acrosome reaction correlates with fertilization in vitro. Hum Reprod 1993;8(12):2102–7. DOI: 10.1093/oxfordjournals.humrep.a137990Yunes R., Fernández P., Doncel G.F., Acosta A.A. Cyclic nucleotide phosphodiesterase inhibition increases tyrosine phosphorylation and hyper motility in normal and pathological human spermatozoa. Biocell 2005;29(3):287–93.Yunes R., Fernández P., Doncel G.F., Acosta A.A. Cyclic nucleotide phosphodiesterase inhibition increases tyrosine phosphorylation and hyper motility in normal and pathological human spermatozoa. Biocell 2005;29(3):287–93.Wang C., Chan C.W., Wong K.K., Yeung K.K. Comparison of the effectiveness of placebo, clomiphene citrate, mesterolone, pentoxifylline, and testosterone rebound therapy for the treatment of idiopathic oligospermia. Fertil Steril 1983;40(3):358–65. DOI: 10.1016/s0015-0282(16)47300-0Wang C., Chan C.W., Wong K.K., Yeung K.K. Comparison of the effectiveness of placebo, clomiphene citrate, mesterolone, pentoxifylline, and testosterone rebound therapy for the treatment of idiopathic oligospermia. Fertil Steril 1983;40(3):358–65. DOI: 10.1016/s0015-0282(16)47300-0Lopes S., Jurisicova A., Sun J.G., Casper R.F. Reactive oxygen species: potential cause for DNA fragmentation in human spermatozoa. Hum Reprod 1998;13(4):896–900. DOI: 10.1093/humrep/13.4.896Lopes S., Jurisicova A., Sun J.G., Casper R.F. Reactive oxygen species: potential cause for DNA fragmentation in human spermatozoa. Hum Reprod 1998;13(4):896–900. DOI: 10.1093/humrep/13.4.896Twigg J., Fulton N., Gomez E. et al. Analysis of the impact of intracellular reactive oxygen species generation on the structural and functional integrity of human spermatozoa: lipid peroxidation, DNA fragmentation and effectiveness of antioxidants. Hum Reprod 1998;13(6):1429–36. DOI: 10.1093/humrep/13.6.1429Twigg J., Fulton N., Gomez E. et al. Analysis of the impact of intracellular reactive oxygen species generation on the structural and functional integrity of human spermatozoa: lipid peroxidation, DNA fragmentation and effectiveness of antioxidants. Hum Reprod 1998;13(6):1429–36. DOI: 10.1093/humrep/13.6.1429Jannini E.A., Lombardo F., Salacone P. et al. Treatment of sexual dysfunctions secondary to male infertility with sildenafil citrate. Fertil Steril 2004;81(3):705–7. DOI: 10.1016/j.fertnstert.2003.08.032Jannini E.A., Lombardo F., Salacone P. et al. Treatment of sexual dysfunctions secondary to male infertility with sildenafil citrate. Fertil Steril 2004;81(3):705–7. DOI: 10.1016/j.fertnstert.2003.08.032Lenzi A., Lombardo F., Salacone P. et al. Stress, sexual dysfunctions, and male infertility. J Endocrinol Invest 2003;26(3 Suppl):72–6.Lenzi A., Lombardo F., Salacone P. et al. Stress, sexual dysfunctions, and male infertility. J Endocrinol Invest 2003;26(3 Suppl):72–6.Du Plessis S.S., de Jongh P.S., Franken D.R. Effect of acute in vivo sildenafil citrate and in vitro 8-bromo-cGMP treatments on semen parameters and sperm function. Fertil Steril 2004;81(4):1026–33. DOI: 10.1016/j.fertnstert.2003.09.054Du Plessis S.S., de Jongh P.S., Franken D.R. Effect of acute in vivo sildenafil citrate and in vitro 8-bromo-cGMP treatments on semen parameters and sperm function. Fertil Steril 2004;81(4):1026–33. DOI: 10.1016/j.fertnstert.2003.09.054Dimitriadis