When the semen enters the bladder and does not exit through the penis during ejaculation, the condition is called retrograde ejaculation. The man can still have coitus and have an orgasm, but the ejaculation will produce no or very little semen. When this happens, it is sometimes called dry orgasm. While it is not harmful, it can cause infertility in males.

When an orgasm happens in men, the sperm travels through the vas deferens to the prostate. Here the sperm is mixed with semen and moves on towards the penis. A muscle at the bladder entrance tightens to make sure that the semen passes through the urethra and exits the penis. In retrograde ejaculation, the bladder neck muscle is unable to tighten properly. This causes the sperm to enter the bladder instead. This weakening of the muscle can be due to

• Surgery in the area like bladder neck surgery and retroperitoneal lymph node dissection surgery for cancer.
• Certain medications
• Nerve damage due to conditions like spinal cord injury, Parkinson’s disease, diabetes and multiple sclerosis.
• Radiation therapy
• Surgical removal of bladder or prostate.

• Orgasms that produce little or no semen at all
• Cloudy or hazy post-ejaculation urine
• infertility

Diabetes, surgery on the bladder or prostate, certain medications and spinal cord injury are all risk factors for retrograde ejaculation.

The fertility expert will first ask questions to understand the medical history and give you a thorough physical examination. Then he urine will be tested for the presence of semen before the diagnosis is made.

• Medication
  If the retrograde ejaculation is due to nerve damage or other medical causes, medical treatment may help.
• Infertility treatment
  If medications do not help ejaculate semen, ART may extract semen from the bladder and inseminate the partner. Sometimes, IVF or ICSI may be needed.