Why is there no sperm in ejaculation?

The process of ejaculation is very important not only for a full sense of a man and psychological self-satisfaction, but also for the conception of a child. Several pathological conditions accompanying this process can be identified, but the general name for them is aneyakulyatsiya .

anejaculation and its variations

anejaculation - a pathological condition associated with a lack of ejaculationAnd orgasm during intercourse. In this case, anejaculation can take place both without disturbance of the synthesis and qualitative composition of the seminal fluid, and with their disturbances. In urological practice, distinguishes three clinical forms of anejaculation :

1. Aspermatism.
2. Retrograde ejaculation.
3. Obstruction of the vas deferens.

Aspermatism

Aspermatism is the complete absence of orgasm and ejaculation in sexual intercourse. The formation of spermatozoa and seminal fluid in this pathology is not broken, but ejaculation does not occur. In this case, the causes of aspermatism are very variable, among them can be identified:

• Neurological disorders, such as: trauma to the nervous system, cancer, spinal cord and brain. With any defeat of the nervous system, the pathogenesis of aspermatism is a violation of the innervation of the genital organs.
• Psychological factor. With various forms of psychological disorders, the process of ejaculation slows down due to the formation of pathological neural connections in the cortex of the cerebral hemispheres. The most common psychic cause leading to persistent aspermatism is neurosis.
• Mechanical obstruction. Often, the cause is an inflammatory process in the urethral canal or the vas deferens. Such a process, in turn, leads to the formation of microscopic adhesions in the lumen of the canal, thereby blocking the lumen of the urethra or the vas deferens or leading to its stenosis. In addition to infectious processes in the genitals, men to mechanical aspermatism are caused by surgical interventions of the urological profile, or their complications. In this case, in the lumen of the ducts or urethra, there are cicatricial changes significantly narrowing their lumen.
• Iatrogenic factor associated with the use of medications, the side effect of which is the violation of ejaculation. Hypotensive drugs used in hypertension, in particular, beta blockers, cause a significant decrease in potency, with systematic use.

Retrograde ejaculation

Retrograde ejaculation is a pathological process in which ejaculation is absent, due to the throwing of seminal fluid in the opposite direction through the urethral canal. In this case, the sperm does not fall outside, but into the bladder .In this case, a man experiences an orgasm, but ejaculation does not occur. In the future, a man can notice that during urination, urine acquires a light yellow tint, and its transparency is significantly reduced - urine cloudy.

With retrograde ejaculation of psychological disorders is not observed, but orgasm and sexual desire are not violated. The reasons leading to this form of anejaculation can be as follows:

• Developmental anomalies. During the formation of the reproductive system in the intrauterine period, failure may occur in the formation of the vas deferens, not in the urethral tract, but directly in the bladder.
• Diseases of the nervous system of metabolic origin, such as multiple sclerosis, diabetic polyneuropathy, as well as injuries to the spine and spinal cord.
• Venous and pelvic cognias.
• Application of pharmaceuticals: antipsychotic, hypotensive series.
• Prostatitis and other inflammatory diseases of the genitourinary system of men.
• Anatomical disorders: surgical interventions on the prostate gland and bladder, as well as pelvic lymphatic vessels. All operations, to some extent, violate the innervation of the bladder neck with the subsequent disruption of muscular motility during orgasm.

Fig.1 - Mechanism of sperm entering the bladder( retrograde ejaculation).

Obstruction of the vas deferens

Obstruction of the vas deferens leads to a violation of the emission, i.e., the release of sperm. In this case, the orgasm remains. The cause of obstruction may be factors similar to retrograde ejaculation and aspermatism. One of the most common causes of obstruction is the inflammation of the seminal vesicles or epididymitis.

Diagnosis

If you have the above symptoms, do not delay contacting a specialist - urologist. Only complex and competent diagnostic research can reveal the reason for the absence of ejaculate. The attending physician will examine and palpate the scrotum, testicles, and spermatic cord and determine the consistency, density and size. When anejaculation occurs, either an increase in size( hypertrophy) or a decrease in the size( atrophy) of the testis and appendage on the side of the lesion or both( see "What is the normal size of the male testicles?").

Ultrasound diagnosis of the scrotum helps confirm the findings of palpation research, as well as determine the content, visualize it. In addition to diagnosing the scrotum, transrectal echography is performed, which reveals pathological changes in the prostate gland and cystic inflammatory changes in seminal vesicles.

In addition to instrumental studies, the determination of marker substances: alpha-glucosidase, an enzyme located in the epididymis;Fructose - a substance found in seminal vesicles;Zinc - characteristic of the prostate gland.

In cases of obstructive changes, their level can be accurately determined by the indicated markers. In this case, the secretion of markers above the site of obstruction is not impaired. In a number of cases, a testicular biopsy procedure is performed if the diagnosis is difficult to diagnose. A biopsy can determine whether there is a violation of spermatogenesis and its degree.

Therapeutic tactics in the absence of ejaculation

For the treatment of anejaculation resort to conservative methods - drug therapy.

The treatment regimen depends on the causes that caused this pathological condition. The most common causes leading to anejaculation are metabolic and hormonal disorders associated with diabetes mellitus. And also taking medications, the side effect of which causes a decrease in the tone of the neck of the bladder.

For treatment use physiotherapeutic methods of stimulation of the prostate gland, as well as reflexology. For drug therapy, the following drugs are used:

• Midodrin.
• Epidrin sulfate.
• Imipramine and others.

These substances increase the activity of the adrenergic system and increase the muscle tone of the urogenital tract, which contributes to adequate ejaculation.

Surgical treatment is used in cases of congenital aplasia or hypoplasia of the vas deferens. Reconstructive surgical intervention leads to the restoration of normal passage of seminal fluid and prevents its transfer into the bladder.

The possibility of IVF during anejakuljatsii

ECO - the procedure of in vitro fertilization, when the introduction of sperm into the egg is carried out outside the human body, and then they put the fertilized egg in the uterus cavity to the woman who will bear the child.

For the procedure, various techniques are used to extract spermatozoa in the absence of ejaculation during ejaculation. One type is the sperm extract from the bladder with the retrograde ejaculation .To do this, the bladder cavity is filled with a special solution that protects the spermatozoa from the aggressive environment of the bladder, after which the patient causes ejaculation. Using a special catheter, the sperm is removed and the IVF procedure is performed.

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