Male infertility in spinal cord trauma

Every year there are 10 thousand new cases of patients victimized by spinal cord trauma (SCT) in the United States and it is estimated that there are 7 thousand new cases in Brazil. Eighty percent of patients are fertile males. Infertility in this patient group is due to 3 main factors resulting fro...

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Bibliographic Details
Authors: Utida, Cristiano [UNIFESP], Truzzi, Jose C. [UNIFESP], Bruschini, Homero [UNIFESP], Simonetti, Rogerio [UNIFESP], Cedenho, Agnaldo Pereira [UNIFESP], Srougi, Miguel [UNIFESP], Ortiz, Valdemar [UNIFESP]
Format: article
Status:Published version
Publication Date:2005
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/2651
Online Access:http://dx.doi.org/10.1590/S1677-55382005000400013
http://repositorio.unifesp.br/handle/11600/2651
Access Level:Open access
Keyword:spinal cord injuries
semen
infertility
male
ejaculation
paraplegia
Description
Summary:Every year there are 10 thousand new cases of patients victimized by spinal cord trauma (SCT) in the United States and it is estimated that there are 7 thousand new cases in Brazil. Eighty percent of patients are fertile males. Infertility in this patient group is due to 3 main factors resulting from spinal cord lesions: erectile dysfunction, ejaculatory disorder and low sperm counts. Erectile dysfunction has been successfully treated with oral and injectable medications, use of vacuum devices and penile prosthesis implants. The technological improvement in penile vibratory stimulation devices (PVS) and rectal probe electro-ejaculation (RPE) has made such procedures safer and accessible to patients with ejaculatory dysfunction. Despite the normal number of spermatozoa found in semen of spinal cord-injured patients, their motility is abnormal. This change does not seem to be related to changes in scrotal thermal regulation, frequency of ejaculation or duration of spinal cord damage but to factors related to the seminal plasma. Despite the poor seminal quality, increasingly more men with SCT have become fathers through techniques ranging from simple homologous insemination to sophisticated assisted reproduction techniques such as intracytoplasmic sperm injection (ICSI).