What Is Retrograde Ejaculation? – Causes & Treatment

By BSc, MSc (embryologist) and BA, MA (fertility counselor).
Last Update: 04/15/2014

Men who suffer retrograde ejaculation do not expel semen out through the urethra, but they ejaculate inside the bladder. In a man who ejaculates in a normal way, the semen is carried through the seminiferous tubules and the bladder before arriving to the penis and is finally expelled through the urethra. After passing through the bladder, the sphincter is closed and the semen arrives to the end of the penis due to the positive pressure.

Below you have an index with the 3 points we are going to deal with in this article.


Men suffering from retrograde ejaculation have a problem in the bladder sphincter, which does not close properly so the semen cannot go through the urethra, but goes all the way back and ejaculation occurs in the bladder.

Men with this disorder are likely not to expel semen at all, and their urine after the orgasm can be cloudy due to the presence of sperm. There are not other additional symptoms.

Causes producing retrograde ejaculation are:

  • Diabetes
  • Medicines for hypertension
  • Surgery in the prostate or in the urethra

Pregnancy with retrograde ejaculation

Retrograde ejaculation is not considered an illness but an alteration with serious consequences in male fertility. It is hard for men suffering retrograde ejaculation to make their wives become pregnant in a natural way, since most of their spermatozoa end up in the urine.

There are several options concerning treatment to become pregnant, being the most used in fertility clinics the following one: the man must prevent himself from ejaculating for some days (from 2 to 4 days) and when the bladder is empty he must masturbate and collect the sperm, if any. It is essential to collect the urine after the masturbation because it contains the highest number of spermatozoa. In addition, in the days previous to the collection, it is recommended for the man to consume bicarbonate (about 25 grams) so as to protect the spermatozoa from the urine.

Pregnancy with retrograde ejaculation

These spermatozoa are manipulated in the laboratory and can be used in an assisted reproduction technique adjusted to the patient’s sperm concentration and the sperm motility.

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 Cristina Mestre Ferrer
Cristina Mestre Ferrer
BSc, MSc
Bachelor's Degree in Biological Sciences, Genetics & Human Reproduction from the University of Valencia (UV). Master's Degree in Biotechnology of Human Assisted Reproduction from the UV and the Valencian Infertility Institute (IVI). Embryologist at IVI Barcelona. More information about Cristina Mestre Ferrer
Adapted into english by:
 Sandra Fernández
Sandra Fernández
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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