Anejaculation and fertility: What is it? Is there any treatment? Can I be a father?

Ejaculation disorders are one of the most common sexual disorders in the male population. These are common in urology consultations and a possible cause of infertility.

What is anejaculation?

Anejaculation is defined as a type of ejaculatory dysfunction that consists in the male’s inability to ejaculate during intercourse, preventing the exit of seminal fluid into the female genital tract. Its incidence is 0.39 percent in patients who require assisted reproductive techniques.

What types of anejaculation are there and what are their symptoms?

• It can be classified as primary, when there is an absence of ejaculate throughout the man’s life, or
• secondary, in which the male stops ejaculating during sexual intercourse at a certain moment.
• It can also be differentiated into situational, in which ejaculation occurs during some sexual practices, but not at the time of intercourse, or
• total if ejaculation never occurs regardless of whether the man reaches orgasm or not.

What are the anejaculation causes?

• Anejaculation can be due to psychological causes, such as stress, anxiety or low self-esteem,
• pharmacological causes and
• physical causes such as obstruction of the seminal tract, prostatic hyperplasia or prostate enlargement, prostatitis or inflammation of the prostate, abdominal surgeries, urological surgeries, diabetes, spinal cord injuries, multiple sclerosis, Parkinson’s disease, etc.
• Sometimes due to retrograde ejaculation, in which the seminal fluid is redirected towards the bladder instead of exiting through the urethra.
• It can also be produced by the consumption of other substances such as drugs and alcohol.

How can we diagnose and treat anejaculation?

In order to make the diagnosis, it’s important to know both, the patient’s medical history and perform a detailed physical examination. To find out if the male has retrograde ejaculation, a post-orgasmic urinalysis can be performed to confirm the presence of sperm in the urine. In the case of not visualizing them, a sperm retrieval can be performed by means of an epididymal aspiration or a testicular biopsy. If the anejaculation is caused by medication, it will be removed if the doctor considers it appropriate. Psychological treatment is lso important in these cases.

Can I be a father if I have anejaculation?

Thanks to the different treatments and assisted reproduction techniques, if the man has anejaculation, it will be possible to achieve pregnancy.

Bibliography:

• Clinical review of ejaculatory disfunction. Toshikazu Otani. Reproductive medicine and biology, 2019.
• Infertility and assisted reproduction. Cambridge University Press, 2008

Mónica Aparicio, a biologist at Instituto Bernabeu