Spinal Cord Injuries and Male Infertility
According to the National Spinal Cord Injury Statistical Center (NSCISC), there are approximately 17,810 new cases of spinal cord injury in the United States every year, with 78% of these cases happening to men.
Men with spinal cord injuries can be told that, because of their injury, they are likely to be infertile. While sexual health and fertility can certainly be impacted by such an injury, it’s not impossible for men with a spinal cord injury to conceive. There are several treatment options available that can be used to help them have a child.
Understanding How Spinal Cord Injuries Impact Sexual Function
The spinal cord is a long, cylindrical column of nerve tissue that essentially connects the entire body to the brain via the central nervous system. When the spinal cord becomes damaged due to injury, it impairs the brain’s ability to communicate with the rest of the body’s various systems, including the reproductive system. This can cause disruption to functions such as erections and ejaculation. Spinal cord injuries can also cause sperm quality to be abnormal or have poor motility.
However, although the normal function has been disrupted, in many cases, men with spinal cord injuries continue to produce sperm in their testicles. In order to achieve pregnancy, it’s a matter of retrieving the sperm in order to use it in some form of assisted reproductive technique (ART).
Types of Sperm Retrieval Techniques
Sperm can be extracted in a variety of ways for men with spinal cord injuries. Their chances of success are largely dependent on the type and extent of the injury. These techniques include:
Penile Vibratory Stimulation (PVS)
This nonsurgical method involves the use of a vibrator placed on the tip of the penis, which then stimulates the penis into ejaculating.
Rectal Probe Electroejaculation (EEJ)
This procedure is performed using an electric probe inserted into the rectum. The probe emits an electrical stimulation that massages the prostate and triggers an ejaculation.
There are several aspiration techniques for extracting sperm from the male reproductive system, including:
Microsurgical epididymal sperm aspiration (MESA): Sperm is retrieved from the epididymis tubes that connect from the penis to the vas deferens using a surgical microscope.
Testicular sperm aspiration (TESE): Sperm is pulled out from the testicles using a thin needle.
Percutaneous epididymal sperm aspiration (PESA): Sperm is extracted from the epididymis using a needle.
Once the sperm is harvested, it can be used in one of the following ARTs:
Intrauterine insemination [IUI]: Sperm is placed directly in a woman’s uterus.
In vitro fertilization (IVF): Eggs are fertilized in a lab with sperm.
Intracytoplasmic sperm injection [ICSI]: A single sperm is injected into the center of the egg.