Fertility issues can arise for spinal cord injury survivors, but a spinal cord injury does not have to mean giving up on parenting children. In the aftermath of a spinal cord injury, you might be so overwhelmed by your immediate needs that you give little thought to the future. But as things settle in and you begin to return to your everyday life, you may realize just how normal life with a spinal cord injury can feel. Eventually, being a spinal cord injury survivor will become just one facet of your identity—like your age, hair color, or college degree—not the sum total of who you are or can be.
When life returns to normal—or a new approximation of it—you might begin thinking about having a child. Discussing issues of fertility and sexuality with your doctor can be uncomfortable, especially since stigmatizing assumptions about SCI survivors continue to persist. But your injuries do not mean you cannot become a parent. A majority of SCI survivors have children, and many are active, engaged parents. You can be, too. Don't let your SCI thwart your parenting dreams. Here's what you need to know.
Spinal cord injuries rarely directly affect women's fertility, though women may briefly cease ovulating after an injury. As long as a woman is able to have intercourse, she can often still get pregnant. For men, the picture is a bit murkier.
Because male sexual function depends on both voluntary and involuntary motor control, most spinal cord injuries impede fertility to some extent. The problem is not sperm quality, or even sperm production. Instead, the issue is that men who have survived spinal cord injuries often struggle to get or retain erections. Ejaculation, likewise, can prove difficult or impossible. If you are a man who wants to get your partner pregnant, begin the conversation with your doctor early, so you can explore your options.
For both men and women, issues of sexuality are the primary obstacle to fertility. Women can get pregnant even if they are unable to become sexually aroused. Of course, this doesn't mean they should have to do it that way. But men cannot get their partners pregnant in the traditional way if they are unable to sustain an erection.
Both men and women may struggle to get aroused, and may not have any sexual sensations. This can thwart your desire to have sex, and may even lower your self-esteem. The good news is that a number of therapies can help you regain some functioning. Generally speaking, the lower the injury is, the more likely it is that you will recover some sensation.
What if you can't regain sexual function but still want to become a parent? There are a number of options that allow you to attempt intercourse to become a parent in the “natural” way. Men may use penis pumps or electrostimulation to induce an erection and aid in ejaculation. Some men also have good luck with erectile dysfunction drugs. Women often find that sexual lubricants help them safely have sex; look for a lubricant specifically designed for procreation, such as Pre-Seed. These lubricants help sperm move more efficiently, increasing your odds of a successful pregnancy.
Every spinal cord injury survivor is different, so you should not attempt any method for having intercourse without first discussing it with your doctor. You may also find that the assistance of a nonjudgmental and pragmatic sex therapist is helpful.
Even if you have no other symptoms, a spinal cord injury may mean you have other injuries as well. For instance, even a minor blow to the head during a car accident can damage important regions of your brain, and life in a wheelchair can constrain nerve function in your genitals. Before you embark on a quest to become a parent, consider getting a full fertility workup to ensure that other issues related to your SCI will not prevent you from parenting a child.
As many as 20% of couples struggle with infertility, and very few know there is a problem before they begin attempting to conceive a child. Even if your spinal cord treatment team gives you the go-ahead, you may have other issues that make conception difficult.
Most doctors recommend seeking help if you have not successfully conceived after a year. If you're over the age of 35, it's better to seek help after six months. While you're trying, some steps you can take to increase your odds of success include:
Your overall health can affect your ability to conceive a child. Women, for example, tend to cease ovulating when they are malnourished or too thin. An active infection can undermine sperm and egg quality, making it more difficult to conceive and increasing the likelihood of an early miscarriage. Although there are no guarantees, the following strategies may help increase your fertility:
Even if you are unable to have intercourse or cannot get your partner pregnant, a number of other options are available. Those include: