title: Current trends in the treatment of infertility in men with spinal cord injury.
abstract: OBJECTIVE
  To determine current use of penile vibratory stimulation (PVS), electroejaculation (EEJ), and intrauterine insemination (IUI) in treatment of infertility in men with spinal cord injury (SCI).
  
  
  METHODS
  Prospective survey, retrospective chart review, and literature review.
  
  
  METHODS
  Major university medical center.
  
  
  METHODS
  Male SCI patients and female partners.
  
  
  METHODS
  A survey administered to professionals determined current treatment methods for infertility in couples with SCI male partners.
  
  
  METHODS
  Sperm retrieval methods, ejaculation success rates, total motile sperm (TMS), IUI application, and IUI outcomes.
  
  
  RESULTS
  Twenty-eight percent of surveyed professionals do not retrieve sperm from ejaculates of SCI patients, relying instead on retrieval from reproductive tissues. Reasons for not offering PVS or EEJ were lack of familiarity, training, or equipment. Thirty-four percent do not offer IUI to these couples. Chart review showed that semen could be retrieved by PVS or EEJ in 95% of patients. Fifty-three percent and 43% of trials had TMS >5 and >10 x 10(6), respectively. Of survey respondents performing IUI, 42% lacked enough data to estimate pregnancy rates (PRs) in these couples. Literature review showed IUI PRs between 9% and 18% per cycle and 30% and 60% per couple.
  
  
  CONCLUSIONS
  Based on ejaculation success rates, TMS yields, and IUI outcomes, the methods of PVS, EEJ, and IUI warrant consideration in centers not currently offering these options for couples with SCI male partners.
authors.affiliation: Department of Urology, University of Ioannina, Ioannina, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Kafetsoulis
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Brackett
authors.forename: Emad
authors.initials: E
authors.lastname: Ibrahim
authors.forename: George R
authors.initials: GR
authors.lastname: Attia
authors.forename: Charles M
authors.initials: CM
authors.lastname: Lynne
mesh_terms: D015897:Comorbidity; D019538:Health Care Surveys; D006801:Humans; D007246:Infertility / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000534:rehabilitation*; D014481:United States