Successful treatment of infertility due to retrograde ejaculation by instillation of serum‐containing medium into the bladder. A case report

Abstract

The treatment of infertility caused by retrograde ejaculation has often been ineffective. The unphysiological composition of the urine is the main reason complicating the recovery of motile sperm. We describe a case of retrograde ejaculation caused by a congenital defect of the internal sphinchter muscle of the urinary bladder. In this case, motile sperm were only recovered if the bladder had been filled previously with artificial culture medium (Ham's F-10) supplemented with the patient's own serum. Two pregnancies followed intrauterine insemination with sperm recovered in this way.

Steps in the investigation and management of low semen volume in the infertile man

“…Alternatively, bladder catheterization with the instillation of sperm-friendly buffer solution can be done. 38 Anejaculation, as in retrograde ejaculation, may also respond to oral treatment, especially in patients with diabetes mellitus who have progressed from retrograde ejaculation to anejaculation. 36 Other alternatives in these patients are penile vibratory stimulation or electroejaculation, especially in patients with spinal cord injury.…”

Successful Management of Infertility Due to Retrograde Ejaculation Using Assisted Reproductive Technologies: A Report of Two Cases

“…Various methods have been employed to insure sperm survival in men with retrograde ejaculation. One technique that has been successful is a bladder wash procedure whereby solutions are instilled into the bladder prior to ejaculation in order to create a more hospitable environment for the sperm [10,11,14]. Yet urethral catheterization is an invasive procedure that can be avoided by oral intake of water or sodium bicarbonate which has proven just as successful [2,3,8,12].…”

“…Treatment strategies vary, and are often controversial with respect to the most appropriate therapeutic approach for this disorder. The two major questions pertain to methods for obtaining the sperm [3,8,10,11,14] and the technique for oocyte fertilization [8,12,17]. We report two cases using sperm harvested from the urine of older men with aspermia due to complete retrograde ejaculation by IUI in one case and by IVF using ICSI in the second case by alternate approaches to optimize treatment outcome.…”

Male Infertility

“…The bladder should be emptied prior to masturbation and immediately after climax to limit urine contact. Alternatively, catheterization with instillation of media into the bladder and catheterization immediately after climax may increase motile sperm yield (Suominen et al 1991).…”