title: Electroejaculation combined with intracytoplasmic sperm injection in patients with psychogenic anejaculation yields comparable results to patients with spinal cord injuries.
abstract: OBJECTIVE
  To evaluate sperm quality and fertility potential of men with psychogenic anejaculation treated by electroejaculation (EEJ) and intracytoplasmic sperm injection (ICSI). Treatment results were compared to spinal cord injured (SCI) patients treated similarly.
  
  
  METHODS
  Retrospective clinical study.
  
  
  METHODS
  Academic tertiary referral fertility center.
  
  
  METHODS
  Couples with isolated psychogenic anejaculation or SCI.
  
  
  METHODS
  Electroejaculation and ICSI.
  
  
  METHODS
  Semen analysis, fertilization rate, implantation rate, pregnancy rate, delivery rate and safety of the procedure.
  
  
  RESULTS
  Fifteen patients diagnosed with psychogenic anejaculation underwent 40 EEJ/ICSI cycles. The semen retrieved was characterized by low motility (mean 10.7% ± 12.3%), normal volume (2.2 ± 1.9 mL) and normal count (25.1 ± 29.9 × 10(6)/mL), according to World Health Organization criteria. Results of EEJ/ICSI were compared with 22 SCI patients treated by 66 EEJ/ICSI cycles during the same period. Mean female age and the number of oocytes retrieved per cycle were similar between the groups. Similar semen parameters after EEJ were found between psychogenic and SCI patients. Fertilization rate was significantly lower in the psychogenic patients compared to SCI (47.0% and 57.0%, respectively). No significant differences were found regarding pregnancy rates (20% and 22.7%, respectively), implantation rate (10.2% and 11.6%, respectively) or delivery rates (15% and 18.2%, respectively).
  
  
  CONCLUSIONS
  Sperm retrieved by EEJ is characterized by asthenospermia and normal count. In spite of the lower fertilization rate in psychogenic patients, combination of EEJ and ICSI gives adequate results to couples with psychogenic anejaculation similar to the results obtained for SCI patients. Current results give these couples a reasonable chance of pregnancy achievement.
authors.affiliation: In Vitro Fertilization Unit, Sheba Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel. itaigatmd@gmail.com
authors.forename: Itai
authors.initials: I
authors.lastname: Gat
authors.forename: Ettie
authors.initials: E
authors.lastname: Maman
authors.forename: Gil
authors.initials: G
authors.lastname: Yerushalmi
authors.forename: Micha
authors.initials: M
authors.lastname: Baum
authors.forename: Jehoshua
authors.initials: J
authors.lastname: Dor
authors.forename: Gil
authors.initials: G
authors.lastname: Raviv
authors.forename: Igal
authors.initials: I
authors.lastname: Madjar
authors.forename: Ariel
authors.initials: A
authors.lastname: Hourvitz
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D004542:Ejaculation; D004558:Electric Stimulation; D010064:Embryo Implantation; D005260:Female; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007557:Israel; D050498:Live Birth; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055101:Semen Analysis; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000503:physiopathology; D020018:Sexual Dysfunctions, Psychological / Q000150:complications* / Q000503:physiopathology; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D053625:Sperm Retrieval / Q000009:adverse effects; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome