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Aspermia is the lack of sperm and can be caused by retrograde ejaculation or obstruction of the ejaculatory duct. Retrograde ejaculation is caused by a malfunctioning bladder sphincter, while obstruction can be due to congenital cysts or inflammation. Men with aspermia can still have children through assisted reproductive technologies.
Aspermia is the lack of sperm, not to be confused with azoospermia, which is the lack of reproductive sperm in the semen. It is one of the causes of male infertility. Aspermia has two main causes: retrograde ejaculation and obstruction of the ejaculatory duct. Men with aspermia feel the sensation of ejaculation, but no semen comes out of the body.
Retrograde ejaculation is a condition in which semen flows into the bladder instead of out of the body through the urethra. In normal ejaculation, the sphincter at the entrance to the bladder contracts, forcing semen to be expelled from the bladder and out the urethra. Retrograde ejaculation is therefore caused by a malfunctioning bladder sphincter, caused by weak muscles or defects in the nerves that supply the muscles.
Aspermia due to retrograde ejaculation can be caused by complications of surgery to treat prostate or testicular cancer or by nerve damage caused by disease. Some associated conditions are diabetes, multiple sclerosis, and spinal cord injury. Retrograde ejaculation can also be caused by medications including tamsulosin, used to treat benign prostate tumors, antihypertensives used to treat high blood pressure, and antidepressants and antipsychotics used to treat mood disorders. Sometimes switching medications can reverse the condition. Retrograde ejaculation is not dangerous or life threatening, although it causes infertility and can also decrease sexual sensation.
Ejaculatory duct obstruction, the other possible cause of aspermia, may be due to congenital cysts in the ejaculatory ducts or inflammation caused by prostate inflammation or tuberculosis. Chlamydia, a sexually transmitted infection, is another possible cause. In addition to aspermia, blockage of the ejaculatory duct can also cause pain in the pelvis, especially after ejaculation. Blockage of the ejaculatory duct can also lead to oligospermia, in which some semen is ejaculated, but in less than normal quantities. This condition can be treated surgically by transurethral resection of the ejaculatory ducts (TURED) or by balloon catheterization of the urethra or rectum.
Men with aspermia often have normal sperm counts and can have a child, even if the sperm must be collected and injected into the female. In retrograde ejaculation, sperm can be collected by running the patient’s urine through a centrifuge to separate the sperm, whereas in men with ejaculatory duct obstruction, sperm must be collected directly from the testicles.
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