If a couple is experiencing infertility as a result of retrograde ejaculation and medications are not helping, the male's urine with ejaculate may be centrifuged and the isolated sperm injected directly into the woman's oocyte during IVF-ICSI procedure.

The  procedure includes adjustment of the osmolarity of the patient's urine by drinking water an urinary alkalization by an oral agent. The small amount of antegrade-produced ejaculate is collected in a plastic beaker, while the retrograde fraction of the ejaculate needs to be urinated immediately into a jar with culture medium containing human serum albumin to dilute the urine. Finally, the urine/medium mixture has to be centrifuged, resuspended and filtrated on the glass wool column where sperms are separated. When the sperm is isolate than it could be injected directly into the egg (which is maintained from woman by transvaginal oocyte retrieval). The following procedure is IVF-ICSI.

In more severe cases, where are no sperm present, surgical retrieval methods (TESE, micro TESE, etc.) may be used.

If live spermatozoa are present after isolation form urine the results of IVF-ICSI procedure can be comparable to the situation when spermatozoa are obtained from ejaculate. 

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