Meng Xianghu, Fan Longchang, Wang Tao, Wang Shaogang, Wang Zengjun, Liu Jihong
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Transl Androl Urol. 2018 Mar;7(Suppl 1):S17-S22. doi: 10.21037/tau.2018.01.15.
Psychogenic anejaculation (PAE) is a rare disease in clinic seriously affecting quality of life, especially fertility of patients. However, there is not an effective treatment for these patients. The aim of the study was to evaluate the results of treatment with electroejaculation (EEJ), intrauterine insemination (IUI), and intracytoplasmic sperm injection (ICSI) in patients with PAE who were refractory to penile vibratory stimulation (PVS).
Twenty PVS-refractory patients with PAE were included in the retrospective study. Semen was retrieved through EEJ procedures. According to the semen quality and patient preference, IUI or ICSI was selected.
A total of 23 procedures of EEJ were performed in 20 patients. Sperm was successfully retrieved in all of the cases. Yielded semen was used in a total of 16 ICSI procedures in 6 couples. The fertilization rate was 54.0%. The ICSI cycles resulted in three pregnancies; of these one resulted in a live birth. Fourteen couples were treated with 26 IUI cycles, which resulted in live births in five pregnancies.
EEJ offers an encouraging pregnancy opportunity for men with PAE who were refractory to PVS. The combined use of EEJ and assisted reproductive techniques is excellent management for PAE infertility. In our study, EEJ resulted in pregnancies and the birth of six healthy children.
心因性不射精（PAE）在临床上是一种罕见疾病，严重影响生活质量，尤其是患者的生育能力。然而，目前尚无针对这些患者的有效治疗方法。本研究旨在评估电刺激射精（EEJ）、宫腔内人工授精（IUI）和卵胞浆内单精子注射（ICSI）对阴茎震动刺激（PVS）无效的PAE患者的治疗效果。
本回顾性研究纳入了20例对PVS无效的PAE患者。通过EEJ程序获取精液。根据精液质量和患者偏好，选择IUI或ICSI。
20例患者共进行了23次EEJ操作。所有病例均成功获取精子。6对夫妇共16次ICSI操作使用了获取的精液。受精率为54.0%。ICSI周期中有3例妊娠；其中1例活产。14对夫妇接受了26次IUI周期治疗，其中5例妊娠活产。
EEJ为对PVS无效的PAE男性提供了令人鼓舞的妊娠机会。EEJ与辅助生殖技术联合应用是治疗PAE不孕的理想方法。在我们的研究中，EEJ导致了妊娠并诞育了6名健康儿童。
