Semen Quality in Men Who Sustained a Spinal Cord Injury During the Prepubertal Period

Celigoj, Frank; Ibrahim, Emad; Aballa, Teodoro C.; Lynne, Charles M.; Brackett, Nancy L.

doi:10.1016/j.juro.2012.04.012

Cited by 3 publications

(5 citation statements)

References 13 publications

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“…6,10,29 We found no correlation between the age at SCI and semen impairment. In particular, the semen parameters were not different between the patients injured prior to puberty (n = 4; mean age = 3 ± 1.3 years) and after puberty (n = 23; mean age = 23.9 ± 4.9 years, Table S2), which is contrary to the study by Celigoj et al 30 However, considering the very low number of patients included in both studies, definitive conclusions cannot be drawn and a study enrolling more patients injured prior to puberty needs to be conducted. Unlike the studies by Iremashvili et al 10 and Vargas Baquero et al, 31 we did not find that there was an association between the sperm parameters and the completeness of the lesion although the low number of patients studied could explain this difference.…”

Section: Discussioncontrasting

confidence: 96%

“…We found no correlation between the age at SCI and semen impairment. In particular, the semen parameters were not different between the patients injured prior to puberty ( n = 4; mean age = 3 ± 1.3 years) and after puberty ( n = 23; mean age = 23.9 ± 4.9 years, Table S2), which is contrary to the study by Celigoj et al 30 . However, considering the very low number of patients included in both studies, definitive conclusions cannot be drawn and a study enrolling more patients injured prior to puberty needs to be conducted.…”

Section: Discussioncontrasting

confidence: 96%

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Prospective analysis over time of semen parameters in spinal cord‐injured patients: Results of a pilot study

Chalas

Jilet²,

Wolf

et al. 2021

Andrology

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Background: Spinal cord injury often results in erectile dysfunction and an ejaculation along with impaired semen parameters. Fertility is a major concern in spinal cord injury adult males and some fear that the delay post-spinal cord injury may negatively affect sperm quality. Objectives:We aimed to (i) assess semen parameters over time in SCI patients according to age at spinal cord injury, time post-spinal cord injury, and the spinal cord injury level and completeness and (ii) measure markers in semen for inflammation and marker of oxidative stress to investigate their impact on sperm parameters. Materials and Methods:The study is a prospective, longitudinal, pilot study over 18 months. Thirty-five men with spinal cord injury from 18 to 60 years of age were enrolled. Their mean age was 29.4 ± 6.4 years. Semen retrieval was scheduled every 6 months, allowing analysis of four ejaculates, in association with measurement of granulocyte and seminal plasma elastase concentrations to assess markers in semen for inflammation and spermatozoa DNA fragmentation to assess oxidative stress.Results: Based on reference limits, a normal total sperm number, decreased motility and vitality of the spermatozoa, and increased morphological abnormalities were found. Mean round cell and granulocyte concentrations were elevated in the semen.Markers in semen for inflammation and marker of oxidative stress were elevated in several semen samples, compared to reference limits. However, neither the presence of markers in semen for inflammation or oxidative stress, the completeness or the level of the spinal cord lesion, the age or the time post-spinal cord injury had a negative impact on the semen quality over time.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussioncontrasting

confidence: 96%

Prospective analysis over time of semen parameters in spinal cord‐injured patients: Results of a pilot study

Chalas

Jilet²,

Wolf

et al. 2021

Andrology

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“…Furthermore, the pre‐injury fertility of each patient was unknown to us, and we cannot exclude the possibility that some of our patients could have had azoospermia before their injury. In fact, although our data suggested progressive deterioration of spermatogenesis after injury, previous studies have shown no post‐injury decline in semen quality in SCI patients …”

Section: Discussioncontrasting

confidence: 88%

“…Celigoj et al . reported that SCIs that occur before the age of 9 years appear to interfere with spermatogenesis, whereas the semen quality of those injured near the age of 12 years is not impaired . In the present study, only one participant was aged <18 years at the time of injury, thus we could not evaluate the effects of SCI before puberty.…”

