Fertility following spinal cord injury: a systematic review

Deforge, Dan; Blackmer, Jeff; Garritty, C; Yazdi, Fatemeh; Cronin, Valerie; Barrowman, Nicholas J.; Fang, Manchun; Mamaladze, Vasil; Zhang, Li; Sampson, Margaret; Moher, David

doi:10.1038/sj.sc.3101769

Cited by 89 publications

(74 citation statements)

References 73 publications

(118 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent studies shows that these changes are due to accessory gland dysfunction and altered semen constituents due to stasis of prostatic fluid, testicular hyperthermia, recurrent urinary tract infections, abnormal testicular histology, hypothalamic-pituitary-testicular axis changes, sperm antibodies, chronic long-term use of various medications and bladder dysfunction. [1][2][3]6,[12][13][14] In addition, the EEJ procedure may further hamper sperm quality by the electroporation injuries. [14][15][16] Other SCI patients may also suffer from either primary testicular failure or obstructive azoospermia.…”

Section: Discussionmentioning

confidence: 99%

“…1 Most of them suffer from infertility, mainly due to erectile and/or ejaculatory dysfunction. 2,3 Antegrade ejaculation has been reported in 5% of patients with complete upper motor neuron lesions, 18% with complete lower motor neuron lesions and 32% with incomplete upper motor neuron lesions and 70% with incomplete lower motor neuron lesions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Testicular sperm retrieval and intra cytoplasmic sperm injection provide favorable outcome in spinal cord injury patients, failing conservative reproductive treatment

et al. 2013

View full text Add to dashboard Cite

Study design: Retrospective cohort analysis. Objectives: The objective of this study was to determine the in vitro fertilization (IVF) outcome after testicular sperm extraction (TESE) in a group of spinal cord injury (SCI) male patients not compatible with conservative fertility treatment. Setting: University-affiliated medical center. Methods: Thirty two SCI patients (C2 to L2) were referred to IVF after repeated trials of electroejaculation (EEJ) or penile vibratory stimulation (PVS), and full andrological evaluation. Testicular sperm aspiration (TESA) was the method of choice for sperm extraction. Open TESE was performed only after a negative TESA attempt. Clinical pregnancy and live birth rates were determined. Results: A total of 106 testicular procedures were performed. Sperm was found in 95 cycles (89.6%). The average metaphase II (MII) oocyte number was 11.0 ± 4.2, an average of 5.1 ± 2.3 oocytes became normally fertilized after Intra Cytoplasmic Sperm Injection (ICSI) (fertilization rate 57.1%). On average, 2.7 ± 1.2 embryos were replaced. The clinical pregnancy rate was 32/106 (30.2%) per cycle and 19/32 (59.3%) per couple. Live birth rate was 62.5% (20/32). Conclusions: TESA/E and IVF can provide excellent prognosis for SCI patients that cannot be treated by EEJ or PVS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Testicular sperm retrieval and intra cytoplasmic sperm injection provide favorable outcome in spinal cord injury patients, failing conservative reproductive treatment

et al. 2013

View full text Add to dashboard Cite

show abstract

“…However, like stated before, the hypothesis that fertility is not affected in SCI women is not supported by constructive research. The need for research on fertility in SCI women is essential, as was already urged by DeForge in 2005 [22]. Unfortunately, no new studies about this topic have emerged since.…”

Section: Discussionmentioning

confidence: 99%

“…When menses has returned, fertility of SCI women is assumed to be similar to the general population. However, virtually no data on fertility rates in SCI women are available [22]. With regard to pregnancy and labour, several health risks are identified for SCI women [23,24].…”

Section: Introductionmentioning

confidence: 99%

Discussing reproductive health in spinal care, part II: fertility issues

et al. 2016

View full text Add to dashboard Cite

Purpose Due to advancing insights, discussing fertility in spinal care is an emerging topic. Studies among neurosurgeons to evaluate clinical practice about discussing fertility are non-existent. The aim of this study is to review knowledge, attitude and practice patterns regarding discussing fertility in spinal care. Methods Dutch neurosurgeons and residents were sent a mail-based questionnaire addressing attitude, knowledge and practice patterns regarding discussing fertility. Results Response rate was 62 % (compared to mean of 28 % in similar surveys) with 89 questionnaires suitable for analysis. Mean age was 42 years with 83 % of respondents being male. A quarter of respondents stated neurosurgeons are responsible to discuss fertility, with 12 % indicating to actually do this. Fertility is discussed more often with patients with cauda equina syndrome (70 %) and with men (p = 0.006). Merely 8 % of respondents stated to have adequate knowledge on fertility preservation (FP); this percentage was higher for doctors with spinal surgery as specialty (p = 0.015). In case of cauda equina syndrome, doctors with more knowledge discussed fertility more often (p = 0.002). Fifty-three percent of neurosurgeons wished to enhance their knowledge, in order to feel more comfortable to discuss fertility with their patients.Five percent indicated to have ever referred a patient to a fertility specialist. Conclusion With the exception of cauda equina syndrome, fertility is not routinely discussed in spinal care. Fertility is discussed more often with men. Recent guidelines state that discussing fertility is an essential part of good practice in spinal care. Education on fertility and FP needs to be integrated in the neurosurgical training program to create more awareness, and to enable clinicians to provide adequate information and care to the patient.

show abstract

“…En FIV classique, le taux de grossesse se situe entre 20 et 40% (taux de grossesses par cycle). Peu d'auteurs rapportent les r~sultats en FIV avec ICSI [7,9,14,25], mais ceux-ci sont comparables ~ ceux obtenus dans la population g~n~rale. …”

Section: Prise En Charge Du Couple En Ampunclassified