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Retrograde ejaculation - instructions for patients

Patient information A-Z

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Some patients may produce a very low ejaculate volume or no ejaculate at all. They may suffer from a condition known as retrograde ejaculation. As a result of retrograde ejaculation, these patients ejaculate ‘backwards’ into the bladder and must urinate to release the semen (which contains the sperm). In such cases, the semen must be taken out of the urine to recover the sperm as soon as possible after the sample has been provided.

Sperm can quickly be killed after spending more than a few minutes in the acidic environment of the bladder. To help reduce the acidity of your urine at the time of your test we ask you to carry out the following procedure.

Retrograde ejaculation procedure for patients

To obtain accurate results, please maintain abstinence from sex and/or masturbation at a minimum of two days (48 hours) up to a maximum of five days.

Before your appointment:

  1. The evening before your appointment, mix one teaspoon of sodium bicarbonate powder in a half pint (~250ml) of water or juice, stir until it dissolves and drink.
  2. Eat and drink normally at breakfast.
  3. Prepare a second sodium bicarbonate solution as described above and drink this one hour before your appointment time.

On arrival at Cambridge IVF:

  1. A member of the laboratory team will meet you and complete the necessary paperwork.
  2. You will be shown to a patient toilet and asked to empty your bladder almost completely, but not completely.
  3. After emptying your bladder, you will be shown to a comfortable private room and provided with two sample collection containers.
  4. Please do not use any sort of lubricant, as this will disturb our analysis.
  5. Masturbate to orgasm: if you produce any semen, collect this into the first container, as this is more likely to contain some sperm.
  6. Urinate immediately into the second container. Avoid shaking or disturbing the container after sample production.
  7. Place both containers in the hatch as instructed in the room.

It is important that we are able to analyse the sample as soon as possible after you have provided it, so make sure you pass the sample through the hatch to the lab as soon as you can after you have collected it.

*** Please treat our team with respect and dignity during your appointment ***

Further information is available on our website (opens in a new tab).

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Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge

Telephone +44 (0)1223 245151