(852) Sexual Function Among Married Men with Azoospermia

Introduction Azoospermia refers to the complete absence of spermatozoa in the ejaculated semen. It remains a taboo subject and represents a major cause of male infertility. This condition not only has physiological consequences but also significant psychosocial repercussions, including feelings of stigma, shame, and a negative impact on quality of life and sexual well-being. Objective This study aimed to assess the sexual function of men whose couples were being followed for infertility related to isolated azoospermia, and to evaluate their reproductive concerns, psychological distress, and level of self-esteem. Methods We conducted a cross-sectional analytical study over six months, from September 2023 to February 2024, including infertile couples in whom azoospermia was the sole identified etiology. These couples presented to the Assisted Reproductive Technology (ART) Unit. Validated translated questionnaires were used: the International Index of Erectile Function (IIEF-15) to assess male sexual function, the Fertility Problem Inventory (FPI) to measure infertility-related stress, the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depressive symptoms, and the Rosenberg Self-Esteem Scale to evaluate self-esteem. Results A total of 14 couples were included. The mean age of men was 42 ± 6.05 years, and that of women was 35 ± 5.72 years. This was the first marriage for 78.6% of the men. None of the couples had children. The median duration of infertility was 4 years [3–5]. High infertility-related stress was observed in 28.6% of men with azoospermia. The prevalence of clinically significant anxiety symptoms was 35.7%, and that of depressive symptoms was 7.1%. Low self-esteem was found in 42.9% of the participants. Objective evaluation of male sexual function confirmed the presence of at least one sexual dysfunction in all participants. The most common sexual dysfunctions were low sexual desire, erectile dysfunction, and global dissatisfaction, followed closely by sexual dissatisfaction. Orgasmic disorder was significantly more frequent among men in a second marriage. Erectile dysfunction was associated with sexual preoccupation, desire for parenthood, and overall stress level. Sexual dissatisfaction was associated with sexual preoccupation, parenthood desire, rejection of a childless lifestyle, global stress level, and anxiety symptoms. Conclusions Men with isolated azoospermia often experience profound psychological distress characterized by feelings of uselessness and questioning of their masculinity. This psychological burden directly affects their self-esteem, sexuality, and couple relationships, with a high prevalence of sexual dysfunction and emotional distress. These men, therefore, require specific, holistic care that integrates psychological support alongside medical management. Disclosure No