Treatment of infertility in men with spinal cord injury

Nancy Brackett, Charles M Lynne, Emad Ibrahim, Dana A. Ohl, Jens Sønksen

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Most men with spinal cord injury (SCI) are infertile. Erectile dysfunction, ejaculatory dysfunction and semen abnormalities contribute to the problem. Treatments for erectile dysfunction include phosphodiesterase type 5 inhibitors, intracavernous injections of alprostadil, penile prostheses, and vacuum constriction devices. In anejaculatory patients who wish to father children, semen retrieval is necessary. Penile vibratory stimulation is recommended as the first line of treatment. Patients who fail penile vibratory stimulation can be referred for electroejaculation. If this approach is not possible, prostate massage is an alternative. Surgical sperm retrieval should be considered as a last resort when other methods fail. Most men with SCI have a unique semen profile characterized by normal sperm count but abnormally low sperm motility. Scientific investigations indicate that accessory gland dysfunction and abnormal semen constituents contribute to the problem. Despite abnormalities, sperm from men with SCI can successfully induce pregnancy. In selected couples, the simple method of intravaginal insemination is a viable option. Another option is intrauterine insemination. The efficacy of intrauterine insemination increases as the total motile sperm count inseminated increases. In vitro fertilization and intracytoplasmic sperm injection are options in cases of extremely low total motile sperm count. Reproductive outcomes for SCI male factor infertility are similar to outcomes for general male factor infertility.

Original languageEnglish
Pages (from-to)162-172
Number of pages11
JournalNature Reviews Urology
Volume7
Issue number3
DOIs
StatePublished - Mar 1 2010

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Semen
Spinal Cord Injuries
Infertility
Insemination
Sperm Count
Male Infertility
Erectile Dysfunction
Sperm Retrieval
Penile Prosthesis
Oligospermia
Phosphodiesterase 5 Inhibitors
Massage
Intracytoplasmic Sperm Injections
Sperm Motility
Alprostadil
Fertilization in Vitro
Therapeutics
Vacuum
Constriction
Fathers

ASJC Scopus subject areas

  • Urology

Cite this

Treatment of infertility in men with spinal cord injury. / Brackett, Nancy; Lynne, Charles M; Ibrahim, Emad; Ohl, Dana A.; Sønksen, Jens.

In: Nature Reviews Urology, Vol. 7, No. 3, 01.03.2010, p. 162-172.

Research output: Contribution to journalArticle

Brackett, N, Lynne, CM, Ibrahim, E, Ohl, DA & Sønksen, J 2010, 'Treatment of infertility in men with spinal cord injury', Nature Reviews Urology, vol. 7, no. 3, pp. 162-172. https://doi.org/10.1038/nrurol.2010.7
Brackett, Nancy ; Lynne, Charles M ; Ibrahim, Emad ; Ohl, Dana A. ; Sønksen, Jens. / Treatment of infertility in men with spinal cord injury. In: Nature Reviews Urology. 2010 ; Vol. 7, No. 3. pp. 162-172.
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