Current trends in the treatment of infertility in men with spinal cord injury

Kafetsoulis, Apostolos; Brackett, Nancy L.; Ibrahim, Emad; Attia, George R.; Lynne, Charles M.

doi:10.1016/j.fertnstert.2006.01.060

Cited by 102 publications

(74 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2,6,7,17 In the present study, sperm quality was determined after repeated EEJ attempts, therefore, these 32 patients represent a group of SCI patients with poor reproductive prognosis. Quite often inappropriate management and treatments such as delayed treatment of accessory gland infections or repeated traumatic self-catheterizations may lead to either testicular failure or obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies shows that these changes are due to accessory gland dysfunction and altered semen constituents due to stasis of prostatic fluid, testicular hyperthermia, recurrent urinary tract infections, abnormal testicular histology, hypothalamic-pituitary-testicular axis changes, sperm antibodies, chronic long-term use of various medications and bladder dysfunction. [1][2][3]6,[12][13][14] In addition, the EEJ procedure may further hamper sperm quality by the electroporation injuries. [14][15][16] Other SCI patients may also suffer from either primary testicular failure or obstructive azoospermia.…”

Section: Discussionmentioning

confidence: 99%

“…1 Most of them suffer from infertility, mainly due to erectile and/or ejaculatory dysfunction. 2,3 Antegrade ejaculation has been reported in 5% of patients with complete upper motor neuron lesions, 18% with complete lower motor neuron lesions and 32% with incomplete upper motor neuron lesions and 70% with incomplete lower motor neuron lesions.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Testicular sperm retrieval and intra cytoplasmic sperm injection provide favorable outcome in spinal cord injury patients, failing conservative reproductive treatment

et al. 2013

View full text Add to dashboard Cite

Study design: Retrospective cohort analysis. Objectives: The objective of this study was to determine the in vitro fertilization (IVF) outcome after testicular sperm extraction (TESE) in a group of spinal cord injury (SCI) male patients not compatible with conservative fertility treatment. Setting: University-affiliated medical center. Methods: Thirty two SCI patients (C2 to L2) were referred to IVF after repeated trials of electroejaculation (EEJ) or penile vibratory stimulation (PVS), and full andrological evaluation. Testicular sperm aspiration (TESA) was the method of choice for sperm extraction. Open TESE was performed only after a negative TESA attempt. Clinical pregnancy and live birth rates were determined. Results: A total of 106 testicular procedures were performed. Sperm was found in 95 cycles (89.6%). The average metaphase II (MII) oocyte number was 11.0 ± 4.2, an average of 5.1 ± 2.3 oocytes became normally fertilized after Intra Cytoplasmic Sperm Injection (ICSI) (fertilization rate 57.1%). On average, 2.7 ± 1.2 embryos were replaced. The clinical pregnancy rate was 32/106 (30.2%) per cycle and 19/32 (59.3%) per couple. Live birth rate was 62.5% (20/32). Conclusions: TESA/E and IVF can provide excellent prognosis for SCI patients that cannot be treated by EEJ or PVS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Testicular sperm retrieval and intra cytoplasmic sperm injection provide favorable outcome in spinal cord injury patients, failing conservative reproductive treatment

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Couples with an SCI male partner in whom the semen parameters are poor can certainly benefit from ART, as pregnancy and delivery rates per couple appear to be similar to other infertility couples without an SCI situation. 17 In IUI, semen is collected at the clinic and injected into the uterine cavity. As IUI is performed in the clinic, it is less convenient and more expensive than home vaginal self-insemination.…”

Section: Resultsmentioning

confidence: 99%

“…A number of centers are even using surgical sperm retrieval followed by IVF/ICSI as the first line of treatment. 17 Reasons for not offering the less invasive techniques include a lack of equipment and/or lack of knowledge and training, as well as a lack of trust in the effectiveness of these techniques.…”

Section: Resultsmentioning

confidence: 99%

Vibratory ejaculation in 140 spinal cord injured men and home insemination of their partners

et al. 2011

View full text Add to dashboard Cite

Study design: Retrospective cohort study. Objectives: Anejaculation is commonly found in spinal cord injured (SCI) men. Clinical treatments and assisted reproductive techniques allow SCI men to father children but few home pregnancies have been reported. The objective of this paper is to evaluate the results from the last 20 years' of treatment with penile vibratory stimulation (PVS) and vaginal self-insemination at home in SCI men and their partners. Setting: The data originate from two European centers and one American center. Methods: A total of 140 SCI men with anejaculation and their healthy partners were available for this analysis. Men who obtained antegrade ejaculation by PVS and had motile sperm in the ejaculate were offered the possibility of PVS combined with vaginal selfinsemination at home. Couples were instructed to perform PVS and to instill the ejaculate intravaginally. Outcome measures were pregnancy rate per couple, number of live births, total motile sperm count and time to pregnancies. Results: Median total motile sperm count was 29 million (range, 1-92 million). In all, 60 of the 140 couples (43% pregnancy rate) achieved 82 pregnancies. Seventy-two of the pregnancies resulted in live births with the delivery of 73 healthy babies. Median time to first pregnancy was 22.8 months (6.0-98.4). No complications were reported. Conclusion: PVS combined with vaginal self-insemination may be performed as a viable, inexpensive option for assisted conception in couples in whom the SCI male partner has an adequate total motile sperm count and the female partner is healthy.

show abstract