Anejaculation and fertility

Anejaculation refers to the lack of ejaculation. This can complicate conception since there is no means for the sperm to reach the woman. But there is hope: there is a method in which the man's sperm is directly extracted, which has proven to be an effective solution for many couples.

Because the number of sperm recovered is usually relatively low, it is necessary to combine this technique with intracytoplasmic sperm microinjection (ICSI), in which a good quality sperm is enough to fertilize the egg.

What is anejaculation?

Anejaculation is the absence of ejaculation and is classified as:

• Situational anejaculation:
  • The man ejaculates normally in some situations but not in others.

• Total anejaculation:
  • The man is unable to ejaculate while awake.
  • In total anorgasmic anejaculation, the man does not ejaculate because he cannot reach orgasm.
  • In total orgasmic anejaculation, the man reaches orgasm but does not ejaculate.

This condition causes infertility because, without ejaculation, sperm cannot enter the woman's uterus.

Causes of anejaculation

Typically, situational anejaculation and anorgasmic total anejaculation occur due to psychological factors, however, orgasmic total anejaculation can be caused by:

• Diabetes
• Prostatic hyperplasia or prostate growth
• Prostatitis or inflammation of the prostate
• Abdominal surgeries
• Urological surgeries such as prostatectomies
• Obstruction of the ejaculatory ducts
• Neurological disorders
• Parkinson disease
• Multiple sclerosis
• Spinal cord injuries
• Use of antidepressant medications such as fluoxetine
• Cancer treatments such as chemotherapy and radiotherapy

Another common cause of total orgasmic anejaculation is retrograde ejaculation, in which seminal fluid enters the bladder during orgasm instead of exiting through the penis and the sperm go into the urine.

How are the causes of anejaculation diagnosed?

The more information you can give the specialist about your medical history, the better able he or she will be to identify the causes of anejaculation.

Alternatives to having a baby at home when you suffer from anejaculation

Knowing the causes of anejaculation is essential when it comes to selecting a comprehensive fertility program that allows you to have a baby at home with the least amount of wear and tear.

If anejaculation is caused by medications, your doctor will ask you to stop using them and help you find other options, while if there is an underlying medical condition, your comprehensive fertility program may be enough to reverse anejaculation.

If the procedure is sufficient, sperm recovery through epididymal aspiration or testicular biopsy is the technique of choice to achieve a successful pregnancy.

Because the number of sperm recovered is usually relatively low, it is necessary to combine this technique with intracytoplasmic sperm microinjection (ICSI), in which one sperm of good quality is sufficient to fertilize the egg.

It is important to note that in cases of retrograde ejaculation, it is possible to recover sperm directly from the urine to use them in assisted reproduction procedures later. At Ingenes we are convinced that as stress decreases, reproductive potential increases, which is why we have an emotional support unit to accompany our patients from day one. And with our Initial Program, you will know the cause and the appropriate comprehensive program.