Sperm Retrieval in Non-azoospermic Patients with Persistent Ejaculation Dysfunction

Abstract

Infertility is a common disease that affects 15 to 20% of couples at some point in their lives. Among infertile couples, male factor accounts for 50% of infertile cases. Assisted reproductive techniques are the gold standard approach in case of failure in medical or surgical treatments. Moreover, the role of the urologist in these approaches is to provide appropriate sperm on the day of oocyte pick-up. However, sperm retrieval procedure is quite different in azoospermic and non-azoospermic men. Although most cases of infertile patients are not azoospermic, their ejaculation disorder prevents obtaining sperm for assisted reproductive techniques. This review article explains common problems of sperm retrieval in non-azoospermic patients with persistent ejaculatory dysfunction and introduces some management strategies. In fact, it is possible to design a classic approach for managing such patients, which definitely reduces the problems faced by clinicians as well.

The erectile and ejaculatory implications of the surgical management of rectal cancer

“…90,91 Intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection have also proven to be successful in the treatment of retrograde ejaculation. 92 To aid in this process, urinary sperm retrieval can be done by first emptying and washing the bladder with Ringer's lactate or sperm wash medium using catheterization. 93,94 Then, Ringer's lactate or sperm wash medium is instilled into the bladder before the catheter is removed.…”

“…Additionally, there has been success in restoring antegrade ejaculation in patients by injecting Deflux, a gel composed of dextranomer and hyaluronic acid typically used to treat vesicoureteral reflux in pediatric patients, into the transurethral bladder neck 90,91 . Intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection have also proven to be successful in the treatment of retrograde ejaculation 92 . To aid in this process, urinary sperm retrieval can be done by first emptying and washing the bladder with Ringer's lactate or sperm wash medium using catheterization 93,94 .…”