Male Fertility

Male fertility after SCI is often compounded by the difficulties of erectile dysfunction, as well as retrograde ejaculation or anejaculation. Ejaculation is a complex process involving coordinated activity of the sympathetic (smooth muscle) and somatic (striated muscle) nervous system controlling prostate and seminal vesicles, bladder neck/sphincter, pelvic floor and urethra. Few men with SCI are able to ejaculate with partner sexual practices alone and require medical assistance to obtain sperm. This sperm is then used for intravaginal/intrauterine insemination or other assisted reproductive technology (ART) interventions. Although most of the male fertility studies describe issues of retrieval, sperm quality, reproductive technology, pregnancy and live births within a single study, the tabled studies have been sorted into the topics of sperm retrieval, sperm quality and pregnancy based on the primary focus of the paper, although overlap does occur.