The Agency for Clinical Innovation has published an eBook titled “Fertility Following Spinal Cord Injury: Information for Health Professionals.” This eBook covers various aspects of reproductive health and fertility for people with spinal cord injury. While it is written for health professionals, it is worth recommending to anyone concerned about these factors.
Fertility issues for men with SCI
The main fertility issue for men with spinal cord injuries is semen quality. Studies show that men with SCI often have semen with a high total sperm count but poor motility and viability. Many factors may contribute to this issue, including:
- testicular hypofunction,
- epididymal function,
- seminal fluid changes,
- prostate gland dysfunction,
- recurrent urinary tract infections (UTIs),
- sperm ultrastructure,
- immune regulatory dysfunction,
- and early spinal cord injury.
For improving semen quality, several factors may have a positive impact, including:
- bladder management
- using monoclonal antibodies against cytokines in semen
- repeated vibroejaculation probenecid.
Freezing sperm in the first two weeks after spinal cord injury can also be an opportunity to raise fertility rates, as sperm motility and viability rapidly deteriorate after 16 days until it becomes similar to males with chronic spinal cord injury.
However, it’s important to note that the cryopreservation process reduces sperm motility by about 65% and negatively affects vitality, mitochondrial activity, and DNA fragmentation. Obtaining semen can also be challenging due to medical instability and the absence of an ejaculatory reflex. Fresh sperm is usually preferred over cryopreserved sperm in assisted reproductive technology (ART) procedures.
Fertility issues for women with SCI
As for women with spinal cord injury, they generally have relatively normal fertility, although spinal cord injury significantly impacts female reproductive physiology. Women with spinal cord injury can still expect to have satisfying sexual relationships, bear children, and experience motherhood. However, there are many special considerations for women with spinal cord injury related to various aspects of female reproductive physiology, including:
- menstruation,
- contraception,
- pregnancy,
- labour and delivery,
- postpartum issues,
- and health maintenance.
Parenting and child-rearing
Studies have shown that parents with a spinal cord injury can provide adequate care and supervision for child-rearing. They can continue to offer verbal and psychological support regardless of the level of spinal cord injury and share the more physical aspects of the parenting role with their partner.
Meanwhile, planning and assistance are still crucial for parents with spinal cord injuries to care for a newborn, including home modifications and using assistive technologies for safety and improvement. Connecting with peers and searching for resources on related topics can provide practical advice for parents with spinal cord injury, and a social worker may be able to explore services and funding as part of early pregnancy planning.
It’s just a brief overview of the eBook on fertility after spinal cord injury. For the complete content, you can download the eBook for more information.
