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Electroejaculation (EEJ)
Men
with ejaculatory failure due to nerve damage caused
by spinal injury, and occasionally by other
conditions, can produce sperm by electrical
stimulation of the ejaculatory ducts internally.
Though sperm quality is often poor due to remaining
too long in the body, the sperm are usually suitable
for ICSI treatment. EEJ is a method that can be
used to stimulate ejaculation in men with spinal
cord injuries.
How does
electroejaculation work?
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In electroejaculation, an electric
probe, or electroejaculator, is
inserted into the rectum near the
prostate to stimulate the nerves and
contract the pelvis muscles, causing
ejaculation.
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Ejaculate is collected from the
urethra, and processed in the
laboratory to determine sperm
quality.
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If enough high-quality sperm are
recovered from the semen, they can
be washed in our laboratory and used
in Intrauterine Insemination (IUI),
a process where, using a small tube
or catheter, prepared sperm is
injected directly into the uterus to
achieve egg fertilization.
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If a
lower number or lower quality of
sperm are recovered in the semen, it
can still be used with In Vitro
Fertilization (IVF). Using
Intracytoplasmic Sperm Injection (ICSI),
a single sperm, processed in our
laboratory, is injected directly
into an oocyte (egg) to fertilize
it. Once fertilized, the developing
embryo is implanted into the uterus. |
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Electroejaculation must be performed under
satisfactory anesthesia in men with spinal cord
injuries with sensation in or below the abdomen. A
complete urologic examination must be performed
prior to the procedure to detect and treat any
urinary tract infections.
Often
during this procedure retrograde ejaculation occurs,
which is a backwards ejaculation into the bladder,
and sperm must be collected from the urine. Men with
SCI with a history of autonomic dysreflexia, or the
sudden onset of high blood pressure, must be
carefully monitored, as electroejaculation can cause
a significant increase in blood pressure and heart
rate. These individuals may benefit from
prophylactic treatment with nifedipine or
phenoxybenzamine.
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