title: The management of retrograde ejaculation: a systematic review and update.
abstract: OBJECTIVE
  To determine the best management of retrograde ejaculation to optimize the chance of conception.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Tertiary reproductive medicine center.
  
  
  METHODS
  Subfertile men with retrograde ejaculation.
  
  
  METHODS
  Systematic search of studies using search terms "management" or "therapy" or "treatment" and "retrograde ejaculation." We excluded case reports and papers not in English.
  
  
  METHODS
  Pregnancy and live birth rates and rates of achievement of antegrade ejaculation.
  
  
  RESULTS
  Thirty-four studies met our criteria. Studies were mostly observational. Descriptions of predictive and confounding variables were often insufficient. The treatment options included urinary sperm retrieval and medical management with anticholinergics and sympathomimetics. Successful pregnancies and live births were also achieved using surgical techniques and electroejaculation; however, numbers were small.
  
  
  CONCLUSIONS
  Many treatment options exist in the management of retrograde ejaculation; however, current literature is insufficient to allow firm comparisons between interventions. Treatment should be tailored, therefore, to the individual. Our findings support the need for further research in this area-including large randomized controlled trials. However, these would be difficult logistically and may not be possible.
authors.affiliation: Department of Women's Health, Southmead Hospital, Bristol, United Kingdom. ajefferys@doctors.org.uk
authors.forename: Amanda
authors.initials: A
authors.lastname: Jefferys
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Siassakos
authors.forename: Peter
authors.initials: P
authors.lastname: Wardle
mesh_terms: D004542:Ejaculation; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D016896:Treatment Outcome