535 The effects of repeated ejaculations on the quality of sperms following spinal cord injury

Hamid, Rizwan; Bywater, H.; Patki, Prasad; Knight, SL; Shah, Prithvi; Craggs, Michael

doi:10.1016/s1569-9056(04)90530-1

European Urology Supplements

2004

DOI: 10.1016/s1569-9056(04)90530-1

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535 The effects of repeated ejaculations on the quality of sperms following spinal cord injury

Rizwan Hamid¹,

H. Bywater²,

Prasad Patki³

et al.

Abstract: Acknowledgements 4 List of contents 5 List of Abbreviations 12 List of Figures 13 List of Tables 19 List of Appendices 20 LIST OF APPENDICES Appendix 1 WHO Reference values for semen analysis Appendix 2 Inclusion and exclusion criteria Appendix 3 Patient information sheet Appendix 4 Consent form Appendix 5 Papanicolaou staining procedure modified for Spermatozoa Appendix 6 Data Collection Proforma Appendix 7 Basic requirements for an andrology Laboratory

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“…We have reported data from a randomised controlled study, which clearly shows a statistically significant improvement in morphology (P ¼ 0.02) and forward progression (P ¼ 0.03) in semen samples of spinally injured men repeatedly vibroejaculating once a week for 12 weeks. 2 Unfortunately, the translation of this improved semen quality into improved fertility still remains to be seen.…”

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confidence: 99%

Fertility following spinal cord injury: a systematic review

Patki¹,

Hamid²,

Shah³

et al. 2006

Spinal Cord

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We read this article by DeForge et al 1 with interest and congratulate the eminent authors for an extensive indepth systematic review about fertility in spinal cord injury (SCI).It is generally accepted that ejaculatory dysfunction and poor sperm quality are the two main reasons for the high infertility rates in SCI men. In recent times, the advancement in semen retrieval techniques has improved this outcome marginally. Vibroejaculation and electroejaculation are the two most commonly used techniques. Although authors have quoted 86% ejaculation response rates from the pooled data of studies using both the methods, the high rates appear to be due to high success rates with electroejaculation. In our study 2 using vibroejaculation, the ejaculation rates were 50% despite having used the optimum parameters and technique as described by Sonsken et al. 3 This, however, matches well with the success rate of 60% quoted in a meta-analysis of 10 studies by Beckerman et al. 4 It is possible that some of our failures could be due to retrograde ejaculation. We did not check for this phenomenon as it was felt that the semen analysis of the ejaculate mixed with urine would be inaccurate measure of sperm quality.Authors, based on the studies by Ohl et al 5 and Siosteen et al, 6 state that too frequent ejaculations (ie once a week) cause the sperm quality to fall off. Siosteen 6 performed repeated PVS in 16 men for 4-6 months in an uncontrolled study and noted an increase in volume, fructose level and acid phosphatase levels suggesting an improved function of seminal vesicles and prostate. However, he did not observe any significant improvement in motility or morphology. Conversely, Brindley 7 has shown a progressive increase in sperm motility with repeated electro-ejaculation and Francois et al 8 helped to increase the motility of a man with repeated electro-ejaculations from 0 to 30%. We have reported data from a randomised controlled study, which clearly shows a statistically significant improvement in morphology (P ¼ 0.02) and forward progression (P ¼ 0.03) in semen samples of spinally injured men repeatedly vibroejaculating once a week for 12 weeks. 2 Unfortunately, the translation of this improved semen quality into improved fertility still remains to be seen.A scientific paper on this subject describing the further analysis of this study is accepted for publication in Spinal Cord in July 2005. Electro-ejaculation of a complete paraplegic followed by pregnancy. Paraplegia 1978; 16: 248-251.

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mentioning

confidence: 99%

Fertility following spinal cord injury: a systematic review

Patki¹,

Hamid²,

Shah³

et al. 2006

Spinal Cord

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Sperm cryopreservation and assisted reproductive technology outcome in patients with spinal cord injury

et al. 2017

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This study aimed to describe spinal cord injured patients' semen characteristics before and after cryopreservation, and assisted reproductive technology cycles outcome compared to the infertile population. Data about sperm analysis and assisted reproductive technology (ART) cycles outcomes for 78 men with spinal cord injury referred for sperm cryopreservation between 1998 and 2013 were retrospectively analysed and compared with a reference group consisting of every Intra Cytoplasmic Sperm Injection (ICSI) cycle performed in our in vitro fertilization unit over the 2009-2014 period. Semen was collected by penile vibratory stimulation (PVS), electroejaculation or via testis biopsies. Fresh and frozen semen parameters and ART outcomes with frozen-thawed sperm were measured. Patients were divided into three groups according to the sperm retrieval methods: 37 electroejaculations, 37 PVSs and four surgical sperm retrievals. Low ejaculate volume was observed in 33% of the patients, and oligozoospermia in 37% of the patients. Specimens from 77 of the patients contained motile sperm and were therefore frozen for future use. There was no statistical difference for any of the fresh semen parameters between all groups. Twenty of them underwent ICSI leading to five live births, while four underwent intrauterine insemination. ART with frozen-thawed spermatozoa can provide men with SCI with comparable results as in the infertile population.

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535 The effects of repeated ejaculations on the quality of sperms following spinal cord injury

Cited by 2 publications

References 47 publications

Fertility following spinal cord injury: a systematic review

Fertility following spinal cord injury: a systematic review

Sperm cryopreservation and assisted reproductive technology outcome in patients with spinal cord injury

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