Treatment by assisted conception of severe male factor infertility due to spinal cord injury or other neurologic impairment.
OBJECTIVE
This retrospective study evaluated the pregnancy rates of 23 couples with male factor infertility due to traumatic spinal cord injury (N = 21), multiple sclerosis (N = 1) or transverse myelitis (N = 1).


METHODS
Ovulation induction by clomiphene citrate or gonadotropins was used in combination with intrauterine insemination as an initial approach for assisted conception in all but one couple.


RESULTS
Six pregnancies occurred in 60 cycles of intrauterine insemination (mean of 2.6 cycles). In this group, the cumulative pregnancy rate was 26%. Six couples who failed after a total of 33 intrauterine insemination cycles (mean of 5.5 cycles), and 1 couple with no previous intrauterine insemination cycles, initiated 10 cycles of in vitro fertilization (mean of 1.4 cycles). In this group, five pregnancies occurred. The pregnancy rate was 71%.


CONCLUSIONS
We conclude that ovulation induction in combination with intrauterine insemination offers an effective initial therapy of severe male factor infertility due to spinal cord injury.
Miami Project to Cure Paralysis, University of Miami School of Medicine, Florida 33136, USA.
N L
NL
Brackett
M
M
Abae
O F
OF
Padron
C M
CM
Lynne
D000328:Adult; D002996:Clomiphene / Q000494:pharmacology; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology; D006801:Humans; D007248:Infertility, Male / Q000191:economics / Q000209:etiology; D007315:Insemination, Artificial / Q000191:economics; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications*; D009188:Myelitis, Transverse / Q000150:complications*; D010060:Ovulation / Q000187:drug effects / Q000502:physiology; D010062:Ovulation Induction / Q000191:economics / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012661:Semen / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications*
D005300:Fertility Agents, Female; D002996:Clomiphene