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Management of male neurologic patients with infertility.
Handb Clin Neurol. 2015; 130:435-49.HC

Abstract

Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve injury. Normal ejaculation is the result of coordinated reflex activity involving both the sympathetic and somatic nervous systems. Nerve injury can result in retrograde ejaculation, and anejaculation. With retrograde ejaculation, the ejaculate is propelled into the bladder instead of out through the urethra. In mild cases this condition can be reversed by sympathomimetic medications and, in more severe cases, sperm cells can be extracted from the bladder following ejaculation. With anejaculation, the ejaculatory reflex is not activated by normal sexual stimulation. In such cases, the first choice of treatment is assisted ejaculation, preferably by penile vibratory stimulation. If vibratory stimulation is unsuccessful, then ejaculation can almost always be induced by electroejaculation. In cases where assisted ejaculation fails, sperm can be retrieved surgically from either the epididymis or from the testis. Once viable sperm cells have been obtained, these are used in assisted reproductive techniques, including intravaginal insemination, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection.

Authors+Show Affiliations

Department of Urology, Herlev Hospital, University of Copenhagen, Herlev, Denmark. Electronic address: mikkelfode@gmail.com.Department of Urology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26003259

Citation

Fode, Mikkel, and Jens Sønksen. "Management of Male Neurologic Patients With Infertility." Handbook of Clinical Neurology, vol. 130, 2015, pp. 435-49.
Fode M, Sønksen J. Management of male neurologic patients with infertility. Handb Clin Neurol. 2015;130:435-49.
Fode, M., & Sønksen, J. (2015). Management of male neurologic patients with infertility. Handbook of Clinical Neurology, 130, 435-49. https://doi.org/10.1016/B978-0-444-63247-0.00025-0
Fode M, Sønksen J. Management of Male Neurologic Patients With Infertility. Handb Clin Neurol. 2015;130:435-49. PubMed PMID: 26003259.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of male neurologic patients with infertility. AU - Fode,Mikkel, AU - Sønksen,Jens, PY - 2015/5/25/entrez PY - 2015/5/25/pubmed PY - 2015/8/22/medline KW - assisted reproductive techniques KW - ejaculation KW - electroejaculation KW - infertility KW - nervous system diseases KW - penile vibratory stimulation KW - retrograde ejaculation KW - surgical sperm retrieval SP - 435 EP - 49 JF - Handbook of clinical neurology JO - Handb Clin Neurol VL - 130 N2 - Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve injury. Normal ejaculation is the result of coordinated reflex activity involving both the sympathetic and somatic nervous systems. Nerve injury can result in retrograde ejaculation, and anejaculation. With retrograde ejaculation, the ejaculate is propelled into the bladder instead of out through the urethra. In mild cases this condition can be reversed by sympathomimetic medications and, in more severe cases, sperm cells can be extracted from the bladder following ejaculation. With anejaculation, the ejaculatory reflex is not activated by normal sexual stimulation. In such cases, the first choice of treatment is assisted ejaculation, preferably by penile vibratory stimulation. If vibratory stimulation is unsuccessful, then ejaculation can almost always be induced by electroejaculation. In cases where assisted ejaculation fails, sperm can be retrieved surgically from either the epididymis or from the testis. Once viable sperm cells have been obtained, these are used in assisted reproductive techniques, including intravaginal insemination, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection. SN - 0072-9752 UR - https://www.unboundmedicine.com/medline/citation/26003259/Management_of_male_neurologic_patients_with_infertility_ L2 - https://linkinghub.elsevier.com/retrieve/pii/B978-0-444-63247-0.00025-0 DB - PRIME DP - Unbound Medicine ER -
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