Nancy L. Brackett, Ph.D., Research Professor, Departments of Urology, Neurological Surgery and The Miami Project, and colleagues, published a paper titled Reproductive Health of Men with Spinal Cord Injury in Topics in Spinal Cord Injury Rehabilitation. The paper cites that men with spinal cord injuries (SCI) face obstacles when pursuing sexual activity and/or biologic fatherhood. Hypogonadism and premature symptoms of aging may interfere with sexual function and effect the reproductive health of men with SCI. Erectile dysfunction is prevalent in the SCI population. Treatments for erectile dysfunction in the general population are also effective in the SCI population. Most men with SCI cannot ejaculate with sexual intercourse. Medical assistance is necessary to retrieve semen for assisted conception.
A management algorithm for ejaculatory dysfunction has been recommended that allows for semen retrieval, non-surgically, in 97% of men with SCI. Semen quality is abnormal in most men with SCI. While sperm concentration is typically normal, sperm motility and viability are abnormally low. The cause of this condition is an active area of research and seems to be related to factors in the seminal plasma. Management of the couple with a male partner with SCI should include evaluating both the male and female partners. The semen quality of the male partner with SCI should be assessed.
With sufficient total motile sperm, the assisted conception procedures of intravaginal insemination or intrauterine insemination should be considered prior to referring the couple for surgical sperm retrieval and/or IVF/ICSI. For more information about The Miami Project’s Male Fertility Research visit: https://www.themiamiproject.org/research/areas-of-research/fertility/