Achieving Pregnancy in Situational Psychogenic Anejaculation in an Islamic Community - Two Case Reports and Literature Review

Introduction: Psychogenic anejaculation is a rare cause of male infertility. In this type of anejaculation, the patient cannot ejaculate while awake. Most cases of this disorder were reported in Jewish communities. In the present report, we describe the successful achievement of pregnancy in two Muslim men with situational psychogenic anejaculation. The treatment involved the simplest approach in one case but the highly technical procedure in the second case. Case presentation: Two men presented with situational psychogenic anejaculation and concern to conceive. Clinical examination, hormonal assay, urine analysis and ultrasound imaging identified irrelevant data in both. Psychosexual counseling was rejected by both men and penile vibration did not give a response in either. Case 1 succeeded to get sperm from masturbation-induced ejaculate. Case 2 got sperm after doing conventional testicular sperm extraction. The use of the retrieved sperms succeeded to attain pregnancy in both cases. However, the anejaculationdid not revert in either patient. Conclusion: Men from Islamic communities with strict religious upbringing have the possibility to have psychogenic anejaculation. This report confirms the good fertilizing potential of sperm and its capability of achieving pregnancy in men with psychogenic anejaculation. Men with this type of anejaculation are resistant to improvement even after their concern to conceive dissipates.