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 psychogeni c anejaculation.Design: Retrospective clinical. study. Setting: In Vit ro Fertilization Unit, Bikur Cholim Hospital, Jerusalem. Israel. Patie nts: Twenty men with psychogenic anejaculation who underwent 55 sessio ns of electroejaculation and their spouses. Interventions: Electroejac ulation, assisted reproduction technologies. Main Outcome Measures: Se men analysis, IVF, intracytoplasmic injection (ICSI), fertilization ra tes, 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 inseminat ions performed in eight couples did not result in a pregnancy. Four co uples underwent IVF-ET treatments. Two pregnancies were achieved with overall success rates of 22% per cycle. Five couples were treated usin g the ICSI procedure. Although good quality embryos were transferred, none of the treatments resulted in a pregnancy. Conclusions: Psychogen ic failure to ejaculate may be treated by electroejaculation. However, the average motility of the sperm obtained is diminished. The combina tion of electroejaculation with IVF, including the ICSI procedure, sho uld improve chances of fertilization and pregnancy in these cases.