Yes. In retrograde ejaculation, there is a failure in the valve mechanism that causes semen to exit the urethra and not enter the urine bladder (in the male, as we know, the same tube is used to ejaculate and to urinate, so both systems are connected). This problem is typical of the involvement of the nerves that control this system, common for example in diabetic neuropathy. The man will achieve orgasm without any problem, but a part or usually all of his sperm will not come out, so the main symptom is the appearance of orgasm without ejaculation (or almost none).
There are two ways to give these people the possibility of having a baby, both carried out in the context of in vitro fertilization:
- Sperm retrieval from urine: just before the urine sample is taken, the patient must have a full bladder and have ingested a large amount of bicarbonate. Urine is usually acidic, which will destroy the sperm when they come into contact with it. When the person takes bicarbonate, it deacidifies the urine, as it is eliminated via the urine. Thus, by accumulating this relatively alkaline urine before ejaculation, we obtain a sufficient medium for the sperm to survive in it until the time of collection. Once this medium is prepared, the man must masturbate, until he reaches orgasm (with a full bladder). The sperm will go directly into this prepared urine. Now we simply collect a urine sample after the orgasm, and look for the sperm in it. These sperm will then be used for IVF. This technique is relatively old and has been, and is being, used successfully for many years.
- Testicular biospia/epididymis puncture: the development of new minimally invasive surgical extraction techniques directly from the testicle has become a regulated alternative, clean and perceived as more professional, clean and comfortable for the patient, which is why they are now widely used in these cases.
In both cases, the probability of gestation is maintained with respect to an IVF carried out due to other diagnoses.
