Electro-ejaculation of a complete paraplegic followed by pregnancy

François, N; Maury, M; Jouannet, D; David, Gal Ben; Vacant, J

doi:10.1038/sc.1978.46

Cited by 46 publications

(13 citation statements)

References 3 publications

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“…12,[17][18][19] Many investigators have suggested that the stasis of semen in the ejaculatory ducts leads to the deterioration in sperm motility. 13,15,20,21 Brindley 21 has shown a progressive increase in sperm motility with repeated electro-ejaculation. Francos et al 20 helped to increase the motility of a man with repeated electro-ejaculations from 0 to 30%.…”

Section: Introductionmentioning

confidence: 99%

Effects of repeated ejaculations on semen characteristics following spinal cord injury

et al. 2005

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Study design: Prospective randomised controlled study. Objective: To evaluate the effects of repeated ejaculation on semen characteristics following spinal cord injury (SCI) in a prospective randomised controlled study. Setting: Spinal Research Centre, Stanmore, UK and Institute of Urology and Nephrology, London, UK. Methods: A total of 74 patients with SCI above T10 were tested by vibro-ejaculation using a Ferticare penile vibrator (Multicept A/S Horsholm, Denmark) using a standardised technique. The ejaculate was examined according to WHO protocol. The successfully vibro-ejaculated subjects (n ¼ 32) were randomised into a study group (n ¼ 18) and a control group (n ¼ 14). The patients in the study group vibro-ejaculated weekly for 3 months with semen analysis performed at baseline and then monthly. The control group vibro-ejaculated at baseline and at the end of the 3-month period. Two experienced observers performed the semen analysis independently. All measures were compared for statistical significance across the two groups at the beginning and at the end of the 3-month period using a two-tailed student t-test. Significance was determined at the 95% confidence interval (Po0.05). Results: In total, 10 patients in the study group and nine in the control group have completed the study so far. Six patients have dropped out of the study group and three from the control group for varied reasons. Two patients are currently enrolled in the study and control groups. The morphology and forward progression of sperm shows a statistically significant increase in the study group. The motility improves but is not statistically significant in the study group. No significant adverse effects were reported. Conclusions: We have shown in this unique randomised controlled study that repeated ejaculation does improve the sperm characteristics in SCI patients. It is suggested that SCI men should undergo repeated ejaculation for at least 3 months before trying intravaginal or intrauterine insemination techniques. If this fails then in vitro fertilisation can be used. This method promotes natural conception, is intimate and cost effective.

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Section: Introductionmentioning

confidence: 99%

Effects of repeated ejaculations on semen characteristics following spinal cord injury

et al. 2005

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“…Many possible factors contributing to poor semen quality in SCI males have been identi®ed, and include seminal¯uid stasis, 45 urinary tract infection, 46 increased scrotal temperature, 47,48 antisperm antibodies, 35,49 ± 51 urine contamination due to retrograde ejaculation, 28 catheter composition, 24 the use of lubricants, 24,27 endocrine disturbances 52 and increased reactive oxygen species in semen. 53 The method of bladder management used has also been shown to a ect semen quality.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive approach to the management of male infertility following spinal cord injury

et al. 1999

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Objectives: To review the outcomes of management of male infertility following spinal cord injury in a specialised fertility clinic. Study Design: Retrospective review of medical records. Setting: The Fertility Clinic of a 45-bed spinal cord injury service in New South Wales, Australia. Methods: The medical and fertility clinic records of 113 males who attended the clinic between 1987 and 1997 were reviewed. Results: The rates of semen retrieval using vibroejaculation and electroejaculation were 67% and 97% respectively. Thirty-one individuals (37%) and their partners sought assistance with the primary aim of achieving a pregnancy. Intravaginal insemination (IVI) undertaken at home following vibroejaculation resulted in a pregnancy rate per cycle of 22%. Electroejaculation and IVI proved less successful with a pregnancy rate per cycle of only 5%, although with intrauterine insemination (IUI) this rate improved to 30%. Micromanipulation in vitro fertilisation (IVF) procedures, primarily intracytoplasmic sperm injection, were used in 18 couples resulting in a pregnancy rate per cycle of 19%. In the 31 couples there have been a total of 17 pregnancies in 97 cycle attempts for an overall pregnancy rate per cycle of 18% and a cumulative pregnancy rate per couple of 55%. Twelve of the pregnancies have resulted in 14 live births (including two sets of twins), there were three pregnancies ongoing at the date of review and there have been two spontaneous abortions. Conclusion: The bene®ts of a specialised fertility clinic o ering a comprehensive, clientfocused approach with education, fertility assessment and a range of semen retrieval and assisted reproduction options, are highlighted.

