Álvarez Ernesto Veiga, García Nuria Zopeque, Gutiérrez Romero Javier M, Díaz-Fierros Pilar Reimundo, Lozano Arana María D, Pérez Tamara Rodríguez, Álvarez Javier Sánchez, Rodríguez Guadalupe Bueno, Bernardo Vanesa Castañón, Moyano Gallego María J
Working Group on Andrology and Assisted Reproduction Technologies, Spanish Society of Laboratory Medicine (SEQCML),, Barcelona, Spain.
Assisted Human Reproduction Unit, Central Laboratory, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Adv Lab Med. 2024 Aug 22;5(4):356-365. doi: 10.1515/almed-2024-0109. eCollection 2024 Dec.
Retrograde ejaculation (RE) consists of the reflux backwards, towards the bladder, of the ejaculate, during the emission phase of ejaculation, causing a total or partial absence of sperm emission, with the consequent diversion of semen into the bladder during the emission phase of ejaculation. Evaluating the ejaculate may not be sufficient for identifying RE in some patients. Hence, the management of infertility may involve the use of invasive methods such as epididymal fluid retrieval or testicular biopsy.
This paper defines RE and methods for its diagnosis. A description is also provided of the techniques used for the detection of sperm in post-ejaculatory urine (PEU), the preparation and retrieval of sperm from urine and their subsequent use in assisted reproductive techniques.
The diagnosis of RE is based on the detection of spermatozoa in PEU in patients with aspermia or oligozoospermia and low or normal seminal volume. Although the presence of sperm in PEU could be sufficient for a diagnosis of RE, there is a lack of consensus regarding the diagnostic criteria for PEU, and the literature available is very limited. A correct diagnosis of RE allows the use of PEU for recovering sperm and its subsequent use in assisted human reproduction techniques, thus avoiding invasive techniques.
A significant number of patients with RE may remain undiagnosed. Therefore, it is essential to conduct an RE study in patients with suspicion, through the analysis of PEU, and to properly interpret the results for accurate diagnosis.
逆行射精（RE）是指在射精的射出阶段，精液逆向流入膀胱，导致完全或部分无精子射出，从而在射精的射出阶段精液转而进入膀胱。对某些患者而言，评估射出的精液可能不足以确诊逆行射精。因此，不孕症的治疗可能涉及使用如附睾液采集或睾丸活检等侵入性方法。
本文定义了逆行射精及其诊断方法。还描述了用于检测射精后尿液（PEU）中精子的技术、从尿液中制备和采集精子及其随后在辅助生殖技术中的应用。
逆行射精的诊断基于在无精子症或少精子症且精液量低或正常的患者的射精后尿液中检测到精子。尽管射精后尿液中存在精子可能足以诊断逆行射精，但关于射精后尿液的诊断标准缺乏共识，且现有文献非常有限。逆行射精的正确诊断允许使用射精后尿液来回收精子并随后用于人类辅助生殖技术，从而避免侵入性技术。
大量逆行射精患者可能仍未被诊断。因此，对于疑似患者，通过分析射精后尿液进行逆行射精研究并正确解读结果以进行准确诊断至关重要。
