Final answer:
Possible diagnoses for little or no ejaculate during orgasm include male infertility, ejaculatory duct obstruction, retrograde ejaculation, or hormone imbalances, and are often associated with conditions like diabetes or certain medications.
Step-by-step explanation:
Bill reported that during an orgasm, there is little or no ejaculate. This condition can point to several possible diagnoses that the doctor should evaluate. A common condition associated with this symptom is male infertility, which occurs when there are no or too few healthy, motile sperm. This could be due to issues with spermatogenesis or a blockage in the male reproductive tract preventing ejaculation. Other potential conditions include ejaculatory duct obstruction, retrograde ejaculation, or hormone imbalances. Conditions like diabetes, certain medications, and procedures such as prostate surgery can also affect ejaculate volume. It is essential that a thorough medical evaluation is conducted to determine the specific cause.