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“…The ®rst healthy live birth from EEJ was documented in 1978, after cervical inseminations. 17 Since then, the conception rate of SCIP following in conjunction with IUI or IVF/ICSI consists mainly of anecdotal case reports and case series. 8 ± 10,14,20,24,25 The present study, as well as other studies, demonstrates clearly the improvement in the fertility results during the last decade.…”

Section: Discussionmentioning

confidence: 99%

Treatment of male infertility due to spinal cord injury using rectal probe electroejaculation: the Israeli experience

et al. 2001

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Study design: Male infertility caused by anejaculation is common among patients with spinal cord injury (SCIP). The fertility options for SCIP have improved impressively over the past 10 years. We present the Israeli experience in the treatment of infertility in a large series of SCIP. The issues which are addressed include the treatment of ejaculatory dysfunction, seminal quality and fertility management in SCIP. Setting: Sexual rehabilitation clinic, Neuro-Rehabilitation department, Sheba Medical Center, Israel. Methods: Between June 1992 and May 1998, a total of 84 consecutive SCIP were treated in our clinic with electro-ejaculation (EEJ), representing a sample of the SCIP population, composed mostly of young men traumatically injured. The patients have sustained dierent levels and completeness of spinal injury. Among the patients 33 were interested in achieving pregnancy (39.3%), while the rest were interested in determining fertility potential for family. With EEJ, a low-current stimulation of the ejaculatory organs via a rectal probe is done. The collected semen is used for fertility determination or for fertilization. Results: Eighty-four patients were treated by EEJ. Mean age was 31.3 and mean age at injury was 21.7. There were 29 cervical, 50 thoracic and ®ve lumbar lesions. Sixty-three had complete injury (ASIA A) and 21 incomplete (ASIA B -15, ASIC C -5, ASIA D -1). Fifty-nine had upper motor neuron lesions, and 25 had lower motor neuron. A total of 355 stimulations were performed. Ejaculate was obtained in all patients in 350 stimulations (98.6%), and sperm was present in 74 patients (88.1%) in 296 of the stimulations (83.4%). Fairly good numbers of spermatozoa were obtained, whereas sperm motility and morphology of spermatozoa were low in most cases. A signi®cant dierence in sperm count, motility and morphology was noted between antegrade and retrograde samples. No signi®cant improvement in sperm quality after four repeated consecutive stimulations was noted in 38 SCIP. Side eects were minor and encountered in 16 patients (19.1%). Out of 33 couples who wished to achieve pregnancy, 26 reached the stage of insemination. Four pregnancies were achieved after 33 cycles of InUterine-Insemination (pregnancy rate 28.6% per couple), and 15 after 68 cycles of In-VitroFertilization (micromanipulation) (pregnancy rate of 68.75% per couple). In all, of 101 conception attempts 23 were successful, resulting in pregnancies in 18 couples, and accounting for an overall pregnancy rate of 70% per couple. Conclusion: The high percentage of pregnancies imply that, despite the typically poor sperm motility noted in EEJ, rectal probe EEJ combined with assisted reproductive techniques, and performed by a team approach, is an ecient and safe technique for treating infertility among SCIP.

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Electro-ejaculation of a complete paraplegic followed by pregnancy

Cited by 46 publications

References 3 publications

Effects of repeated ejaculations on semen characteristics following spinal cord injury

Effects of repeated ejaculations on semen characteristics following spinal cord injury

A comprehensive approach to the management of male infertility following spinal cord injury

Treatment of male infertility due to spinal cord injury using rectal probe electroejaculation: the Israeli experience

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