Can men with spinal cord injuries have children? Learn the success rates of reproductive technology and other statistics about the fertility of men with SCI.
A spinal cord injury can make it impossible for men to reproduce using traditional methods. However, modern reproductive technology and medical procedures provide options for men with SCI who want to have children.
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How Paralysis Affects Male Sexual Reproduction
Spinal cord injuries can have a significant impact on male sexual reproduction abilities. SCI can interfere with the communication between the brain and the reproductive system, leading to erectile dysfunction, decreased sperm motility, and difficulty ejaculating.
These and other factors can make it challenging for men with paralysis to conceive a child through traditional methods. However, research shows encouraging possibilities for men with SCI who want to have children thanks to advancements in medical technology.
Pregnancy Rate & Live Birth Rate Unaffected
Despite the challenges that men with spinal cord injuries face in terms of sexual reproduction, there is still hope for those who wish to have a child with their partner.
Even if semen retrieval is needed, the chances of pregnancy and live birth are comparable to those of non-disabled couples. The pregnancy rate for couples where the male partner has a spinal cord injury is 51%, with a 40% live birth rate.
These encouraging statistics show that parenthood is still a possibility for men with paralysis, and they can take comfort in knowing that their chances of success are similar to those of their non-disabled peers.
Sperm Motility Affected by Catheter-Use
The average percent of motile sperm in men with a spinal cord injury is 20% compared to 70% in non-disabled men. The type of bladder management a person uses can affect their sperm motility differently. Those who opt for an indwelling catheter generally have the lowest motility rate, around 5%. Those who only intermittently cath will typically have a higher sperm motility rate, around 27%.
Semen Retrieval Methods
Only 9% of men with paralysis can ejaculate via masturbation, so semen retrieval methods have been developed so that the semen can be used for in vitro fertilization. It's important to note that not all methods will work for everyone.
Surgical Sperm Retrieval
Surgical sperm retrieval involves a minor surgical procedure to obtain sperm directly from the man's reproductive tract. This method is typically used when other methods are not successful.
Penile Vibratory Stimulation (PVS)
Penile vibratory stimulation is another option that involves the use of a vibrator placed on the head of the penis to stimulate ejaculation. PVS successfully causes ejaculation in ~86% of men whose level of injury is T10 or above, but only ~17% of men whose level of injury is below T10.
Electroejaculation (EEJ)
Electroejaculation is often used when PVS fails. A physician delivers electrical stimulation via a rectal probe to cause an ejaculation. Virtually all men with paralysis can ejaculate via electroejaculation.
Prostate Massage
The physician pushes on the prostate gland and seminal vesicles to mechanically push sperm through the ejaculatory ducts and urethra. This method is less commonly used, but it can be effective for some men and carries less risk than surgical sperm retrieval.
Conclusion
Men with paralysis should discuss their options with their healthcare provider to determine the best course of action. While not all methods will work for everyone, there are options available that can help men with paralysis achieve their goal of fatherhood.
References
Ibrahim, E., Lynne, C.M. and Brackett, N.L., Male Fertility Following Spinal Cord Injury: An Update. Andrology vol. 4,1 (2016)
Craig Hospital. Male Fertility Following Spinal Cord Injury: A Guide For Patients. (2010)
Craig Hospital. Male Fertility after Spinal Cord Injury. (2019)