Section: Discussionmentioning

confidence: 61%

Testicular sperm extraction for patients with spinal cord injury‐related anejaculation: A single‐center experience

et al. 2016

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Abbreviations & Acronyms ART = assisted reproductive technologies C-TESE = conventional testicular sperm extraction EEJ = electroejaculation EjD = ejaculatory dysfunction FSH = follicle-stimulating hormone ICSI = intracytoplasmic sperm injection IUI = intrauterine insemination LH = luteinizing hormone micro-TESE = microdissection testicular sperm extraction PVS = penile vibratory stimulation SCI = spinal cord injury SRR = sperm retrieval rate TESE = testicular sperm extraction Objectives: To present a single-center experience with testicular sperm extraction and intracytoplasmic sperm injection for fathering biological children in patients with ejaculatory dysfunction as a result of spinal cord injury. Methods: Testicular sperm extraction was carried out in 52 male patients with ejaculatory dysfunction as a result of spinal cord injury. We investigated sperm retrieval rates and pregnancy rates from medical records. Data on age, testicular volume, hormonal status (luteinizing hormone, follicle stimulating hormone and testosterone), and time since spinal cord injury were obtained and analyzed to detect potential associations with the presence of spermatogenesis. Results: Testicular sperm retrieval was achieved in 42 of 52 patients (80.7%). Intracytoplasmic sperm injection was carried out for 37 patients, and pregnancy was achieved in 32 (86.5%). The take-home baby rate was 70.2%. In the group with successful sperm extraction, testicular volume was significantly greater, time from spinal cord injury to extraction was significantly shorter, and serum luteinizing hormone and folliclestimulating hormone levels were significantly lower. Serum follicle-stimulating hormone levels had the strongest association with feasibility of sperm retrieval by testicular sperm extraction. Furthermore, the sperm retrieval rates of patients injured within the preceding 12 years were significantly better than those injured longer before treatment (P = 0.045). Conclusions: Testicular sperm extraction and intracytoplasmic sperm injection seem to provide favorable results for patients with ejaculatory dysfunction as a result of spinal cord injury. However, early testicular sperm extraction is recommended, because sperm retrieval becomes more difficult with time from spinal cord injury.

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“…These boys may have impaired spermatogenesis as adults. 75 Many studies have shown hormonal changes after SCI; however, these hormonal changes have not shown clear associations with abnormal semen analysis parameters in men with SCI. 10 …”

Section: Semen Abnormalities In Men With Scimentioning

confidence: 99%

Advances in the management of infertility in men with spinal cord injury

2016

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Couples with a spinal cord injured male partner require assisted ejaculation techniques to collect semen that can then be further used in various assisted reproductive technology methods to achieve a pregnancy. The majority of men sustaining a spinal cord injury regardless of the cause or the level of injury cannot ejaculate during sexual intercourse. Only a small minority can ejaculate by masturbation. Penile vibratory stimulation and electroejaculation are the two most common methods used to retrieve sperm. Other techniques such as prostatic massage and the adjunct application of other medications can be used, but the results are inconsistent. Surgical sperm retrieval should be considered as a last resort if all other methods fail. Special attention must be paid to patients with T6 and rostral levels of injury due to the risk of autonomic dysreflexia resulting from stimulation below the level of injury. Bladder preparation should be performed before stimulation if retrograde ejaculation is anticipated. Erectile dysfunction is ubiquitous in the spinal cord injured population but is usually easily managed and does not pose a barrier to semen retrieval in these men. Semen analysis parameters of men with spinal cord injury are unique for this population regardless of the method of retrieval, generally presenting as normal sperm concentration but abnormally low sperm motility and viability. When sperm retrieval is desired in this population, emphasis should be placed on initially trying the simple methods of penile vibratory stimulation or electroejaculation before resorting to more advanced and invasive surgical procedures.

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Semen Quality in Men Who Sustained a Spinal Cord Injury During the Prepubertal Period

Abstract: Spinal cord injury before the age of 9 years appears to interfere with spermatogenesis. In subjects injured near the age of 12 years semen quality in adulthood appears to be similar to that of subjects injured as adults.

Cited by 3 publications

References 13 publications

Prospective analysis over time of semen parameters in spinal cord‐injured patients: Results of a pilot study

Prospective analysis over time of semen parameters in spinal cord‐injured patients: Results of a pilot study

Testicular sperm extraction for patients with spinal cord injury‐related anejaculation: A single‐center experience

Advances in the management of infertility in men with spinal cord injury

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