SUCCESSFUL TREATMENT OF INFERTILITY DUE TO ANEJACULATION WITH IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER - A REPORT OF 2 CASES

We investigated the efficacy of assisted ejaculation in combination wi th in vitro fertilization and embryo transfer (IVF-ET) in two couples with infertility due to anejaculation. Case 1 was in an anejaculatory condition associated with a spinal cord-injury. me performed intrauter ine insemination (IUI) three times using motile sperm obtained by intr athecal injection of neostigmine, but no pregnancy followed. The coupl e then entered IVF-ET. The semen volume obtained by assisted ejaculati on was 4.5 ml. The sperm count was 33 x 10(6)/ml with 33% motility. At 35 weeks of gestation she delivered three healthy babies by cesarean section. Case 2 was in an unexplained retrograde ejaculatory condition . We performed IUI eight times before changing to IVF-ET. We then used sperm obtained from urine or sperm recovered from the bladder after a dministration of human tubal fluid, but no pregnancy followed. At the fifth IVF-ET attempt, using sperm obtained from urine, we succeeded. W e prepared the sperm by the Percoll gradient method. The sperm count w as 36 x 10(6)/ml with 64% motility. At 39 weeks of gestation she deliv ered a healthy baby. Deficient seminal quality contributes to the decr eased fertility potential in patients with anejaculation. With the use of IVF-ET methods, pregnancies can be achieved in these couples. (C) 1998 Tohoku University Medical Press.