title: Electroejaculation and assisted reproductive technologies in the treatment of anejaculatory infertility.
abstract: OBJECTIVE
  To determine the efficacy of electroejaculation in combination with assisted reproductive technology (ART).
  
  
  METHODS
  Case series.
  
  
  METHODS
  University fertility program.
  
  
  METHODS
  One hundred twenty-one consecutive couples seeking treatment of anejaculatory infertility.
  
  
  METHODS
  Electroejaculation with IUI, or gamete intrafallopian transfer or IVF.
  
  
  METHODS
  Pregnancy and pregnancy outcome.
  
  
  RESULTS
  Fifty-two couples became pregnant (43%), 39 by IUI alone (32.2%). Cycle fecundity for IUI was 8.7%. No difference in cycle fecundity was seen among ovarian stimulation protocols (clomiphene citrate, 7.6%, hMG, 13.2%, and natural cycle, 11.2%). Pregnancy was unlikely when the inseminated motile sperm count was <4 million. Female management protocol and etiology of anejaculation did not affect results. Patients undergoing IVF had higher cycle fecundity (37.2%) than did those undergoing IUI. The rates of spontaneous abortion and multiple gestations were 23% and 12%, respectively.
  
  
  CONCLUSIONS
  Electroejaculation with stepwise application of ART is effective in treating anejaculatory infertility. Intrauterine insemination with the least expensive monitoring protocol should be used for most couples, because use of more expensive monitoring did not improve results. It is cost-effective to bypass IUI and proceed directly to IVF in men who require anesthesia for electroejaculation and in those with a total inseminated motile sperm count < 4 million.
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan, USA. dana.ohl@umich.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Ohl
authors.forename: L J
authors.initials: LJ
authors.lastname: Wolf
authors.forename: A C
authors.initials: AC
authors.lastname: Menge
authors.forename: G M
authors.initials: GM
authors.lastname: Christman
authors.forename: W W
authors.initials: WW
authors.lastname: Hurd
authors.forename: R
authors.initials: R
authors.lastname: Ansbacher
authors.forename: Y R
authors.initials: YR
authors.lastname: Smith
authors.forename: J F
authors.initials: JF
authors.lastname: Randolph
mesh_terms: D004542:Ejaculation / Q000502:physiology*; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000295:instrumentation*