Sperm retrieval for people with spinal cord injury (SCI)
When ejaculation cannot occur, sperm can be collected in other ways.
Women’s Health Melbourne can support you and your partner to conceive in the context of SCI.
Common concerns include experiencing difficulty maintaining an erection long enough to have penetrative intercourse
Difficulty ejaculating (releasing semen) during orgasm or retrograde ejaculation (spurting sperm backwards, towards the bladder).
Inflammation or infection that can interfere with sperm function
Sperm production concerns associated with reduced nerve signalling
When ejaculation cannot occur, sperm can be collected in other ways.
How can sperm be obtained from men with SCI?
Sperm can be collected in the following ways:
Vibratory stimulation:
Vibratory stimulation works best in people with spinal cord injury around the middle spine and is rarely effective with injuries at lower levels level. Vibratory stimulation uses a small vibrator device placed on the penis to achieve release of semen, containing sperm. Semen can be used for vaginal insemination, intrauterine insemination (IUI) or in vitro fertilization (IVF).Electroejaculation:
Electroejaculation is a technique that applies electrical current to stimulate nerves near the prostate gland transrectally to cause the release of semen, often into the bladder. A trans penile catheter may be passed into the bladder prior to and after the procedure, first to fill the bladder with sperm friendly media (liquid) and later to collect sperm. Referral to a specialist urologist can be made to facilitate this method.Testicular sperm retrieval by fine needle aspiration:
Fine needle testicular sperm retrieval for ICSI (Intacytoplasmic sperm injection) can be performed by your WHM specialist during the process of IVF under local anaesthetic with sedation or general anaesthetic if preferred.Testicular open biopsy or microtese
Where a more extensive sample is needed due to poor sperm quality or impaired sperm production, an open surgical technique may be used for sperm retrieval. this technique can take several hours and is always performed under a general anaesthetic.
Once sperm is collected, how is it used to create a pregnancy?
Depending on sperm quality and concentration, pregnancy can be achieved via insemination IVF or ICSI techniques.
How do I know which method is right for us?
Your WHM specialist will discuss the details of your injury, your partners fertility concerns and your family planning goals to decide together which method is most appropriate for you.
Written by Dr Raelia Lew
RANZCOG Board Certified CREI Fertility specialist, Gynaecologist and the Director of Women’s Health Melbourne.
Co-host of the Knocked Up Podcast, Co-founder of Lovers intimate wellness solutions. Raelia has a PhD in Preconception Health Promotion and Genetic Screening. Raelia is a leading Australian expert in IVF and egg freezing, pioneering a bespoke model of care.