Retrograde Ejaculation and Infertility – Causes, Symptoms & Treatment

What is Retrograde Ejaculation?

Retrograde ejaculation is a condition where semen enters into the bladder instead of exiting the body through penis. This results in a little or no semen during ejaculation or cloudy colored urine. This condition doesn’t cause any pain, but it can affect male fertility by making natural conception difficult.

Bladder neck muscles normally close during ejaculation to ensure semen moves forward. But in this condition the muscles don’t function properly, thus the sperm gets redirected into the bladder.

Some common causes of retrograde ejaculation include:

• Nerve damage – Nerve damage can be caused by conditions like diabetes or multiple sclerosis. Nerve damage can disrupt the normal functioning of the nerves that control ejaculation, causing semen to flow backward into the bladder.
•  Prostate or bladder surgery – Surgeries can weaken or disrupt muscle control.
•  Spinal cord injuries – Damage to the spinal cord can disrupt nerve signals that control ejaculation, leading to retrograde ejaculation.
•  Certain medications – Medications used to treat high blood pressure or psychiatric disorders may affect ejaculation.

Although retrograde ejaculation doesn’t affect a man’s ability to have an orgasm, it reduces semen volume, leading to fertility challenges.

How Retrograde Ejaculation Affects Male Fertility

Testicles not only produce sperm but also regulate hormones which are essential for reproductive health. When they remain undescended, several fertility issues arise:

• Higher Temperatures Affect Sperm Quality – The abdomen is warmer than the scrotum, and sperm cannot thrive in high temperatures. This results in low sperm count (Oligospermia) or poor sperm motility (Asthenospermia).
•  Hormonal Imbalances – Testosterone production gets disrupted by Cryptorchidism, which leads to sexual health issues.
•  Testicular Damage Over Time – The longer a testicle stays in the abdomen, the greater the risk of irreversible sperm damage.
•  Higher Risk of Testicular Cancer – Studies shoes that Untreated cryptorchidism have a higher chance of developing testicular cancer.

Early diagnosis and treatment can improve fertility outcomes and reduce long-term risks.

Symptoms & Diagnosis

Common Symptoms of Retrograde Ejaculation

Men with retrograde ejaculation often experience:

•  You produce little to no semen during ejaculation.
•  You will have a cloudy urine after ejaculation, indicating sperm presence.
•  You will face difficulty conceiving, despite regular unprotected intercourse.

Some men may not even realize they have this condition until they face challenges with fertility. If you or your partner notice any of these symptoms, a fertility evaluation is the next best step.

Diagnostic Tests

To confirm retrograde ejaculation, doctors may perform:

• Post-Ejaculatory Urinalysis – After ejaculation, a urine sample is collected to check the presence of sperm. If sperm are found, it will indicate retro ejaculation.
•  Semen Analysis – This is a test that determines sperm count, assess sperm motility, and evaluates sperm quality.
•  Hormonal Testing – This test assesses testosterone and other reproductive hormones, which are important for sperm production, to rule out hormonal imbalances.

With a proper diagnosis, treatment can be planned to improve fertility outcomes.

Treatment Options for Retrograde Ejaculation

Medications

For mild cases, certain medications can help strengthen bladder sphincter muscles and direct sperm forward. Common options include:
  Alpha-adrenergic drugs (e.g., pseudoephedrine, imipramine) – These improve bladder control and prevent sperm from flowing backward.

Note: Don’t use medicines without a doctor’s recommendation. Not all cases respond to medication, so alternative options might be needed.

Sperm Retrieval & Assisted Reproductive Techniques (ART)

If medications don’t work, sperm retrieval can be performed. The collected sperm can then be used in:

• IUI (Intrauterine Insemination) – In this treatment sperm is directly placed into the uterus. It is performed during ovulation to increase the chance of fertilization.
• ·IVF (In Vitro Fertilization) – In IVF Treatment eggs and sperm are fertilized in a lab before being implanted. Fertilized eggs (embryos) are cultured for 3-5 days. Then one or more embryos are transferred into the uterus.
• ICSI (Intracytoplasmic Sperm Injection) – In this process a single healthy sperm is injected into an egg to enhance fertilization.

This ensures that couples dealing with retrograde ejaculation still have the opportunity to conceive.

Nerve-Stimulating Therapy

For men whose condition is linked to diabetes or nerve damage, certain nerve-stimulating therapies may help restore ejaculation function. This depends on the severity of nerve impairment and overall health.

Next Steps for Couples Facing Male Infertility

Retrograde ejaculation can be frustrating, especially when trying to conceive. But the good news? It’s treatable. With the right combination of medical support and assisted reproductive techniques, many couples successfully achieve pregnancy.

At Curves & Kicks, we specialize in advanced fertility treatments, helping couples overcome male and female infertility challenges. If you or your partner are experiencing fertility issues, our experts can guide you on the best approach to parenthood.