Spinal Cord Injury and Fertility

Spinal Cord Injury and Fertility

It was once believed that spinal cord injury or trauma can affect a man’s ability to impregnate his partner as in most cases, spinal cord damage can affect reproductive functions like erection, ejaculation or insemination. However, thanks to advancements in science and technology, it is now possible for men with damaged spinal cord to enjoy the blessings of fatherhood, with innovative options like artificial insemination. In fact, healthcare providers can even collect healthy semen samples from such men without penile erection or ejaculation.

How can spinal cord injury affect your fertility?

Injuries or damage to spinal cord can affect several aspects of a man’s reproductive and sexual life; for example:

  • Erectile dysfunction: Inability to obtain and/or sustain a strong penile erection during the act of sexual intercourse. Due to erectile dysfunction, men with spinal injury avoid indulging in sexual activities that greatly suppresses libido and overall fertility
  • Ejaculatory dysfunction: Even if such men obtain optimal penile erection, the incidence of ejaculatory dysfunction is very high in men with spinal cord injury.
  • Low sperm count: Men with spinal cord injury tends to have a low sperm count in the semen sample that impairs fertility in men
  • Poor quality of sperms: It has been observed that males with spinal injury have poor quality sperms (low motility or viability) which in turn reduces the ability of such men to impregnate their partner.

It is also imperative to mention that in most cases, these ailments or complications coexists, which further decreases the fertility in males with spinal cord injury by up to 95%. Luckily, with innovative scientific techniques such as artificial insemination and other assisted reproductive techniques, about 80% men with spinal cord injury can still become father.

Spinal cord injury does not render complete infertility and protection must be practiced if you are not looking to impregnate your partner.

How to treat impaired fertility?

The goal of infertility treatment in men revolves around identifying the core issue and taking measures to resolve it. For example, if infertility is due to erectile dysfunction, optimal measures must be obtained to achieve normal and adequate penile erection.

For male who are unable to achieve climax or are experiencing ejaculatory dysfunction due to spinal cord injury, certain helpful measures such as vibratory stimulation (via penile vibrator) or masturbation can be used to achieve desired results. Healthcare providers recommend ejaculating in the female vaginal once the male partner is about to ejaculate. If somehow, this is not possible, it is perfectly safe and effective to collect semen or ejaculate in a sterilized plastic syringe and ejecting the contents in the female genital tract. It is important that semen sample is introduced into the female genital tract at the time of ovulation. Penile vibrator is by far the most efficient method in achieving fertilization, even if used by patient himself in the comforts of home.

Other methods of collecting semen sample are:

  • Sperm extraction by an injection (or needle) from the vas deferens
  • Punch biopsy can also be performed to obtain a healthy tissue from the testicles to examine the health of testicles and also to obtain viable sperms for fertilization
  • Electroejaculation is another viable option in men who can’t achieve ejaculation with penile vibration or masturbation. In all such men, an electrode can be introduced via anal opening to stimulate hypogastric nerve to allow successful ejaculation

Once sperms are obtained, the next step is to fertilize the egg and implant the zygote (combination of egg and sperm) in the female fallopian tubes. A variety of in-vitro fertilization techniques can be employed such as intracytoplasmic sperm injection (introduction of sperm into the egg) or fertilization of egg and sperm in a controlled environment and transfer of embryos into the uterus.

Does spinal injury affect female fertility?

Spinal cord injury does not permanently alter female fertility. There may be a transient decline in the chances of getting pregnant due to menstrual cessation soon after the injury due to injury induced spike of cortisol levels that suppresses prolactin. Depending upon the intensity of injury, normal fertility is restored within 6 to 12 months of initial injury.

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