A protocol of electroejaculation and systematic assisted reproductive technology achieved high efficiency and efficacy for pregnancy for anejaculatory men with spinal cord injury.
OBJECTIVE
To help anejaculatory men with spinal cord injury (SCI) to procreate.


METHODS
Prospective, clinical study.


METHODS
A team of physiatrists, urologists, and gynecologists at a university hospital in Taiwan.


METHODS
Ten infertile men with SCI seen at our hospital between 1995 and 2001.


METHODS
Electroejaculation induced their seminal emission. Depending on semen parameters, the couples were treated with intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), surgical retrieval of sperm, cryopreservation of sperm, or donor sperm.


METHODS
Fertilization and pregnancy.


RESULTS
Ten couples underwent assisted reproductive technology (ART). One couple achieved pregnancy after the second cycle of electroejaculation and IUI. Seven couples underwent 8 cycles of ICSI, 4 cycles with fresh electroejaculates, 2 with cryopreserved samples, and 2 with cryopreserved samples with addition of pentoxifylline. Seven (88%) clinical pregnancies were achieved, 2 of which ended with spontaneous abortion. One couple accomplished pregnancy by ICSI with cryopreserved sperm from vasal aspiration. The percentages of fertilization and pregnancy of ICSI cycles using sperm from men with SCI were comparable to men without SCI. One couple attained pregnancy by using donor sperm. The cumulative successful pregnancy rate per couple was 80% (8/10).


CONCLUSIONS
Electroejaculation and systematic ART are highly efficient for achieving pregnancy with the spouses of men with SCI. The neurologic deficit and electroejaculation did not affect the outcome of ICSI. Using cryopreserved sperm for ICSI may reduce risk from electroejaculation or surgery.
Shieh
Jeng-Yi
JY
Department of Physical Medicine and Rehabilitation, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan.
Chen
Shee-Uan
SU
Wang
Yen-Ho
YH
Chang
Hong-Chiang
HC
Ho
Hong-Nerng
HN
Yang
Yu-Shih
YS
D000328:Adult; D015925:Cryopreservation; D004542:Ejaculation; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000628:therapy*; D007317:Insemination, Artificial, Homologous; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted; D012661:Semen / Q000502:physiology; D012662:Semen Preservation; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome