Retrograde ejaculation: a systematic approach to non‐invasive recovery of spermatozoa from post‐ejaculatory urine for artificial insemination

Abstract

Retrograde ejaculation is an uncommon but treatable form of male infertility. Successful recovery of live spermatozoa from the post-ejaculatory urine for artificial insemination is dependent on careful regulation of pII and osmolarity of the urine into which ejaculation takes place, and separation of the motile spermatozoa from the debris and cells which are found in these samples. Three pregnancies established by artificial insemination o f spermatozoa recovered by noninvasive means from the bladders of men suffering from retrograde ejaculation are described. The techniques for preparing the urine for spermatozoa1 survival. and for removal of cells and debris by sedirnentation or buoyant density centrifugation are discussed.

Effects of nitrogenous components of urine on sperm motility: an in vitro study

“…Motile spermatozoa were not found in urine specimens with a pH < 5.5 ( Makler et al ., 1981 ; Zavos & Wilson, 1984). A pH > 9.0 is spermatotoxic ( Braude et al ., 1987 ). It has been reported that sperm motility is maintained over a very large range of osmolality (200–800 mOsm/kg) with better survival under hypertonic rather than hypotonic conditions ( Makler et al ., 1981 ).…”

“…(1995 ) reported that urine, even at a low concentration, was deleterious to sperm function and that this effect might involve other biochemical factors that are unrelated to urine pH and osmolality. Contamination of the semen with cells and debris ( Braude et al ., 1987 ) and bacteria ( Auroux et al ., 1991 ) found in urine can also have detrimental effects on sperm motility ( Braude et al ., 1987 ; Auroux et al ., 1991 ). In this regard, the biochemical compounds present in urine cannot be ignored; however, their effect on sperm motility has attracted little attention so far ( Crich & Jequier, 1978; Ronquist et al ., 1985 ).…”

A Comprehensive Guide to Sperm Recovery in Infertile Men with Retrograde Ejaculation

“…Both, high urine osmolality and low pH are considered toxic to spermatozoa, and hence, both parameters need optimization to enhance sperm survival [ 5 27 28 29 ]. Urine preparation in the patients with RE can be performed by ingestion of oral alkalinizing agents [ 29 ].…”

Noninvasive Techniques for Improving Fertility Potential of Retrograde Ejaculates

“…We altered the dosage to just twice-5 gm each at 2 h and 1 h prior to ejaculation-and found a consistent pH between 7.3 to 7.6. Similarly, Braude et al [4] were able to maintain the pH between 7.6 and 8.1 by giving one dose of 5-10 gm NaHCO, 2 to 3 h before voiding for spermatozoa collection. Perhaps the slightly higher pH reported by Braude et al…”