Male infertility is a problem in 20% to 30% of couples that fail to conceive naturally. When the problem is with the male partner, this may be due to various aspects. A poor seminal emission can be one of the causes of infertility. Electroejaculation is a method that can be used to obtain healthy sperm from patients with a low seminal emission. The method is often used to assist an in vitro fertilization.
Seminal Emission and Fertility
Seminal emission, or the amount of sperm that is ejaculated, may be influenced by several factors, both physical and psychological. A patient that has reduced seminal emission may be affected by:
- Stress
- Multiple sclerosis
- Neurological issues
- Diabetes
- Idiopathic anejaculation
- A tumor that affects the reproductive area
- A spinal cord injury (SCI)
- A surgery in the reproductive area
The seminal emissions may influence fertility, as when there is not enough seminal fluid, the fertilization of an egg is not possible.
Preparing for Electroejaculation or EEJ
The EEJ procedure requires general or local anesthesia. The bladder of the patient must be empty so that the procedure is easier to perform. The bladder may be emptied during the procedure as well. The pH is of the urine may be tested and ideally, this should be over 6.5. This is important, as retrograde ejaculation (ejaculation in the bladder) may happen during the EEJ and the bladder should be empty and contain alkaline urine, so that the sperm will not be destroyed. If the pH of the urine is acidic, sodium bicarbonate can be added to the bladder.
Glycerin will be used to lubricate the urethra and a catheter will be inserted in the bladder. This will extract any sperm that may be collected in the bladder. A rectal exam may be necessary prior to the EEJ to ensure that there are no injuries in the area that may be aggravated by the EEJ procedure.
The EEJ Procedure
The EEJ will be performed via rectal electrosimulation and the fertility doctor will used variable voltage, to ensure that there will be no injuries. If the patient feels any pain, the voltage should be adapted so that it will not cause any discomfort.
The process is continued until ejaculation occurs. If the ejaculation is retrograde, this can be indicated by an erection followed by its disappearance. In case of a retrograde ejaculation, the sperm will have to be collected from the bladder. In the case of a normal ejaculation, the sperm will be collected in a cup and stored until used. The cells may be frozen, as otherwise, they will be viable for 3 days only. The rectal temperature should be monitored during the entire process of EEJ.
