Condition & Treatments
/ Spinal cord injury
Spinal cord injury doesn't have to mean you can't become a father
Most men with a spinal cord injury can't ejaculate normally, and sperm quality often changes after injury. But sperm production usually continues, and there are wellestablished ways to collect sperm for pregnancy.
I N S H O R T
The main problem is getting sperm out, not making it.
A vibrator device (penile vibratory stimulation) works for many men, sometimes at home.
If it doesn't, electroejaculation or surgical sperm retrieval can be used.
Why it happens
Ejaculation depends on nerves in the lower spinal cord. Injury interrupts these signals. Sperm motility is often low after injury, partly because of changes in the seminal fluid, so sperm is best collected and used promptly.
Ways to collect sperm
Penile vibratory stimulation (PVS). A medical vibrator applied to the penis triggers a reflex ejaculation. Usually tried first. Some couples go on to home insemination.
Electroejaculation. A probe gently stimulates the nerves near the prostate, under anaesthetic if you have sensation. It works in almost all men.
Surgical sperm retrieval. If neither method works, sperm can be taken directly from the testis or epididymis for IVF/ICSI.
Collecting sperm from the urine, if semen flows backwards into the bladder (retrograde ejaculation).
Safety
Men with injuries at T6 or above can develop autonomic dysreflexia, a sudden rise in blood pressure, during ejaculation. Collection is planned with blood pressure monitoring and preventive medicine where needed.
Why this matters to your care
Prof Raheem performs electroejaculation and surgical sperm retrieval, and co-ordinates with your spinal team and IVF clinic so the method matches your level of injury. He has written on male fertility after spinal cord injury, and spoken on fertility in neurological disease at the N Spine Congress, Royal College of Surgeons, London.
Common questions
Can we try for a baby naturally?
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Sometimes. With PVS at home, some couples achieve pregnancy with home insemination.
Is it painful?
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Most men with complete injuries feel little. If you have sensation, electroejaculation is done under anaesthetic.
Should I freeze sperm soon after my injury?
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It is worth discussing early, as sperm quality can decline over time.