Treatment of infertility due to anejaculation in the male with electroejaculation and intracytoplasmic sperm injection

Edward C. Schatte, Francisco J. Orejuela, Larry I. Lipshultz, Edward Kim, Dolores J. Lamb

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Purpose: We tested the hypothesis that spinal cord injury and/or anejaculation affects the outcome of intracytoplasmic sperm injection (ICSI). Materials and Methods: From November 1993 to October 1998 we obtained and prospectively reviewed data on 34 ICSI cycles using electroejaculated sperm, 620 male factor infertility ICSI cycles using normal ejaculated sperm and 120 cases of obstructive azoospermia, in which microsurgical epididymal aspiration and testicular sperm extraction-ICSI were done in 93 and 27, respectively. Results: A total of 34 ICSI cycles were performed in 17 couples with male infertility due to anejaculation secondary to spinal cord injury in 10 patients and retroperitoneal lymph node dissection in 5, and idiopathic in 2. In all 17 couples at least 3 previous intrauterine insemination cycles had failed. After electroejaculation 11 men had oligozoospermia and 6 normal sperm density. Median sperm retrieval volume plus or minus standard deviation was 1.9 ± 1.9 ml., median sperm concentration 70.7 ± 60.2 x 106 sperm per ml., median motility 10.7% ± 10.8% and median forward progression 2.3 ± 0.5 (scale 1 to 4). In the anejaculation group ICSI resulted in a median fertilization of 60% ± 28%, 15% pregnancies per cycle and 29% pregnancies per couple. In the control group of 620 ICSI cycles from ejaculated specimens obtained from male patients with infertility median fertilization was 58% ± 26%, and there were 39% pregnancies per cycle and 47% pregnancies per couple. The rate of pregnancies per embryo transfer and per couple was higher in the control than in the electroejaculation-ICSI group (p <0.05). However, there was no statistically significant difference in the fertilization rate. Conclusions: ICSI or in vitro fertilization is a viable alternative for patients with anejaculation in whom intrauterine insemination failed. While the fertilization rate is similar in these couples, the pregnancy rate is significantly lower than that achieved with ejaculated specimens from patients with severe male factor infertility. ICSI is a viable alternative for a patient with anejaculation in whom intrauterine insemination or in vitro fertilization failed.

Original languageEnglish (US)
Pages (from-to)1717-1720
Number of pages4
JournalJournal of Urology
Volume163
Issue number6
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

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Intracytoplasmic Sperm Injections
Infertility
Spermatozoa
Fertilization
Insemination
Male Infertility
Sperm Retrieval
Therapeutics
Pregnancy
Pregnancy Rate
Fertilization in Vitro
Spinal Cord Injuries
Oligospermia
Azoospermia
Embryo Transfer
Lymph Node Excision
Control Groups

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Treatment of infertility due to anejaculation in the male with electroejaculation and intracytoplasmic sperm injection. / Schatte, Edward C.; Orejuela, Francisco J.; Lipshultz, Larry I.; Kim, Edward; Lamb, Dolores J.

In: Journal of Urology, Vol. 163, No. 6, 01.01.2000, p. 1717-1720.

Research output: Contribution to journalArticle

Schatte, Edward C. ; Orejuela, Francisco J. ; Lipshultz, Larry I. ; Kim, Edward ; Lamb, Dolores J. / Treatment of infertility due to anejaculation in the male with electroejaculation and intracytoplasmic sperm injection. In: Journal of Urology. 2000 ; Vol. 163, No. 6. pp. 1717-1720.
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abstract = "Purpose: We tested the hypothesis that spinal cord injury and/or anejaculation affects the outcome of intracytoplasmic sperm injection (ICSI). Materials and Methods: From November 1993 to October 1998 we obtained and prospectively reviewed data on 34 ICSI cycles using electroejaculated sperm, 620 male factor infertility ICSI cycles using normal ejaculated sperm and 120 cases of obstructive azoospermia, in which microsurgical epididymal aspiration and testicular sperm extraction-ICSI were done in 93 and 27, respectively. Results: A total of 34 ICSI cycles were performed in 17 couples with male infertility due to anejaculation secondary to spinal cord injury in 10 patients and retroperitoneal lymph node dissection in 5, and idiopathic in 2. In all 17 couples at least 3 previous intrauterine insemination cycles had failed. After electroejaculation 11 men had oligozoospermia and 6 normal sperm density. Median sperm retrieval volume plus or minus standard deviation was 1.9 ± 1.9 ml., median sperm concentration 70.7 ± 60.2 x 106 sperm per ml., median motility 10.7{\%} ± 10.8{\%} and median forward progression 2.3 ± 0.5 (scale 1 to 4). In the anejaculation group ICSI resulted in a median fertilization of 60{\%} ± 28{\%}, 15{\%} pregnancies per cycle and 29{\%} pregnancies per couple. In the control group of 620 ICSI cycles from ejaculated specimens obtained from male patients with infertility median fertilization was 58{\%} ± 26{\%}, and there were 39{\%} pregnancies per cycle and 47{\%} pregnancies per couple. The rate of pregnancies per embryo transfer and per couple was higher in the control than in the electroejaculation-ICSI group (p <0.05). However, there was no statistically significant difference in the fertilization rate. Conclusions: ICSI or in vitro fertilization is a viable alternative for patients with anejaculation in whom intrauterine insemination failed. While the fertilization rate is similar in these couples, the pregnancy rate is significantly lower than that achieved with ejaculated specimens from patients with severe male factor infertility. ICSI is a viable alternative for a patient with anejaculation in whom intrauterine insemination or in vitro fertilization failed.",
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AU - Kim, Edward

