Does repeated electro-ejaculation improve sperm quality in spinal cord injured men?

Das, Sangeeta; Dodd, Susanna; Soni, B M; Sharma, Sanjeev; Gazvani, Rafet; Lewis‐Jones, D. I.

doi:10.1038/sj.sc.3101898

Cited by 24 publications

(14 citation statements)

References 13 publications

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“…Prolonged anejaculation may induce the development of anti-sperm antibodies but the available evidence regarding their role in the development of male infertility after SCI is conflicting. On the other hand, repeated ejaculations do not change the spermatozoal quality of SCI men (Sonksen et al, 1999;Das et al, 2006). This fact may suggest that stagnation in the seminal ducts due to infrequent ejaculations is not the cause of the poor spermatozoal parameters in SCI men (Sonksen et al, 1999).…”

Section: Seminal Plasma Biochemistry and Scimentioning

confidence: 82%

Erectile function and male reproduction in men with spinal cord injury: a review

et al. 2010

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Spinal cord injury (SCI) in men results in defects in erectile function, ejaculatory process and male reproductive potential. There are alterations in the capacity of men with SCI to achieve reflexogenic, psychogenic and nocturnal erections. The sexual function in different stages after SCI and the types of erections depend mainly on the completeness of the injury and the level of neurological damage. Furthermore, most of the SCI men demonstrate defects concerning the entrance of semen into the posterior urethra and the expulsion of the semen through the penile urethra and the urethral orifice. In addition, SCI men develop defects in the secretory function of the Leydig cells, Sertoli cells and the male accessory genital glands. The overall result is a decreased quality of the semen is recovered either with penile vibratory stimulation (PVS) or with electroejaculation. Nowadays the therapeutic andrological approach of SCI men focuses on achievement of erectile function, recovery of spermatozoa and assisted reproductive technology. The first line of therapy recommended for infertility in SCI men is collection of semen via PVS with concomitant evaluation of total motile sperm yields for assisted conception which may include intravaginal insemination, intrauterine insemination, or in vitro fertilisation/intracytoplasmic sperm injection. Patients failing PVS may be referred for electroejaculation or surgical sperm retrieval.

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Section: Seminal Plasma Biochemistry and Scimentioning

confidence: 82%

Erectile function and male reproduction in men with spinal cord injury: a review

et al. 2010

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“…14 Beretta et al also observed improvement of sperm motility, after 3 months of weekly PVS. 22 Four other groups reported no significant improvement of semen parameters after repeated (electro)ejaculation; that is, Heruti et al, 4 Das et al, 11 Sonksen et al 17 and Siosteen et al 16 However, it remains debatable whether carrying out a second EEJ in men whose first ejaculates contain progressively motile spermatozoa is necessary at all. Since the introduction of ICSI, patients with severe oligoasthenospermia now have a realistic chance of conceiving.…”

Section: Discussionmentioning

confidence: 99%

“…Whether or not repeated (electro)ejaculation has a positive effect on semen quality remains debatable, as studies on this issue show contradictory results. 4,[11][12][13][14][15][16][17] Therefore, deciding on how many attempts of EEJ should be carried out before proceeding to surgical sperm retrieval remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

Electroejaculation in patients with spinal cord injuries: A 21‐year, single‐center experience

et al. 2016

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“…One study found improved sperm motility after 3 months of weekly PVS performed by patients at home (Beretta et al ., ). The majority of studies, however, found no statistically significant improvement in sperm motility after regular ejaculation by PVS or EEJ (Siosteen et al ., ; Sonksen et al ., ; Das et al ., ; Hamid et al ., ). Further, no study has found normalization of sperm motility in men with SCI by increasing the frequency of ejaculation.…”

Section: Semen Quality In Men With Scimentioning

confidence: 98%

Male fertility following spinal cord injury: an update

2015

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SUMMARYSpinal cord injury (SCI) occurs most often in young men at the peak of their reproductive health. The majority of men with SCI cannot father children naturally. Three major complications contribute to infertility in men with SCI: erectile dysfunction, ejaculatory dysfunction, and abnormal semen quality. Erectile dysfunction can be managed by regimens available to the general population, including oral administration of phosphodiesterase-5 (PDE-5) inhibitors, intracavernosal injections, vacuum devices, and penile prostheses. Semen may be obtained from anejaculatory men with SCI via the medically assisted ejaculation methods of penile vibratory stimulation (PVS) or electroejaculation (EEJ). Sperm retrieval is also possible via prostate massage or surgical sperm retrieval. Most men with SCI have abnormal semen quality characterized by normal sperm concentrations but abnormally low sperm motility and viability. Accessory gland dysfunction has been proposed as the cause of these abnormalities. Leukocytospermia is evident in most SCI patients. Additionally, elevated concentrations of pro-inflammatory cytokines and elevated concentrations of inflammasome components are found in their semen. Neutralization of these constituents has resulted in improved sperm motility. There is a recent and alarming trend in the management of infertility in couples with SCI male partners. Although many men with SCI have sufficient motile sperm in their ejaculates for attempting intrauterine insemination (IUI) or even intravaginal insemination, surgical sperm retrieval is often introduced as the first and only sperm retrieval method for these couples. Surgical sperm retrieval commits the couple to the most advanced, expensive, and invasive method of assisted conception: in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI). Couples should be informed of all options, including semen retrieval by PVS or EEJ. Intravaginal insemination or IUI should be considered when indicated.

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Does repeated electro-ejaculation improve sperm quality in spinal cord injured men?

Cited by 24 publications

References 13 publications

Erectile function and male reproduction in men with spinal cord injury: a review

Erectile function and male reproduction in men with spinal cord injury: a review

Electroejaculation in patients with spinal cord injuries: A 21‐year, single‐center experience

Male fertility following spinal cord injury: an update

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