A step-wise approach to sperm retrieval in men with neurogenic anejaculation
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A step-wise approach to sperm retrieval in men with neurogenic anejaculation. / Fode, Mikkel; Ohl, Dana A; Sønksen, Jens.
In: Nature Reviews. Urology, Vol. 12, No. 11, 11.2015, p. 607-16.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - A step-wise approach to sperm retrieval in men with neurogenic anejaculation
AU - Fode, Mikkel
AU - Ohl, Dana A
AU - Sønksen, Jens
PY - 2015/11
Y1 - 2015/11
N2 - Normal fertility is dependent on intravaginal delivery of semen through ejaculation. This process is highly dependent on an intact ejaculatory reflex arc, which can be disrupted through any type of trauma or disease causing damage to the CNS and/or peripheral nerves. Neurogenic anejaculation is most commonly associated with spinal cord injury. This aetiology is especially relevant because most men with spinal cord injuries are injured at reproductive age. Assisted ejaculation in the form of penile vibratory stimulation is the first choice for sperm retrieval in such patients because it is noninvasive and inexpensive. In patients in whom vibratory stimulation fails, electroejaculation is almost always successful. When both methods of assisted ejaculation are unsuccessful, sperm retrieval by aspiration from either the vas deferens or the epididymis, or by testicular biopsy or surgery are reasonable options. In such cases the most inexpensive and least invasive methods should be considered first. The obtained semen can be used for intravaginal or intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection.
AB - Normal fertility is dependent on intravaginal delivery of semen through ejaculation. This process is highly dependent on an intact ejaculatory reflex arc, which can be disrupted through any type of trauma or disease causing damage to the CNS and/or peripheral nerves. Neurogenic anejaculation is most commonly associated with spinal cord injury. This aetiology is especially relevant because most men with spinal cord injuries are injured at reproductive age. Assisted ejaculation in the form of penile vibratory stimulation is the first choice for sperm retrieval in such patients because it is noninvasive and inexpensive. In patients in whom vibratory stimulation fails, electroejaculation is almost always successful. When both methods of assisted ejaculation are unsuccessful, sperm retrieval by aspiration from either the vas deferens or the epididymis, or by testicular biopsy or surgery are reasonable options. In such cases the most inexpensive and least invasive methods should be considered first. The obtained semen can be used for intravaginal or intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection.
KW - Algorithms
KW - Ejaculation
KW - Electric Stimulation
KW - Equipment Design
KW - Humans
KW - Male
KW - Sexual Dysfunction, Physiological
KW - Sperm Retrieval
KW - Spinal Cord Injuries
U2 - 10.1038/nrurol.2015.241
DO - 10.1038/nrurol.2015.241
M3 - Review
C2 - 26481575
VL - 12
SP - 607
EP - 616
JO - Nature Reviews. Urology
JF - Nature Reviews. Urology
SN - 1759-4812
IS - 11
ER -
ID: 161846697