F., Giannakis D., Pardalidis N. et al. Effects of phosphodiesterase 5 inhibitors on sperm parameters and fertilizing capacity. Asian J Androl 2008;10(1):115–33. DOI: 10.1111/j.1745-7262.2008.00373.xDimitriadis F., Giannakis D., Pardalidis N. et al. Effects of phosphodiesterase 5 inhibitors on sperm parameters and fertilizing capacity. Asian J Androl 2008;10(1):115–33. DOI: 10.1111/j.1745-7262.2008.00373.xSofikitis N.V., Miyagawa I. Endocrinological, biophysical, and biochemical parameters of semen collected via masturbation versus sexual intercourse. J Androl 1993;14(5):366–73.Sofikitis N.V., Miyagawa I. Endocrinological, biophysical, and biochemical parameters of semen collected via masturbation versus sexual intercourse. J Androl 1993;14(5):366–73.Pomara G., Morelli G., Canale D. et al. Alterations in sperm motility after acute oral administration of sildenafil or tadalafil in young, infertile men. Fertil Steril 2007;88(4):860–5. DOI: 10.1016/j.fertnstert.2006.12.019Pomara G., Morelli G., Canale D. et al. Alterations in sperm motility after acute oral administration of sildenafil or tadalafil in young, infertile men. Fertil Steril 2007;88(4):860–5. DOI: 10.1016/j.fertnstert.2006.12.019Burger M., Sikka S.C., Bivalacqua T.J. et al. The effect of sildenafil on human sperm motion and function from normal and infertile men. Int J Impot Res 2000;12(4):229–34. DOI: 10.1038/sj.ijir.3900551Burger M., Sikka S.C., Bivalacqua T.J. et al. The effect of sildenafil on human sperm motion and function from normal and infertile men. Int J Impot Res 2000;12(4):229–34. DOI: 10.1038/sj.ijir.3900551Lefièvre L., De Lamirande E., Gagnon C. The cyclic GMP-specific phosphodiesterase inhibitor, sildenafil, stimulates human sperm motility and capacitation but not acrosome reaction. J Androl 2000;21(6):929–37.Lefièvre L., De Lamirande E., Gagnon C. The cyclic GMP-specific phosphodiesterase inhibitor, sildenafil, stimulates human sperm motility and capacitation but not acrosome reaction. J Androl 2000;21(6):929–37.Cuadra D.L., Chan P.J., Patton W.C. et al. Type 5 phosphodieste-rase regulation of human sperm motility. Am J Obstet Gynecol 2000;182(5):1013–5. DOI: 10.1067/mob.2000.105435Cuadra D.L., Chan P.J., Patton W.C. et al. Type 5 phosphodieste-rase regulation of human sperm motility. Am J Obstet Gynecol 2000;182(5):1013–5. DOI: 10.1067/mob.2000.105435Glenn D.R.J., McVicar C.M., McClure N., Lewis S.E. Sildenafil citrate improves sperm motility but causes a premature acrosome reaction in vitro. Fertil Steril 2007;87(5):1064–70. DOI: 10.1016/j.fertnstert.2006.11.017Glenn D.R.J., McVicar C.M., McClure N., Lewis S.E. Sildenafil citrate improves sperm motility but causes a premature acrosome reaction in vitro. Fertil Steril 2007;87(5):1064–70. DOI: 10.1016/j.fertnstert.2006.11.017Salonia A., Bettocchi C., Boeri L. et al. European Association of Urology Guidelines on Sexual and Reproductive Health – 2021 Update: Male Sexual Dysfunction. Eur Urol 2021;80(3):333–57. DOI: 10.1016/j.eururo.2021.06.007Salonia A., Bettocchi C., Boeri L. et al. European Association of Urology Guidelines on Sexual and Reproductive Health – 2021 Update: Male Sexual Dysfunction. Eur Urol 2021;80(3):333–57. DOI: 10.1016/j.eururo.2021.06.007

The authors declare that there are no conflicts of interest present.