Infertility: retrograde ejaculation: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Infertility: retrograde ejaculation

Sample item

A 35-year-old diabetic man has a very low semen volume with azoospermia on semen analysis and reports a dry orgasm. What test confirms the cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Sperm in a post-ejaculatory urine sample

In retrograde ejaculation the bladder neck fails to close, so semen passes into the bladder, which occurs in diabetic neuropathy, after prostatic or bladder neck surgery and with alpha-blockers. Finding sperm in the post-ejaculatory urine confirms the diagnosis. Sperm can be recovered from alkalinised urine for assisted reproduction.

Option by option

  • A. Karyotype

    Karyotype is for suspected genetic causes of azoospermia.

  • B. Serum prolactin

    Prolactin does not explain a dry orgasm.

  • C. Sperm in a post-ejaculatory urine sample (correct)

    Correct. Sperm in post-ejaculation urine confirms retrograde ejaculation.

  • D. Scrotal ultrasound

    Scrotal ultrasound does not assess bladder neck function.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Sperm in a post-ejaculatory urine sample. In retrograde ejaculation the bladder neck fails to close, so semen passes into the bladder, which occurs in diabetic neuropathy, after prostatic or bladder neck surgery and with alpha-blockers.

Why is "Karyotype" not the answer?

Karyotype is for suspected genetic causes of azoospermia.

Why is "Serum prolactin" not the answer?

Prolactin does not explain a dry orgasm.

Why is "Scrotal ultrasound" not the answer?

Scrotal ultrasound does not assess bladder neck function.

What concept does this question test?

It tests Infertility: retrograde ejaculation in OBG. Finding sperm in the post-ejaculatory urine confirms the diagnosis. Sperm can be recovered from alkalinised urine for assisted reproduction.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infertility: retrograde ejaculation?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.