Reproductive aspects in spinal cord injured males

Infertility in paraplegic males is determined by two major factors: (1) most patients with spinal cord lesions cannot ejaculate, and (2) if ejaculation is possible, then the features of the semen are constantly abnormal. Various methods have been proposed to stimulate the ejaculatory reflex in paraplegics. From 1983 we have used for this purpose a simple vibrator applied to the penis and with this method the ejaculatory response was obtained in 72 of 102 patients treated. Fifteen patients who desired a child, received instruction in self-using the vibrator at home weekly. Sperm characteristics were evaluated (mean of two samples) before and after 3 months of self-use of the vibrator. Statistical evaluation of the results was performed with Student t-test. At the end of the treatment an improvement of sperm concentration and progressive motility was evident, but the result of highest statistical significance was the decrease of abnormal sperm morphology. Three couples obtained a pregnancy with AIH.