PREGNANCY AFTER ASSISTED EJACULATION PROCEDURES IN MEN WITH SPINAL-CORD INJURY

Objective: To present the results of fertility treatment in 28 men wit h spinal cord injury (SCI) and their partners. Design: Retrospective a nalysis. Setting: University hospital outpatient clinic and home. Pati ents: Twenty-eight anejaculatory men with SCI and their partners seeki ng treatment for infertility. Intervention: Penile vibratory stimulati on and electroejaculation as semen retrieval methods. Assisted reprodu ctive techniques used: vaginal self-insemination at home, intrauterine insemination, in vitro fertilization with or without intracytoplasmic sperm injection. Main Outcome Measures: Ejaculation rare; sperm count and motility; pregnancy rates. Results: All of the men were able to e jaculate either by penile vibratory stimulation (79%) or electroejacul ation (21%). Median total sperm count was 65 million (range, 0.1 to 48 0) with a median motility of 13% (range, 1% to 60%). Overall, 9 of 28 couples (32%) achieved 10 pregnancies (4 self-insemination, 3 intraute rine insemination, 1 in vitro fertilization, and 2 intracytoplasmic sp erm injection). Conclusions: An ejaculation rate of 100% was achieved using penile vibratory stimulation as a first treatment option with el ectroejaculation as a second option. Motivated couples with adequate s emen quality may be offered penile vibratory stimulation combined with self-insemination at home. Together with intrauterine insemination or fertilization techniques used in vitro, the pregnancy rate per treatm ent cycle for SCI couples may approach that of natural procreation in healthy and fertile couples. (C) 1997 by the American Congress of Reha bilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.