Low sperm quality causes infertility in men with SCI

Institute for Reproductive Medicine and Genetic Testing

Pioneer in Embryo Genetic Testing and Gender Selection

- Spinal Cord Injuries and Fertility -

Sperm Quality

Of those couples in which the man can ejaculate during intercourse, only 10% conceive a child. While it is relatively easy to obtain sperm samples through assisted ejaculation, the quality of sperm for men with spinal cord injuries is markedly lower than that of the uninjured population. Therefore, overcoming the problem of ejaculatory dysfunction does not necessarily overcome the problem of infertility.

Research has shown that the quality of sperm in the ejaculate of men with spinal cord injuries is lower than in uninjured men in a number of ways:

· The motility, or ability to swim, of sperm in men with SCI is much lower. Sperm with low motility have a much harder time reaching the egg to fertilize it.

· The morphology, or shape of the sperm, is also affected. Malformed sperm cells have a harder time penetrating the egg to achieve fertilization. The rate of miscarriages is thought to be higher in these cases as well.

· The survivability of the sperm cells is shorter. The sperm from men with spinal cord injuries are considered fragile, and don't survive as long as the sperm of uninjured men. Moreover, the sperm loses motility faster.

· The number of living sperm is lower in men with spinal cord injuries.

Research has shown that repeated ejaculations can improve sperm quality. In fact, studies have shown that when men who undergo surgery to reconnect the vas (vasectomy reversal), sperm quality improves over time. Some other factors that could negatively affect sperm production and quality include: elevated scrotal temperatures, urinary tract infections, changes in testicular cells, effects of urine on sperm cells, and medication. Although much research is being done, there has yet to be a definitive answer to why men with SCI have lower sperm quality.

Fortunately, procedures are available that can increase the fertility chances of men with low-quality sperm. Advanced assisted reproductive techniques such as intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF) can increase their fertility chances. For men with very little or no living or motile sperm in their ejaculate, sperm can be taken directly from the testicles by testicular sperm aspiration, to be used with ICSI and IVF to achieve pregnancy.

Procedures for men with spinal cord injuries

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