Triplet pregnancy achieved through intracytoplasmic sperm injection with spermatozoa obtained by prostatic massage of a paraplegic patient: Case report

Abstract

Spinal cord-injured men with ejaculation disorders can have children thanks to assisted reproduction techniques. Spermatozoa from these patients are usually obtained through vibratory stimulation, electroejaculation or by puncturing the seminal duct or the testicle. We present the first published case, as far as we are aware, of spermatozoa obtained through prostatic massage of a paraplegic patient. Penile vibratory stimulation was unsuccessful in this patient. In-vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) with spermatozoa obtained through electroejaculation was performed at another centre but pregnancy was not achieved. Through prostatic massage, we obtained a total semen volume of 6 ml containing a total count of 12.32x10(6) spermatozoa (6.24x10(6) with tails), 8% of which had motility (graded + and ++); and 16% of which had normal morphology. The spermatozoa obtained were then used to perform IVF with ICSI and a triplet pregnancy was achieved. Prostatic massage appears to be an easy, non-traumatic and risk-free method to obtain spermatozoa from paraplegic patients.

Erectile function and male reproduction in men with spinal cord injury: a review

“…A less problematic and faster technique for semen retrieval in SCI men is the prostatic massage. Its efficacy has been reported by several authors (Fahmy et al, 1999;Marina et al, 1999;Hovav et al, 2000;Okada et al, 2001;Arafa et al, 2007). The patient is placed in lateral decubitus position which is the most practical for manipulations in SCI men.…”

Penile vibratory stimulation and electroejaculation in the treatment of ejaculatory dysfunction1

“…If assisted ejaculation procedures fail or yield insufficient motile and/or viable spermatozoa for assisted reproductive techniques, surgical procedures of sperm retrieval are indicated. There have been several case reports of pregnancies obtained with sperm from surgical retrieval in SCI men (Dahlberg et al ., 1995; Watkins et al ., 1996; Marina et al ., 1999).…”

Sperm retrieval in anejaculatory diabetic men who failed in drug treatment and penile vibratory stimulation during blood sugar under control

“…In recently reported cases, prostatic massage was used to obtain spermatozoa from patients with paraplegic and psychogenic anejaculation. Marina et al (1999) were able to obtain spermatozoa equally with electro-ejaculation and prostatic massage, but few reports were issued for diabetes mellitus with anejaculation. Prostatic massage is a simple, noninvasive and inexpensive way to obtain sufficient numbers of spermatozoa for ICSI (Fahmy et al, 1999).…”