Sperm motility from the vas deferens of spinal cord injured men is higher than from the ejaculate

Purpose: Recent evidence suggests that the seminal plasma of spinal cord in jured men contributes to their distinctive semen profile of normal sperm co ncentration but low sperm motility and viability. This finding indicates th at sperm in these men may be normal before exposure to the seminal and pros tatic fluids. To investigate this question we compared vas aspirated to eja culated sperm in 12 men with spinal cord injury and 14 healthy, age matched controls. Materials and Methods: Ejaculate was collected by penile vibratory stimulat ion or electroejaculation in spinal cord injured men and by masturbation in controls. Sperm was aspirated via microsurgery from 1 hemisectioned vas de ferens in spinal cord injured men and during routine elective vasectomy in controls. Ejaculated and aspirated specimens were compared. Results: In men with spinal cord injury mean vas aspirated sperm motility a nd viability plus or minus standard error of mean were significantly higher than mean ejaculated sperm motility and viability (54.4% +/- 5.0% and 74.1 % +/- 5.3% versus 14.1% +/- 2.6% and 26.1% +/- 4.9%, respectively). In cont rols mean vas aspirated sperm motility and viability were not significantly different from mean ejaculated sperm motility and viability (77.5% +/- 5.2 % and 88.9% +/- 2.5% versus 74.3% +/- 5.2% and 85.0% +/- 3.5%, respectively ). Conclusions: In spinal cord injured men sperm motility and viability were s ignificantly higher before contact with seminal fluids. Although aspirated sperm from men with spinal cord injury generally had lower motility and via bility than that of controls, implying that epididymal or testicular factor s may also have a part, the greatest decrease was observed in the ejaculate . Further study of infertility in these men should focus on prostatic and s eminal vesicle factors.