Spinal Cord Injury Journal

Male Fertility After a Spinal Cord Injury

Written by Spinal Cord Team | December 07, 2020

Following a spinal cord injury (SCI), men are more likely than women to suffer from fertility concerns and infertility. The sad and untrue belief held by so many is that following a SCI an individual becomes sexually inactive. This is a misleading and unfortunate scenario, leading to the gross misinformation and a lack of circulating knowledge for SCI sufferers worldwide.

 Studies suggest that men in parenting ages are the most common individuals to suffer from a SCI, and so it is appropriate there is more talk about the subject of male fertility in this situation. There is a tendency for sperm quality and/or quantity to decrease through this kind of injury.

It is true that only 1 percent of men with SCI go on to father children through conventional sexual intercourse, but this statistic does not mean only 1 percent of men with SCI can father at all. Quite the contrary. Research and tests have shown that, depending on the level of your injury, total infertility is not common.

‘Normal’ sexual function

Diane M. Rowles says that fertility in males with SCI can depend on a few major points. Firstly, the ability to ejaculate, controlled by T10 - L2 and S2 - S4 and then the quantity and quality of the semen. T10 - L2 control the release of semen, whereas S2 - S4 determine the propulsion of semen out of the body.

Of course, if these functions are impaired, this can make fathering a child through conventional methods very difficult. Less than 10 percent of men with complete SCI will find they can ejaculate in a way they see as ‘normal.’ However, there are developed techniques and methods which can help simulate situations which assist in ejaculation.

Vibratory stimulation massage, either through the anus or on the penis, can create appropriate actions which will cause ejaculation, from which a woman can be artificially inseminated. These methods can be taught to a partner, which means it can become a more private and intimate moment, rather than done by medical professionals in hospitals. If this kind of treatment is inappropriate for the individual, internal surgery at a medical facility can be done to retrieve semen for insemination.

How will I know if my fertility has been affected?

Through all of the aforementioned methods, semen can be collected for analysis, to determine the quality and quantity of the sperm. These allow doctors to see whether or not the ejaculate is appropriate and capable of impregnation. Often, although males with SCIs do not have a lower sperm count, it is found that the number of sperm moving in their semen is much less - around 20 percent in comparison with an average of 70 percent in an able-bodied man.

In conclusion…

The level of fertility of males with SCI can vary greatly depending on their injury (location,  severity, etc.). Sperm quality and quantity is often seen to decrease in men following SCIs. However, this does not mean there is no chance of fathering children. There are ways in which to acquire semen to test - through stimulating massage or surgical retrieval - which can reveal whether or not the sperm are doing what they should in an ideal situation.

With so little literature circulating about this important topic, it can often seem taboo, and is easily assumed that following a SCI, a person will no longer be sexually active. If you are concerned about your future chances of fatherhood after your SCI, it is important to discuss your anxieties with a doctor or your healthcare team to look further into options which may increase your fertility.

Learn more about the basics of spinal cord injuries by downloading the guide below.