Nursing support for testicular sperm aspiration and intracytoplasmic sperm injection in patients with high paraplegia: a retrospective case series.

BACKGROUND

High paraplegia, primarily affecting young men during their reproductive years, often results in ejaculatory dysfunction and infertility. Testicular sperm aspiration (TESA) combined with intracytoplasmic sperm injection (ICSI) offers a viable path to biological parenthood for this population. However, evidence on nursing strategies supporting such procedures is limited. This study aimed to evaluate the clinical and psychosocial outcomes of patients with high paraplegia due to spinal cord injury who underwent TESA-ICSI and explore the effectiveness of specialized nursing interventions.

CASE PRESENTATION

A retrospective case series was conducted on nine male patients with high paraplegia treated at Sir Run Run Shaw Hospital (Zhejiang, China) between January 2021 and October 2023. The mean age of the patients was 31.89 ± 4.83 years, with injury durations ranging from 1 to 13 years. Psychological evaluations using the SAS, SDS, SSRS, and WHOQOL-BREF scales revealed that three patients had anxiety, four had depression, and most had moderate to high social support. The WHOQOL-BREF scores indicated generally good perceived quality of life (score range, 82-91). TESA was performed under local anesthesia, with perioperative nursing measures including bladder management, wound care, and infection prevention. Viable sperm were successfully retrieved in all cases without complications. Eight couples proceeded to ICSI, with viable embryos obtained in all. Six couples achieved pregnancy (66.7%)and live births. One case ended in miscarriage due to trauma, and one couple had no embryos suitable for transfer.

CONCLUSION

Comprehensive nursing interventions, including psychological support, ethical evaluation and procedural adaptations, may facilitate the successful application of TESA-ICSI in men with high paraplegia, highlighting the need for standardized interdisciplinary nursing protocols to optimize fertility outcomes in this underserved population.