Andrology: Transrectal electroejaculation in combination with in-vitro fertilization: an effective treatment of anejaculatory infertility after testicular cancer

Abstract

Treatment of non-seminomatous testicular cancer often leads to infertility due to anejaculation/retrograde ejaculation and poor sperm quality. In these men spermatozoa may be obtained by transrectal electroejaculation (TE), but the optimal strategy for assisted procreation in these couples is not known. Our aim was to examine whether TE and conventional in-vitro fertilization (IVF) would be successful. A total of 10 couples, with long-standing infertility due to anejaculation or retrograde ejaculation after treatment for testicular cancer 5-14 years earlier, were referred to our unit. All men underwent diagnostic TE under general anaesthesia. Spermatozoa were recovered in nine cases. The antegrade fraction was prepared and used for IVF. Sperm quality was variable and conventional IVF was considered impossible in three cases. Altogether six IVF treatment cycles in six couples resulted in five pregnancies, of which four resulted in a delivery and one resulted in a spontaneous abortion. One additional pregnancy is ongoing after transfer of cryopreserved embryos. The fertilization rate was 54% (33/61) and the cleavage rate was 97% (32/33). No complications relating to the procedure have been encountered.