How can a 73-year-old male with dry orgasm and retrograde ejaculation achieve pregnancy?

Question

Hello doctor,

Thanks for the reply.

I am a 73-year-old male with a height of 6 inches and 172 pounds. My wife and I are working with a fertility clinic to conceive. We went through 2 cycles of IVF and ICSI two years ago, resulting in two frozen embryos. I have 21 vials of cryopreserved sperm specimens produced over the past ten years. I now have a dry orgasm, retrograde ejaculation, low testosterone, and prostatomegaly. So now we have these possibilities for producing my sperm, like retrograde ejaculation, other means of sperm collection, my cryopreserved sperm specimens, and our frozen embryos. How do we best continue at this point, and how can my issues be addressed individually? I currently take Atorvoststin 80 mg, Metoprolol succinate ER 25 mg extended release 24 hours, Tadalafil 5 mg, Ecotrin low strength 81 mg EC tablet, and Cyanocobalamin (vitamin B12) 500 mcg tablet. I have uploaded my laboratory reports for you to check. Please help.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concerns.

I have seen your attachments (attachments are hidden to protect the patient's identity). You have an enlarged prostate, but in your list of current medications, I cannot see Tamsulosin.

1. Retrograde ejaculation: If you are taking Tamsulosin, then it may be causing this problem. The remedy is to stop Tamsulosin and take Tadalafil instead, which you are already doing.

2. Other means of sperm collection: Other means are surgical retrieval of sperm by testicular extraction or aspiration from the testis or epididymis.

3. Cryopreserved sperm specimens: If your cryopreserved sperms are viable, you do not need surgical retrieval of sperms. Viability is the primary concern, even if numbers and motility are low. Single non-motile sperm can create pregnancy by ICSI (intracytoplasmic sperm injection).

4. Frozen embryos: Frozen embryo use depends on the quality of the embryos. A prenatal genetic diagnosis PGD (pre-implantation genetic diagnosis) can help here.

You can make a decision depending on the above factors. If the quality of frozen embryos is good, you can go for embryo transfer. If the quality is not good, you can use a fresh fertilized embryo from the cryopreserved sperms. If you oppose the idea, you can go for donor sperm, donor ovum, or both.

I hope this information will help you.

Thanks.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your queries.

Tadalafil 5 mg taken daily at bedtime may cure retrograde ejaculation if only Tamsulosin is stopped. Tamsulosin is for enlarged prostate, and Tadalafil helps in this problem, too. You can not determine if cryopreserved sperms are viable or not. Only the laboratory can do that. Mostly, the cryopreserved sperms remain feasible for years together.

Hope this helps.

Thanks.