Case Report
Successful Treatment of Infertility Due to Anejaculation with In Vitro Fertilization and Embryo Transfer: A Report of Two Cases
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SEIICHIRO NAGAI, TSUYOSHI KASAI, KEIGO OGAWA, KAORUKO MlZUNO, SHOJI OHTA and KAZUHIKO HOSHI
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Department of Obstetrics aud Gynecology, Yamanashi Medical University, Yamanashi 409-3898
We investigated the efiicacy of assistcd ejaculation in combination with in vitro fertilization and embryo transfer (IVF-ET) in two couples with infertility due to anejaculation. Case 1 was in an anejaculatory condition associated with a spinal cord-injury. We performed intrauterine insemination (IUI) three times using motile speun obtained by intrathecal injection of neostigmine, but no pregnancy followed. The couple then entered IVF-ET. The semen volume obtained by assisted ejaculation was 4.5 ml. The sperm count was 33 ´ 106/ml with 33% motility. At 35 weeks of gestation she delivered three healthy babies by cesarean section. Case 2 was in an unexplained retrograde ejaculatory condition. We performed IUl eight times before changing to IVF-ET. We then used sperm obtained from urine or sperm recovered from the bladder after administration of human tubal fluid, but no pregnancy followed. At the fifth IVF-ET attempt, using sperm obtained from urine, we succeeded. We prepared the sperm by the Percoll gradient method. The sperm count was 36 ´ 106/ml with 64% motility. At 39 weeks of gestation she delivered a healthy baby. Deficient seminal quality contributes to the decreased fertility potential in patients with anejaculation. With the use of IVF-ET methods, pregnancies can be achieved in these couples.
Key words---
male infertility; anejaculation; spinal cord injury; retro-grade ejaculation; IVF-ET
© 1998 Tohoku University Medical Press
Tohoku J. Exp. Med., 1998, 184, 241-246
Address for reprints:
Seiichiro Nagai, M.D., Department of Obstetrics and Gynecology, Yamanashi Medical University, Yamanashi 409-3898, Japan.
e-mail: seiichi@res.yamanashi-med.ac.jp
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