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Overcoming Fertility Issues for Men Post-SCI

20th July 2021

Overcoming Fertility Issues for Men Post-SCI

Steven Santy, Senior Associate in the Personal Injury team at Higgs LLP, examines some of the options available to men who are experiencing fertility problems following a spinal cord injury.

It is generally considered that women are unaffected by spinal cord injury when it comes to long-term fertility.  That is not to say that an injury does not have any effect. Issues can arise including a reduction in sexual desire and a decrease in genital sensation, but pregnancy is achievable and long-term fertility is usually unaffected.

In the UK, around 2,500 people are diagnosed with spinal cord injury every year, of which around 80% are men.  Advances in rehabilitation, particularly physiotherapy, have enabled spinal cord injured people to lead fulfilling lives and with this often comes the desire to start a family.  But for men, the impact on sexuality and fertility is far more significant, with the large majority of victims unable to father a child naturally.

The extent by which someone is affected is dictated by the location and severity of the injury itself.  But common problems arising include the ability to achieve and maintain an erection, the ability to orgasm and/or ejaculate and impaired quality of sperm.  Sadly, this can dissuade many men, however various medical therapies, technologies and techniques can help someone achieve their dream of fatherhood.

Treatment

Whilst fertility is not dependent upon the ability to achieve an erection, natural conception is the preferred option for many couples.  Erectile dysfunction can be overcome with medications such as Viagra or with urethral suppositories and vacuum erection devices.  In more severe cases, intracavernous injections or insertion of a penile implant can be indicated.  

Most men with spinal cord injury cannot produce an ejaculation during intercourse.   Penile vibratory stimulation (PVS) involves placement of a vibrator on the penis until ejaculation occurs.  This is a popular choice and can be done at home, without clinical supervision.  Electroejaculation is a technique where an electrical current travels through an electrode positioned on a probe within the rectum, with the result that an ejaculation (and sometimes an erection) is produced.  

Where the quality of the sperm is an issue, extraction is possible.  A careful dissection is performed using an operating microscope before any sperm are extracted.  Following the extraction, sperm are processed for fertilization.

The last factor contributing to infertility in men with spinal cord injuries is abnormal sperm. Men with spinal cord injuries often have a unique semen profile often characterized by normal semen numbers but abnormally low sperm motility and viability. 

At Higgs LLP, as part of our holistic approach towards our clients, we work to ensure they receive not only the legal support they require but also advice and signposting to get their lives back on track.

Contact us if you’ve suffered an injury and need our help.

 

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