title: Testicular sperm extraction for patients with spinal cord injury-related anejaculation: A single-center experience.
abstract: To present a single-center experience with testicular sperm extraction and intracytoplasmic sperm injection for fathering biological children in patients with ejaculatory dysfunction as a result of spinal cord injury.
  
  
  
  Testicular sperm extraction was carried out in 52 male patients with ejaculatory dysfunction as a result of spinal cord injury. We investigated sperm retrieval rates and pregnancy rates from medical records. Data on age, testicular volume, hormonal status (luteinizing hormone, follicle stimulating hormone and testosterone), and time since spinal cord injury were obtained and analyzed to detect potential associations with the presence of spermatogenesis.
  
  
  
  Testicular sperm retrieval was achieved in 42 of 52 patients (80.7%). Intracytoplasmic sperm injection was carried out for 37 patients, and pregnancy was achieved in 32 (86.5%). The take-home baby rate was 70.2%. In the group with successful sperm extraction, testicular volume was significantly greater, time from spinal cord injury to extraction was significantly shorter, and serum luteinizing hormone and follicle-stimulating hormone levels were significantly lower. Serum follicle-stimulating hormone levels had the strongest association with feasibility of sperm retrieval by testicular sperm extraction. Furthermore, the sperm retrieval rates of patients injured within the preceding 12 years were significantly better than those injured longer before treatment (P = 0.045).
  
  
  
  Testicular sperm extraction and intracytoplasmic sperm injection seem to provide favorable results for patients with ejaculatory dysfunction as a result of spinal cord injury. However, early testicular sperm extraction is recommended, because sperm retrieval becomes more difficult with time from spinal cord injury.
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Iwahata
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.|Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shin
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Shimomura
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Miyata
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Kobori
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Soh
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.|Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval; D013094:Spermatozoa; D013119:Spinal Cord Injuries; D013737:Testis
keywords: anejaculation; infertility; intracytoplasmic sperm injection; spinal cord injury; testicular sperm retrieval