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Spinal Cord Injury and Fertility

Some men with spinal cord injury can still father children biologically, but it can be a difficult process.

Ejaculation and semen quality are the two most common problems these men face.

When a man is sexually aroused, messages travel through the spinal cord, coordinating stimuli between the brain and penis.  These messages eventually trigger ejaculation.  But for a man with spinal cord injury, these messages aren’t always sent and received properly.

Most men with spinal cord injury experience anejaculation. They cannot ejaculate at all.  Some men have retrograde ejaculation, which causes semen to travel backward into the bladder.

Some men can still ejaculate through masturbation, or with a penile vibrator.  Electroejaculation at a doctor’s office is another option.  In this procedure, a doctor inserts a probe into the rectum to stimulate ejaculatory nerves. 

Sperm can also be retrieved surgically, either from the testis or the epididymis (area of sperm ducts near the testis).

But even if semen is successfully collected, there can still be problems with sperm quality.  While men with spinal cord injury make the same amount of sperm as they did before injury, the percentage of motile (moving) sperm is much lower.  Immotile sperm may not be alive and therefore unable to fertilize the eggs.

Researchers are not certain what causes this poor sperm quality, but some are studying semen to see if something in the ejaculate is damaging sperm cells. 

Women’s fertility is not as affected by spinal cord injury and many women are able to carry babies to term.