Psychosexual issue affecting men with Klinefelter Syndrome seeking fertility management

Abstract

ABSTRACT Introduction and Objective Klinefelter Syndrome (KS) is the commonest hypo-androgenic chromosomal anomaly affecting fertility (1:600 men). KS frequently goes undiagnosed until middle age during fertility investigations. However, beyond fertility issues there is little known of the psychological effect of KS on these newly diagnosed men. This study aims to examine the psychosexual impact of newly diagnosed KS in couples presenting to a multidisciplinary KS clinic. Methods Prospectively compiled data from 18 recently diagnosed KS patients with subfertility attending a multidisciplinary KS clinic were analyzed. A baseline patient-centered psychosexual function questionnaire (NSOG) was used to identify issues with body image, sexual function and wellbeing whilst erectile dysfunction (ED) issues were specifically sought using the validated IIEF-5 questionnaire. Ethics approval was obtained. Results 89% (17/18) of KS men rated their sex life as highly important but less than 44% rated the quality of intercourse and a similar proportion were anxious about having sexual intercourse. This was in keeping with a mean IIEF-5 score of 16 (range 24- 12) in this group indicating mild to moderate ED. 56% felt that their body could adequately work sexually but 17% felt their mood negatively affected influencing sexual performance, with only 38% satisfied in their sex life. 50% of men also reported perceived delayed ejaculation. Whilst the majority reported noticed libido issues, 5% of men reported hyperactive sexual desire which impacted on social functioning. Conclusions Psychosexual difficulties are common in KS patients undergoing fertility treatments and yet this aspect of their management is often neglected. Psychosexual treatment should be discussed with all KS patients as all patients reported wanting to receive help and advice on improving their sexual lives. A study is now in place to determine the longer-team outcomes of targeted psyhosexual therapy in this cohort of KS men on general wellbeing and memntal health. Disclosure Work supported by industry: no.