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Spinal Cord Injury (SCI)
and Fertility

T
here are approximately 10,000 new spinal cord injuries every year in the U.S. The majority of these injuries occur in healthy men of reproductive age (30 year old average), when sexuality and fertility are affected. Depending on the degree of injury, men often report a decreased sexual desire and problems with erection and ejaculation, making the wish for children often seem impossible. Many factors may predispose spinal cord injured men to infertility. Ejaculatory dysfunction, abnormalities of sperm production, chronic infections and blockage of sperm within the male reproductive tract are all potential factors.

As a spinal cord injury patient, can I still have children?

Yes. At Fertility Center of California, we made it our high priority to help our patients with spinal cord injury fulfill their dream of having children. Our staff is trained and experienced in caring for all of our patients with the utmost respect and compassion. The procedures to obtain ejaculate for insemination and insemination procedures are routinely performed at our facilities.

What are my SCI fertility treatment options?

Management of male infertility due to spinal cord injury includes a number of different methods to obtain sperm. Please note that none of these techniques should be applied to a male spinal cord injury patient before undergoing a thorough medical evaluation. The sperm harvesting techniques are often combined with various forms of assisted reproductive techniques.

Vibration Technique:

Sperm can often be obtained through vibratory stimulation to the head and shaft of the penis if the level of injury is T-12 or above. This technique is less often successful for lower motor neuron (areflexic) injured patients.

Rectal probe Electroejaculation (EEJ):

The technique stimulates via a small electric current applied in the prostate area to produce an ejaculate. A common side-effect is inflammation to the rectal mucosa. In patients with spastic injuries, this technique tends to cause autonomic dysreflexia.

Testicular biopsy or Vas Aspiration:

These are invasive sperm harvesting techniques mostly used for patients with acquired or congenital obstructions along the reproductive tract. Sperm is retrieved either along the ejaculatory path from the vas deferens, epididymis, or directly from the testis. The techniques are commonly known as MESA (microsurgical sperm aspiration), TESE (testicular sperm aspiration) and PESA (percutaneous epididymal sperm aspiration.

Once sperm has been obtained, the semen is then processed for one of the following assisted reproductive techniques:

Artificial Insemination: IUI and ICI

Both methods are routinely performed at FCC. Read more (link)

In-vitro Fertilization with Intracytoplasmic Sperm Injection (IVF with ICSI)

The eggs are retrieved from the female’s ovaries and then combined with the sperm in a dish. During ICSI, a single sperm is injected into an egg to fertilize the egg to an embryo.

What are my changes of having children?

Research data shows that the pregnancy success rate of spinal cord injury patients lies at 51% and is greatly increased when advanced fertility techniques are used to achieve the pregnancy. The average live birth rate is 40%, which also is highly improved with the use of fertility treatments. The various methods of sperm retrieval methods do not affect the success rates.

How does my partner prepare for the fertility treatment?

It is important for the success of your fertility treatment that the woman plays an active role in the process. Before starting fertility treatment of the male, we highly recommend that the female undergoes a thorough gynecological exam with a physician. Once it is concluded that there are no female fertility issues, her fertile days of the month are determined. This information is used to schedule the sperm retrieval procedure and the artificial insemination. Using fresh sperm, artificial insemination of the woman should occur within 1 hour of sperm retrieval.