Ejaculation Malfunctions on the Day of Oocyte Pick up for IVF/ICSI: A Report of Four Cases

Abstract

Introduction:The procedure of in-vitro fertilization (IVF) is sometime physically stressful and emotional turmoil on the couples undergoing treatment. The male partner is obliged to produce semen for injection/insemination with the oocytes. Unfortunately, some men are ill-fated, not capable to reproduce semen on the day of oocyte pickup.Objective: To testify four cases of unexpected ejaculation malfunction on the day of oocyte pickup.Setting: Base Fertility Medical Science Pvt Ltd.Materials and method: The case retrospectively reviewed the case records of four couples over a year period (September 2013–November 2014), who suffered unexpected ejaculation complete failure on the day of oocyte pickup for IVF/ICSI. Data, including age, Stimulation Protocol, cause(s) of infertility, previous treatment history (If Any) and various techniques implemented to retrieve sperms were documented.Results: Altogether, 362 oocyte pickup cycles were conducted during a year period. Four men had ejaculatory failure, providing an incidence factor of 1.10 %. Three cases (75%) had no earlier symptom/history of complexity in producing semen on requirement. Even Recommendation of 50 mg Vardenafil /Sildenafil citrate and the couples watching sexually stimulating videos did not remedy the situation. Surgical sperm retrieval was successful in case 1. It yielded no live sperm sample in case 2. Cases 3 and 4 had repeat IVF cycles. The male partners were not aware that oocyte retrieval would take place the next day and produced semen within a couple of hours.Conclusion: Anxiety and psychogenic stress most likely played a major role in these reported cases.Key: It is hoped that liquid nitrogen for cryopreservation would be the more readily available and easy technique to adopt in such scenarios to be followed for the centres for semen cryopreservation as a necessary prestep towards helping such couples and the upcoming techniques’ not widely in practice in developing countries ,oocyte vitrification*.Index Term: Semen Cryopreservation, Ejaculation Malfunction, IVF, ICSI & Stimulants.