AU - Lamb, Dolores J.

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N2 - Purpose: We tested the hypothesis that spinal cord injury and/or anejaculation affects the outcome of intracytoplasmic sperm injection (ICSI). Materials and Methods: From November 1993 to October 1998 we obtained and prospectively reviewed data on 34 ICSI cycles using electroejaculated sperm, 620 male factor infertility ICSI cycles using normal ejaculated sperm and 120 cases of obstructive azoospermia, in which microsurgical epididymal aspiration and testicular sperm extraction-ICSI were done in 93 and 27, respectively. Results: A total of 34 ICSI cycles were performed in 17 couples with male infertility due to anejaculation secondary to spinal cord injury in 10 patients and retroperitoneal lymph node dissection in 5, and idiopathic in 2. In all 17 couples at least 3 previous intrauterine insemination cycles had failed. After electroejaculation 11 men had oligozoospermia and 6 normal sperm density. Median sperm retrieval volume plus or minus standard deviation was 1.9 ± 1.9 ml., median sperm concentration 70.7 ± 60.2 x 106 sperm per ml., median motility 10.7% ± 10.8% and median forward progression 2.3 ± 0.5 (scale 1 to 4). In the anejaculation group ICSI resulted in a median fertilization of 60% ± 28%, 15% pregnancies per cycle and 29% pregnancies per couple. In the control group of 620 ICSI cycles from ejaculated specimens obtained from male patients with infertility median fertilization was 58% ± 26%, and there were 39% pregnancies per cycle and 47% pregnancies per couple. The rate of pregnancies per embryo transfer and per couple was higher in the control than in the electroejaculation-ICSI group (p <0.05). However, there was no statistically significant difference in the fertilization rate. Conclusions: ICSI or in vitro fertilization is a viable alternative for patients with anejaculation in whom intrauterine insemination failed. While the fertilization rate is similar in these couples, the pregnancy rate is significantly lower than that achieved with ejaculated specimens from patients with severe male factor infertility. ICSI is a viable alternative for a patient with anejaculation in whom intrauterine insemination or in vitro fertilization failed.

AB - Purpose: We tested the hypothesis that spinal cord injury and/or anejaculation affects the outcome of intracytoplasmic sperm injection (ICSI). Materials and Methods: From November 1993 to October 1998 we obtained and prospectively reviewed data on 34 ICSI cycles using electroejaculated sperm, 620 male factor infertility ICSI cycles using normal ejaculated sperm and 120 cases of obstructive azoospermia, in which microsurgical epididymal aspiration and testicular sperm extraction-ICSI were done in 93 and 27, respectively. Results: A total of 34 ICSI cycles were performed in 17 couples with male infertility due to anejaculation secondary to spinal cord injury in 10 patients and retroperitoneal lymph node dissection in 5, and idiopathic in 2. In all 17 couples at least 3 previous intrauterine insemination cycles had failed. After electroejaculation 11 men had oligozoospermia and 6 normal sperm density. Median sperm retrieval volume plus or minus standard deviation was 1.9 ± 1.9 ml., median sperm concentration 70.7 ± 60.2 x 106 sperm per ml., median motility 10.7% ± 10.8% and median forward progression 2.3 ± 0.5 (scale 1 to 4). In the anejaculation group ICSI resulted in a median fertilization of 60% ± 28%, 15% pregnancies per cycle and 29% pregnancies per couple. In the control group of 620 ICSI cycles from ejaculated specimens obtained from male patients with infertility median fertilization was 58% ± 26%, and there were 39% pregnancies per cycle and 47% pregnancies per couple. The rate of pregnancies per embryo transfer and per couple was higher in the control than in the electroejaculation-ICSI group (p <0.05). However, there was no statistically significant difference in the fertilization rate. Conclusions: ICSI or in vitro fertilization is a viable alternative for patients with anejaculation in whom intrauterine insemination failed. While the fertilization rate is similar in these couples, the pregnancy rate is significantly lower than that achieved with ejaculated specimens from patients with severe male factor infertility. ICSI is a viable alternative for a patient with anejaculation in whom intrauterine insemination or in vitro fertilization failed.

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