There is a complex interplay between male sexual dysfunction and male factor infertility, including ejaculatory dysfunctions which are the most common male sexual dysfunction. It is divided into four categories: premature ejaculation (PE), delayed ejaculation (DE), retrograde ejaculation (RE), and anejaculation/anorgasmia (AE). Unfortunately, some of these ejaculatory dysfunctions are less studied and not as well understood. Various pharmacologic treatments and surgical procedures can be offered for patients with ejaculatory dysfunctions seeking fertility. These include the off-label use of SSRIs (selective serotonin reuptake inhibitors) for PE, surgical (testicular sperm aspiration, testicular sperm extraction, and microsurgical epididymal sperm aspiration) and nonsurgical methods (medications, positive predictive value, and electroejaculation) for patients with RE and AE. The interaction between chemical impulses and the modulation of the ejaculation process in an individual patient is necessary to conclude the clinical status of the patient and feasibility of the available treatment techniques. Ultimately, this can help in deciding the best sperm retrieval technique to increase pregnancy outcomes.