ELECTROEJACULATION AND ASSISTED REPRODUCTIVE TECHNIQUES FOR ANEJACULATORY INFERTILITY

Objective: To report our experience with electroejaculation combined w ith intrauterine inseminations (IUI) and other assisted reproductive t echnologies. Methods: Anejaculatory men desirous of fertility were eva luated in our Assisted Reproductive Program. Between March 1991 and De cember 1994, 26 men (age 24-48) underwent a total of 84 electroejacula tions. Causes of anejaculation included spinal cord injury (n = 23) an d retroperitoneal lymph node dissection (n = 3). Female partners were superovulated to improve the pregnancy rate. The success in sperm retr ieval and pregnancy rates were determined, and the quality of electroe jaculates was evaluated. Results: Seventy-seven of 84 (92%) electroeja culations were successful, defined by retrieval of more than 10 x 10(6 ) total and more than 10(6) motile spermatozoa. Mean sperm count was 6 5 million/mL (range 0-569), but mean motility was only 16% (range 0-66 ). Mean normal morphology was 27% (range 0-71). Ten couples attempted conception. Fifty cycles of IUIs were performed, resulting in four nor mal term infants and one spontaneous abortion (pregnancy rate 10% per IUI). One patient failed to conceive with eight cycles of IUIs but bec ame pregnant with in vitro fertilization-embryo transfer with microman ipulation using electroejaculates; she delivered a set of healthy twin s. Two couples elected donor sperm insemination after failing to conce ive by IUI with electroejaculates; both became pregnant. Conclusion: E lectroejaculation offers an encouraging pregnancy opportunity for anej aculatory men who otherwise are considered infertile. Marked asthenosp ermia is observed in electroejaculates, the etiology of which remains obscure. Further studies to elucidate the cause may improve pregnancy rates.