Many male fertility problems can be treated without surgery.
Anejaculation (dry ejaculate)
Anejaculation is when there’s no semen fluid released with a man’s sexual climax. It’s not common, but can be caused by:
- spinal cord injury
- prior surgery
- diabetes
- multiple sclerosis
- abnormalities present at birth
- other mental, emotional or unknown problems
Drugs are often tried first to treat this condition. If they fail, there are several option. Penile vibratory stimulation (PVS) or Rectal probe electroejaculation (RPE, better known as electroejaculation or EEJ) may induce ejaculation. Sperm may also be retrieved directly from the testicle with a needle (Testicular Sperm Aspiration)
Rectal probe electroejaculation is most often done under anesthesia. This is true except in men with a damaged spinal cord. RPE retrieves sperm in 90 out of 100 men who have it done. Many sperm are collected with this method. But sperm movement and shape may still lower fertility.
Penile vibratory stimulation vibrates the tip and shaft of the penis to help get a natural climax. While non-invasive, it doesn’t work as well as RPE. This is especially true in severe cases.
Assisted reproductive techniques like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are of great value to men with anejaculation because sperm may be weak in men with impaired sperm (cells) and semen (fluid) transport out of the body, the underlying problem with anejaculation.
Genital Tract Infection
Genital tract infection is rarely linked to infertility. It’s only found in about 2 out of 100 men with fertility problems. In those cases, the problem is often diagnosed from a semen test. In the test, white blood cells are found. White blood cells make too much “reactive oxygen species” (ROS). This can damage sperm, lowering the chances of sperm being able to fertilize an egg. For example, a severe infection of the epididymis and testes may cause testicular shrinking and epididymal duct blockage. The infection doesn’t have to be sudden to cause problems.
Antibiotics are often given for full-blown infections. But they’re not used for lesser inflammations. Some antibiotics can occasionally harm sperm production or function. Non-steroidal anti-inflammatories (such as ibuprofen) are often used instead.
Inflammation from causes other than infection can also affect fertility. For example, chronic prostatitis, in rare cases, can also block the ejaculatory ducts.