Electroejaculation in patients with spinal cord injuries: A 21‐year, single‐center experience

Soeterik, Timo; Veenboer, Paul W.; Ophuis, Ralph J. A. Oude; Lock, Tycho

doi:10.1111/iju.13249

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…There was one case of ectopic gestation and two cases of spontaneous abortion, which meant the live birth rate was 47.2% (25/53). These results are similar to those reported by Soeterik et al (16). Compared to the CBAVD group, sperm from the epididymis achieved similar clinical pregnancy and live birth rates in ICSI using either fresh or frozen sperm (Tables S1 and S2).…”

Section: Discussionsupporting

confidence: 89%

“…In EEJ, rectal electrodes are used to stimulate the peripheral nerves of the prostate to induce ejaculation, but anesthesia is required, and rectal injury may occur as a consequence. The success rate of EEJ was more than 90%, but one-third of them required ICSI on account of poor sperm quality (16).…”

Section: Discussionmentioning

confidence: 96%

“…In patients with ejaculatory disorders, PVS can be used for the retrieval of semen as it is less invasive than EEJ and surgical sperm retrieval, but it may not be effective for all patients (15). Patients with anejaculation caused by a spinal cord injury or orgasmic dysfunction can provide semen through EEJ, but spermatozoa with low motility are not optimal for assisted reproductive technology (16). Surgical sperm retrieval, by either PESA or TESA, can be used as an alternative in patients with severe ejaculatory disorders, or when PVS and EEJ have previously been unsuccessful (17).…”

Section: Discussionmentioning

confidence: 99%

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Intracytoplasmic sperm injection outcomes in patients with orgasmic dysfunction and anejaculation by percutaneous epididymal sperm aspiration (PESA)

Fang

Cai

et al. 2020

Ann Transl Med

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Background: Orgasmic dysfunction and anejaculation are two uncommon yet powerful factors of male infertility. The treatment of orgasmic dysfunction and anejaculation is especially important for men who desire paternity, who otherwise would have to undergo surgical sperm retrieval for use with intracytoplasmic sperm injection (ICSI). We evaluated the reproductive outcomes of percutaneous epididymal sperm aspiration (PESA) for ICSI in a cohort of infertile patients who had presented with orgasmic dysfunction and anejaculation in the past five years. Methods:We conducted a retrospective study of 41 patients with orgasmic dysfunction and 55 patients with anejaculation who underwent surgical sperm retrieval for ICSI. The sperm was firstly aspirated from the cauda epididymis, and then from the caput of the epididymis. If aspiration attempts failed at both locations, testicular sperm aspiration (TESA) was performed. The ICSI outcomes following these collection methods were compared with those of patients with congenital bilateral absence of the vas deferens (CBAVD). The ICSI outcomes of PESA (fertilization rate, high-quality embryo rate, clinical pregnancy, and live birth rate) were recorded.Results: Of all 96 participants, PESA was successfully performed in 91 patients (94.8%), and TESA was necessary for only 5 patients (5.2%). Of the 91 patients who received PESA, 90 succeeded in retrieving sperm from the cauda epididymis, and just 1 from the caput. Among the patients with anejaculation, there were 28 cases (28/55, 50.9%) of diabetes mellitus (DM). In 56 fresh transfer cycles, the clinical pregnancy rate and live birth rate were 57.1% and 51.8%, respectively, both similar to those of CBAVD (53.47% vs.63.4%, P=0.483, 47.2% vs. 53.5%, P=0.393, respectively). The fertilization rate, transferable embryo rate, high-quality embryo rate, clinical pregnancy, early pregnancy loss, and the live birth rate did not show differences resulting from using fresh or frozen sperm in the two groups. The fertilization rate and highquality embryo rate in patients with DM were lower than those of patients without DM (75.0% vs. 86.7%, P=0.002; 50.4% vs. 77.4%, P=0.028, respectively).Conclusions: Like TESA, PESA is an appropriate and convenient way to obtain sperm for ICSI for patients with orgasmic dysfunction and anejaculation. Performing ICSI with sperm from the cauda epididymis can achieve favorable clinical pregnancy and live birth rates in patients with orgasmic dysfunction and anejaculation.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Intracytoplasmic sperm injection outcomes in patients with orgasmic dysfunction and anejaculation by percutaneous epididymal sperm aspiration (PESA)

