Vigorous prostatic massage: a simple method to retrieve spermatozoa for intracytoplasmic sperm injection in psychogenic anejaculation

A simple, non-invasive method to retrieve spermatozoa from patients with an ejaculation is described. Three patients with psychogenic primary anejacula tion were referred for intracytoplasmic sperm injection (ICSI), On the day of oocyte retrieval, vigorous prostatic massage was done. Examination of th e expressed prostatic secretion revealed a sufficient number of motile sper matozoa in cases 1 and 3, In ease 1, only one poor quality oocyte was obtai ned and ICSI was unsuccessful, Spermatozoa were cryopreserved for future us e. In case 2, no spermatozoa were retrieved by prostatic massage. A testicu lar biopsy was performed to retrieve spermatozoa for ICSI, Unfortunately no pregnancy resulted. In ease 3, retrieved spermatozoa were successfully use d for ICSI, and 19 ova mere injected. Fertilization occurred in 10 of these ; seven were cryopreserved and three embryos were transferred. Ultrasound s can has confirmed a singleton pregnancy, which is ongoing. We conclude that vigorous prostatic massage could be an effective method of sperm retrieval for assisted conception in selected patients with anejaculation.