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?

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.   Ejaculate is collected from the urethra, and processed in the laboratory to determine sperm quality.   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.   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.

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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