Assisted ejaculation combined with in vitro fertilisation: an effective technique treating male infertility due to spinal cord injury


Infertility due to spinal cord injury (SCI) in males has been identified for decades as an area of major concern and techniques for assisted ejaculation are available. There has not been an overall consensus regarding which type of assisted procreation is the most appropriate for these couples. We describe here our experience from a programme based on assisted ejaculation combined with in vitro fertilization (IVF). Twelve couples have been treated so far and altogether 22 cycles with ovum pick-up have been completed. Fertilisation of the oocytes was obtained in 18 of these cycles. The overall oocyte fertilisation rate was 49%. Embryo transfer took place in 17 cycles, leading to seven clinical pregnancies. Four of the pregnancies are delivered or are ongoing, whereas three ended in first trimester spontaneous abortion. Thus our initial experience suggests that assisted ejaculation in combination with IVF is an effective option for these couples.


  1. 1

    Levi R, Hulting C, von H olst H, Ekholm J (1992) A new tool for spinal cord injuries. Lkartidningen (Sweden) 89: 3361–3364.

  2. 2

    Linsenmeyer T A, Perkash I (1991) Infertility in men with spinal cord injury. Review article. Arch Phys Med Rehabil 72: 747–754.

  3. 3

    Guttmann L (1949) The effect of prostigmine on the reproductive functions in the spinal man. Proc 4th Int Neurological Congr 2: 69.

  4. 4

    Brindley G S (1984) The fertility in men with spinal injuries. Paraplegia 22: 337.

  5. 5

    Seager S W, Savastano J A, Street J W et al (1984) Semen quality and penile erections in normal and chronic spinal non-human primates. J Urol, Part 2, 131: 234A (abstract 522).

  6. 6

    Denil J, Ohl D A, Menge A C et al (1992) Functional characteristics of sperm obtained by electroejaculation. J Urol 47: 69–72.

  7. 7

    Bennett C J, Seager S W, Washer E A, McGuires E J (1988) Sexual dysfunction and electroejaculation in men with spinal cord injury: Review article. J Urol 139: 453–457.

  8. 8

    Hultling C, Fredricsson B, Garoff L et al (1994) Assisted ejaculation and IVF. A promising method to treat infertility in male SCIs. Läkartidningen (Sweden) 91: 588–590.

  9. 9

    Wikland M, Nilsson L, Hansson R et al (1983) Collection of human oocytes by the use of sonography. Fertil Steril 39: 603–608.

  10. 10

    Lasalle B, Testart J, Renard J P (1985) Human embryo features that influence the success of cryopreservation with the use of 1,2 propandediol. Fertil Steril 44: 645–651.

  11. 11

    Chapelle P A, Biancart F, Puech A J, Held J P (1983) Treatment of anejaculation in the total paraplegic by subcutaneous injection of physostigmine. Paraplegia 21: 30–36.

  12. 12

    Toledo A A, Tucher M J, Bennett J K (1992) Electroejaculation in combination with in vitro fertilization and gamete micromanupulation for treatment of anejaculatory male infertility. Am J Obstet Gynecol 167: 322–326.

  13. 13

    Sönksen J, Biering-Sörensen, F (1992) Fertility in men with spinal cord or cauda equina lesions. Semin Neurol 12: 106–114.

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Hultling, C., Levi, R., Garoff, L. et al. Assisted ejaculation combined with in vitro fertilisation: an effective technique treating male infertility due to spinal cord injury. Spinal Cord 32, 463–467 (1994).

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  • spinal cord injury
  • male infertility
  • in vitro fertilisation (IVF)
  • pregnancy

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