Electroejaculation and assisted fertility in men with psychogenic anejaculation

Objectives: To evaluate sperm characteristics and fertility potential in ejaculates obtained after electroejaculation in men with psychogenic anejaculation. Design: Retrospective clinical. study. Setting: In Vitro Fertilization Unit, Bikur Cholim Hospital, Jerusalem. Israel. Patients: Twenty men with psychogenic anejaculation who underwent 55 sessions of electroejaculation and their spouses. Interventions: Electroejaculation, assisted reproduction technologies. Main Outcome Measures: Semen analysis, IVF, intracytoplasmic injection (ICSI), fertilization rates, and pregnancy rates. Results: in all patients, sperm density and motility rates were unsatisfactory (98 +/- 127 x 10(6) with 14.6% +/- 15% motility in the antegrade portions and 42 +/- 42 x 10(6) with 9.7% +/- 15.6% motility in the retrograde samples). Intrauterine inseminations performed in eight couples did not result in a pregnancy. Four couples underwent IVF-ET treatments. Two pregnancies were achieved with overall success rates of 22% per cycle. Five couples were treated using the ICSI procedure. Although good quality embryos were transferred, none of the treatments resulted in a pregnancy. Conclusions: Psychogenic failure to ejaculate may be treated by electroejaculation. However, the average motility of the sperm obtained is diminished. The combination of electroejaculation with IVF, including the ICSI procedure, should improve chances of fertilization and pregnancy in these cases.