Sperm retrieval in anejaculatory diabetic men who failed in drug treatment and penile vibratory stimulation during blood sugar under control

Abstract

Ejaculatory dysfunction is an uncommon cause of male infertility. The aim of this study was to explore non-invasive methods for sperm retrieval in anejaculatory diabetic men who failed in drug treatment and penile vibratory stimulation during blood sugar under control. Among 21 anejaculatory diabetic men who had failed in drug treatment and penile vibratory stimulation, sperm was collected by retrograde ejaculation in 10 patients (group A), and in eight patients, sperm was collected by prostatic massage (group B). We compared the outcome of subsequent assisted reproductive treatment between the two groups; the rate of fertility in group A and in group B was 78.3% and 66.6% respectively, and the rate of good embryo was 56.6% and 48.8% respectively. Eight singleton pregnancies were achieved in the 18 anejaculatory diabetic men, 5 in group A and 3 in group B, the rate of pregnancy between the two groups was 50% and 37.5% respectively. There was no significant difference in the rate of fertility, good embryo rate and pregnancy outcome between the two groups.

Understanding and treating ejaculatory dysfunction in men with diabetes mellitus

“…27 Despite the success of this technique in spinal cord injury patients, 153 it can be unsuccessful in diabetics. 154 This may be because of peripheral neuropathy impairing the sensory and/or motor arms of the spinal reflex arc. Nevertheless, trial of this technique tends to be reserved for those with AE in whom an ejaculated specimen is needed for assisted conception.…”

“…Sensory afferents stimulated within the pudendal nerve at the penis signal to lumbosacral segments to propagate sympathetic outflow to the seminal tract and induce ejaculation 27 . Despite the success of this technique in spinal cord injury patients, 153 it can be unsuccessful in diabetics 154 . This may be because of peripheral neuropathy impairing the sensory and/or motor arms of the spinal reflex arc.…”

Ejaculatory dysfunction in men with diabetes mellitus

“…If infertility is an issue, several approaches can be employed: (1) Assisted ejaculation by penile vibratory stimulation (PVS) is an option for sperm retrieval[ 136 ] because it is noninvasive and inexpensive[ 137 ]. However, DM patients frequently fail to obtain sperms by this method because it requires intact lumbosacral pathways[ 136 , 137 ]; (2) In cases in whom PVS fails, electroejaculation (EEJ) may be effective to retrieve spermatozoa[ 99 , 138 ]; and (3) If these procedures fail, surgical sperm retrieval can be tried through VD aspiration[ 139 ], percutaneous epididymal sperm aspiration (PESA)[ 140 ], or testicular sperm extraction (TESA)[ 141 ]. Using spermatozoa obtained by any of these procedures and utilizing intracytoplasmic sperm injection (ICSI), one can attain clinical pregnancy and live birth rates in DM-related AE.…”

The Rare Phenomenon of Consecutive Ejaculations in Male Rats

“…In humans, ejaculation and orgasm may be perceived as a single event, even though they are not the same biological process [9]. Furthermore, there is evidence that some men can have an ejaculation without having an orgasm [10,11], and some men can have an orgasm without an ejaculation [12][13][14][15]. There are also case reports on men who can have multiple ejaculations within a short period, but they required at least a few minutes of sexual stimulation between ejaculations [16,17].…”