Advances in the management of infertility in men with spinal cord injury

Emad Ibrahim, Nancy Brackett, Charles M Lynne

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Couples with a spinal cord injured male partner require assisted ejaculation techniques to collect semen that can then be further used in various assisted reproductive technology methods to achieve a pregnancy. The majority of men sustaining a spinal cord injury regardless of the cause or the level of injury cannot ejaculate during sexual intercourse. Only a small minority can ejaculate by masturbation. Penile vibratory stimulation and electroejaculation are the two most common methods used to retrieve sperm. Other techniques such as prostatic massage and the adjunct application of other medications can be used, but the results are inconsistent. Surgical sperm retrieval should be considered as a last resort if all other methods fail. Special attention must be paid to patients with T6 and rostral levels of injury due to the risk of autonomic dysreflexia resulting from stimulation below the level of injury. Bladder preparation should be performed before stimulation if retrograde ejaculation is anticipated. Erectile dysfunction is ubiquitous in the spinal cord injured population but is usually easily managed and does not pose a barrier to semen retrieval in these men. Semen analysis parameters of men with spinal cord injury are unique for this population regardless of the method of retrieval, generally presenting as normal sperm concentration but abnormally low sperm motility and viability. When sperm retrieval is desired in this population, emphasis should be placed on initially trying the simple methods of penile vibratory stimulation or electroejaculation before resorting to more advanced and invasive surgical procedures.

Original languageEnglish (US)
Pages (from-to)382-390
Number of pages9
JournalAsian Journal of Andrology
Volume18
Issue number3
DOIs
StatePublished - May 1 2016

Fingerprint

Spinal Cord Injuries
Infertility
Sperm Retrieval
Ejaculation
Semen
Spermatozoa
Spinal Cord
Wounds and Injuries
Autonomic Dysreflexia
Masturbation
Population
Assisted Reproductive Techniques
Semen Analysis
Massage
Sperm Motility
Coitus
Erectile Dysfunction
Urinary Bladder
Pregnancy

Keywords

  • assisted reproductive technology
  • ejaculation
  • electroejaculation
  • male infertility
  • paraplegia
  • penile vibratory stimulation
  • semen
  • sperm
  • spinal cord injury
  • surgical sperm retrieval

ASJC Scopus subject areas

  • Urology

Cite this

Advances in the management of infertility in men with spinal cord injury. / Ibrahim, Emad; Brackett, Nancy; Lynne, Charles M.

In: Asian Journal of Andrology, Vol. 18, No. 3, 01.05.2016, p. 382-390.

Research output: Contribution to journalArticle

Ibrahim, Emad ; Brackett, Nancy ; Lynne, Charles M. / Advances in the management of infertility in men with spinal cord injury. In: Asian Journal of Andrology. 2016 ; Vol. 18, No. 3. pp. 382-390.
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