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Description:Blood samples collected from of the participants also showed that men who wore boxers had 14 percent lower levels of a substance called follicle stimulating hormone, or FSH. Water restriction was recommended for four hours before sperm retrieval. One additional live birth has been recently achieved by ICSI using fresh sperm [ 19 ]. We previously developed and evaluated a new protocol, including a novel modified Hotchkiss technique in association with sperm cryopreservation, that facilitates the administration of ART to couples with RE [ 10 ]. This condition can occur as a result of spinal cord lesions, neuropathies diabetic autonomic neuropathy and multiple sclerosis , retroperitoneal surgery, acquired anatomic aetiologies bladder neck surgery and transurethral resection of the prostate , congenital abnormalities, or pharmacological treatments psychotropic medications and a-adrenergic blockers , and it can also be idiopathic [ 2 — 4 ]. However, due to its high osmolarity and low pH, urine is cytotoxic to spermatozoa [ 6 — 8 ]. Post-ejaculatory bladder contents are obtained by either voiding or catheterization, and the suspended spermatozoa are used for intrauterine insemination IUI.