Ejaculation failure on the day of oocyte retrieval for IVF: A report of five cases

IntroductionThe process of IVF can be emotionally and physically stressful on the couples. The male partner is only required to produce semen for insemination with the eggs. Unfortunately, some men are not able to produce semen on the day of oocyte retrieval.ObjectiveTo report five cases of unexpected ejaculation failure on the day of oocyte retrieval.Materials and methodWe retrospectively reviewed the case records of five couples over a three-year period (December 2006–November 2009), who experienced unexpected ejaculation failure on the day of oocyte retrieval for IVF. Data, including age, cause(s) of infertility, previous treatment history and methods adopted to recover sperms were documented.ResultsOverall, 301 oocyte retrieval cycles were performed during the three year period. Five men had ejaculatory failure, giving an incidence of 1.66%. Three cases (60%) had no prior history of difficulty in producing semen on demand. Prescription of 50 mg 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.ConclusionAnxiety most likely played a major role in these reported cases. It is hoped that liquid nitrogen for cryopreservation would become more readily available in Nigeria so that more centres can adopt semen cryopreservation as a necessary step towards helping such couples.