title: Testicular sperm retrieval and intra cytoplasmic sperm injection provide favorable outcome in spinal cord injury patients, failing conservative reproductive treatment.
abstract: METHODS
  Retrospective cohort analysis.
  
  
  OBJECTIVE
  The objective of this study was to determine the in vitro fertilization (IVF) outcome after testicular sperm extraction (TESE) in a group of spinal cord injury (SCI) male patients not compatible with conservative fertility treatment.
  
  
  METHODS
  University-affiliated medical center.
  
  
  METHODS
  Thirty two SCI patients (C2 to L2) were referred to IVF after repeated trials of electroejaculation (EEJ) or penile vibratory stimulation (PVS), and full andrological evaluation. Testicular sperm aspiration (TESA) was the method of choice for sperm extraction. Open TESE was performed only after a negative TESA attempt. Clinical pregnancy and live birth rates were determined.
  
  
  RESULTS
  A total of 106 testicular procedures were performed. Sperm was found in 95 cycles (89.6%). The average metaphase II (MII) oocyte number was 11.0±4.2, an average of 5.1±2.3 oocytes became normally fertilized after Intra Cytoplasmic Sperm Injection (ICSI) (fertilization rate 57.1%). On average, 2.7±1.2 embryos were replaced. The clinical pregnancy rate was 32/106 (30.2%) per cycle and 19/32 (59.3%) per couple. Live birth rate was 62.5% (20/32).
  
  
  CONCLUSIONS
  TESA/E and IVF can provide excellent prognosis for SCI patients that cannot be treated by EEJ or PVS.
authors.affiliation: IVF and Andrology Units, Urology and Rehabilitation Department, The Chaim Sheba Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv), Tel Hashomer, Israel. gravivg@zahav.net.il
authors.forename: G
authors.initials: G
authors.lastname: Raviv
authors.forename: I
authors.initials: I
authors.lastname: Madgar
authors.forename: S
authors.initials: S
authors.lastname: Elizur
authors.forename: G
authors.initials: G
authors.lastname: Zeilig
authors.forename: J
authors.initials: J
authors.lastname: Levron
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D053625:Sperm Retrieval; D013119:Spinal Cord Injuries / Q000150:complications*