Vibratory ejaculation in 140 spinal cord injured men and home insemination of their partners.

STUDY DESIGN

Retrospective cohort study.

OBJECTIVES

Anejaculation is commonly found in spinal cord injured (SCI) men. Clinical treatments and assisted reproductive techniques allow SCI men to father children but few home pregnancies have been reported. The objective of this paper is to evaluate the results from the last 20 years' of treatment with penile vibratory stimulation (PVS) and vaginal self-insemination at home in SCI men and their partners.

SETTING

The data originate from two European centers and one American center.

METHODS

A total of 140 SCI men with anejaculation and their healthy partners were available for this analysis. Men who obtained antegrade ejaculation by PVS and had motile sperm in the ejaculate were offered the possibility of PVS combined with vaginal self-insemination at home. Couples were instructed to perform PVS and to instill the ejaculate intravaginally. Outcome measures were pregnancy rate per couple, number of live births, total motile sperm count and time to pregnancies.

RESULTS

Median total motile sperm count was 29 million (range, 1-92 million). In all, 60 of the 140 couples (43% pregnancy rate) achieved 82 pregnancies. Seventy-two of the pregnancies resulted in live births with the delivery of 73 healthy babies. Median time to first pregnancy was 22.8 months (6.0-98.4). No complications were reported.

CONCLUSION

PVS combined with vaginal self-insemination may be performed as a viable, inexpensive option for assisted conception in couples in whom the SCI male partner has an adequate total motile sperm count and the female partner is healthy.