Men with spinal cord injuries still produce sperm in their testicles. But their injury can prevent them from being able to have an erection or being able to ejaculate. Similar limitations may affect men with multiple sclerosis, cerebral palsy and other neurologic conditions.
An injury to the lower spine may affect a man’s ability to have an erection. If the upper spine is injured, however, a man may still be able to have an erection and have sexual intercourse. But even though men with a spinal cord injury can have an erection, the percentage who can successfully ejaculate is low. And although erection is not necessary for ejaculation to occur, without ejaculation, achieving pregnancy through unassisted means is not possible.
Many factors will influence the success of treatment for men with spinal cord injury. At the Reproductive Medicine Center, we discuss each man’s goals, as well as the needs of the couple when determining the appropriate treatment.
For men who are unable to ejaculate, outpatient procedures may be used to collect sperm.
- Electro-ejaculation — using a special machine, an electrical probe is inserted into the rectum. A current generated by the machine stimulates the nerves and produces contraction of the pelvic muscles, resulting in ejaculation.
- Vibratory stimulation — a mechanical vibrator is placed on top of or under the tip of the penis. The vibration travels along the sensory nerves to the spinal cord and may induce a reflex ejaculation. Results of this procedure depend on the level of the spinal cord injury; it may be done at home following an initial procedure at the clinic.
- Vasal aspiration — a procedure in which sperm are surgically removed through an incision in the scrotum
The sperm collected from these procedures may then be used in various assisted reproductive treatments, such as in vitro fertilization, intravaginal insemination or intrauterine insemination, to achieve fertilization and pregnancy.
In an abundance of caution, care and concern for our patients, staff and community, we are delaying fertility treatment starts until we have a greater sense of the degree of COVID-19 transmission in our region. We will closely follow ASRM and CDC recommendations as they become available.