[Infertility caused by ejaculation disturbances and anorgasmy].

Recent progress in andrology, reproduction biology and medical sexuology have led to a substantial increase of the proportions of pregnancy achieved by males with ejaculation disorders or anorgasmy. Impairment in libido and excitement usually has a psychic cause, apart from rare endocrinological abnormalities such as hyperprolactinaemia and androgen depletion. Another possible cause is chronic use of certain drugs. Causes of erection disorders can be classified on the basis of psychogenous, vascular and neurogenous factors. Ejaculation disorders are caused by embryonal anomalies, neurological disorders and use of certain (psychoactive) pharmaceutical agents. Collecting sperm proves to be virtually always possible. According to current views, the treatment of infertility in ejaculation disorders or anorgasmy should be if possible, elimination of the primary cause or else: in-vitro fertilisation (IVF)/intracytoplasmatic sperm injection (ICSI) with semen obtained after processing a retrograde ejaculate or by means of vibro-ejaculation or electro-ejaculation.