Nikita Naredi1, Amit Agrawal2. 1. Senior Advisor (Obst & Gynae) & ART Specialist, ART Centre, Military Hospital, Bhopal, India. 2. Senior Advisor (Surgery) & Urologist, Command Hospital (Western Command), Chandimandir, Haryana, India.
Abstract
BACKGROUND: Apart from neurological consequences, most distressing sequels of spinal cord injury (SCI) in men are erectile dysfunction, ejaculatory dysfunction and abnormal semen quality. Of these, ejaculatory dysfunction and poor semen parameters pose the biggest challenge to their biological fatherhood. Penile vibratory stimulation (PVS) and electroejaculation are first-line modalities for anejaculation, and surgical sperm retrieval (SSR) is adopted when other treatments fail. Sperms obtained using these techniques can be used for various fertility treatments for couples with spinal cord injured men. The aim of the study was to study the effectiveness of various modalities of sperm retrieval for assisted reproductive treatment in men with SCI. METHODS: It was a prospective observational study, wherein partners of 12 men with SCI presenting for subfertility underwent assisted reproduction after retrieving sperms via various modalities. The primary outcome was to assess efficacy of PVS in obtaining sperms and of SSR if PVS failed. The secondary outcome was to assess the pregnancy rate in their partners. RESULTS: PVS was successful in obtaining ejaculate in 7 of 12 men, and SSR was fruitful in 4 of 5 men. In vitro fertilization cycle for men who underwent PVS resulted in a pregnancy rate of 57.14% and 75% in couples for men who underwent SSR with an overall pregnancy rate of 58.33%. CONCLUSION: With new cases of SCI occurring primarily in young men at the peak of their reproductive health, it is imperative that medical professionals involved with reproductive health should be aware of the various modalities to help them achieve biological paternity.
BACKGROUND: Apart from neurological consequences, most distressing sequels of spinal cord injury (SCI) in men are erectile dysfunction, ejaculatory dysfunction and abnormal semen quality. Of these, ejaculatory dysfunction and poor semen parameters pose the biggest challenge to their biological fatherhood. Penile vibratory stimulation (PVS) and electroejaculation are first-line modalities for anejaculation, and surgical sperm retrieval (SSR) is adopted when other treatments fail. Sperms obtained using these techniques can be used for various fertility treatments for couples with spinal cord injured men. The aim of the study was to study the effectiveness of various modalities of sperm retrieval for assisted reproductive treatment in men with SCI. METHODS: It was a prospective observational study, wherein partners of 12 men with SCI presenting for subfertility underwent assisted reproduction after retrieving sperms via various modalities. The primary outcome was to assess efficacy of PVS in obtaining sperms and of SSR if PVS failed. The secondary outcome was to assess the pregnancy rate in their partners. RESULTS: PVS was successful in obtaining ejaculate in 7 of 12 men, and SSR was fruitful in 4 of 5 men. In vitro fertilization cycle for men who underwent PVS resulted in a pregnancy rate of 57.14% and 75% in couples for men who underwent SSR with an overall pregnancy rate of 58.33%. CONCLUSION: With new cases of SCI occurring primarily in young men at the peak of their reproductive health, it is imperative that medical professionals involved with reproductive health should be aware of the various modalities to help them achieve biological paternity.
Authors: D DeForge; J Blackmer; C Garritty; F Yazdi; V Cronin; N Barrowman; M Fang; V Mamaladze; L Zhang; M Sampson; D Moher Journal: Spinal Cord Date: 2005-12 Impact factor: 2.772
Authors: Apostolos Kafetsoulis; Nancy L Brackett; Emad Ibrahim; George R Attia; Charles M Lynne Journal: Fertil Steril Date: 2006-09-11 Impact factor: 7.329
Authors: Anupama S Q Kathiresan; Emad Ibrahim; Teodoro C Aballa; George R Attia; Charles M Lynne; Nancy L Brackett Journal: Fertil Steril Date: 2011-05-31 Impact factor: 7.329
Authors: J Perrin; J Saïas-Magnan; I Thiry-Escudié; M Gamerre; G Serment; J-M Grillo; C Guillemain; G Karsenty Journal: Gynecol Obstet Fertil Date: 2010-08-11