Fang

Cai

et al. 2020

Ann Transl Med

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“…The procedure requires general anesthetic in men with pelvic sensation, because the procedure is painful. EEJ is a highly successful procedure in the SCI population, with extraction of motile sperm in 73.5%-95% of men (18,19). Surgical sperm extraction is another option for men with refractory anejaculation who have failed PVS or EEJ.…”

Section: Neurogenic Anejaculationmentioning

confidence: 99%

Acute anejaculation, hypogonadism, and fertility preservation in the setting of neurosarcoidosis: case report and literature review

Darves-Bornoz

Brannigan

et al. 2020

F&S Reports

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Objective: To examine fertility preservation techniques in the setting of neurosarcoidosis, and to review the impact of corticosteroid and methotrexate therapy on fertility. Design: Case report of a patient with infertility secondary to anejaculation associated with spinal neurosarcoidosis, treated with systemic corticosteroids and methotrexate. Setting: Academic tertiary-care hospital. Patient(s): A 39-year-old man presented with neurosarcoidosis complicated by acute anejaculation, erectile dysfunction, and hypogonadism. He underwent fertility consultation and sperm cryopreservation before initiating methotrexate therapy. His pretreatment total testosterone was low, at 157 ng/dL. Intervention(s): Unsuccessful pharmacologic therapy and penile vibratory stimulation (PVS) were followed by microdissection testicular sperm extraction (microTESE). Clomiphene was administered for optimization of spermatogenesis before microTESE. Main Outcome Measure(s): Vials of cryopreserved sperm, testis histopathology, and serum testosterone levels. Result(s): Eight vials of viable sperm were harvested by means of micro-TESE and cryopreserved. Despite intraoperative appearance of hypospermatogenesis, 90% of seminiferous tubules had active germ cell sloughing. Total testosterone increased to 278 ng/dL 2 months after initiating clomiphene. Conclusion(s):Conventional fertility preservation techniques may be effective in the setting of neurosarcoidosis-induced infertility owing to largely intact spermatogenesis. PVS, though not effective for this patient, should be considered along with electroejaculation, given high success rates in other patients with neurogenic anejaculation. Corticosteroid-mediated hypogonadism also must be considered in these patients, because it can negatively affect downstream spermatogenesis. In addition, evidence for the impact of paternal methotrexate exposure on fertility is limited and requires further investigation. As such, fertility consultation before initiating methotrexate is highly recommended. (Fertil Steril Rep Ò 2020;1:317-25. Ó2020 by American Society for Reproductive Medicine.

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“…La motilidad de los espermatozoides es más baja y la probabilidad de eyaculación retrógrada es mayor con esta técnica, pero puede ser exitosa cuando la vibroestimulación ha fallado. La electroeyaculación requiere asistencia médica, por lo que son candidatos los pacientes que no responden a la vibroestimulación y cuyos fines son reproductivos más que eróticos (65,66,(69)(70)(71).…”

Section: Técnicas De Reproducción Asistidaunclassified

Sexualidad en hombres y mujeres con lesión medular traumática

Alonso¹

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Electroejaculation in patients with spinal cord injuries: A 21‐year, single‐center experience

Abstract: In the majority of spinal cord injury patients treated with electroejaculation, it is possible to obtain semen that can be used for assisted reproductive technologies. Repeated electroejaculation should be considered when the first procedure fails.

Cited by 9 publications

References 31 publications

Intracytoplasmic sperm injection outcomes in patients with orgasmic dysfunction and anejaculation by percutaneous epididymal sperm aspiration (PESA)

Intracytoplasmic sperm injection outcomes in patients with orgasmic dysfunction and anejaculation by percutaneous epididymal sperm aspiration (PESA)

Acute anejaculation, hypogonadism, and fertility preservation in the setting of neurosarcoidosis: case report and literature review

Sexualidad en hombres y mujeres con lesión medular traumática

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