A man without a prostate can still father a child, although natural conception is generally not possible. Fertility remains because the organs responsible for producing sperm are separate from the prostate gland. However, removing the prostate disrupts the delivery system, meaning reproductive cells cannot exit the body through the usual route. This shifts the path to parenthood from sexual intercourse to assisted reproductive technologies.
The Prostate’s Role in Fertility
The prostate is a small, muscular gland situated just below the bladder, surrounding the upper part of the urethra. Its function is to produce a fluid that forms a significant portion of semen volume, not to create sperm. This prostatic fluid is a milky-white, slightly alkaline secretion that mixes with sperm and fluid from the seminal vesicles during ejaculation.
The fluid produced by the prostate contains enzymes, zinc, and citric acid, which collectively serve to nourish and protect the sperm. The alkaline nature of the fluid is also important, as it helps neutralize the acidic environment of the female reproductive tract, prolonging sperm survival and enhancing mobility. Additionally, the prostate’s muscles contract during orgasm to propel the semen through the urethra.
Sperm cells are produced in the testicles and mature in the epididymis, a coiled tube behind the testicles. They travel through the vas deferens to the ejaculatory ducts, combining with fluids from the prostate and seminal vesicles to form semen. While the prostate contributes significantly to the semen that transports and supports sperm, it is not the source of the sperm itself.
Ejaculation After Prostate Removal
The removal of the prostate gland, typically via a radical prostatectomy, directly affects the physical mechanism of ejaculation. This procedure involves excising the entire prostate and often the seminal vesicles, which are sources of seminal fluid. This surgical change means the man will no longer produce or expel semen, a condition called dry orgasm or anejaculation.
The surgical removal of these glands severs the connection between the sperm-carrying ducts and the urethra. The sperm, which continues to be produced in the testicles, has no physical pathway to exit the body. Consequently, the sperm is either reabsorbed by the body or, in rare cases, may pass backward into the bladder, a form of retrograde ejaculation.
The inability to ejaculate semen prevents sperm from reaching the female reproductive tract during sexual intercourse. Although the man can still experience an orgasm, it occurs without fluid emission. This physical obstruction, not a cessation of sperm production, is why natural conception is impossible after a radical prostatectomy.
Paths to Conception
Since sperm production continues, a man who has undergone a prostatectomy can still achieve biological fatherhood through specialized medical interventions. The goal of these methods is to retrieve sperm directly from the reproductive tract and then use assisted reproductive technologies (ART) for fertilization.
The most reliable strategy for preserving fertility is to cryopreserve, or “bank,” sperm samples before the prostatectomy. These frozen samples can be thawed later and used for intrauterine insemination (IUI) or in vitro fertilization (IVF). If pre-surgical banking was not performed, several surgical sperm retrieval methods are available.
If pre-surgical banking was not performed, several surgical sperm retrieval methods are available. These include Testicular Sperm Extraction (TESE), where a small amount of testicular tissue is removed to isolate sperm, and Microsurgical Epididymal Sperm Aspiration (MESA), which retrieves sperm directly from the epididymis. These procedures obtain viable sperm for use with advanced ART techniques.
The retrieved sperm is typically used with Intracytoplasmic Sperm Injection (ICSI), which is an advanced form of IVF. During ICSI, a single sperm is injected directly into a single egg to maximize fertilization chances. The resulting embryo is then transferred into the woman’s uterus. This combination allows for conception despite the lack of a natural ejaculate.