A 30-year-old male with T6 AIS A SCI asks about his ability to father children. Which statement is MOST accurate?

A 30-year-old male with T6 AIS A SCI asks about his ability to father children. Which statement is MOST accurate?

• A. All males with SCI are permanently infertile
• B. Only 6%-8% of males with SCI can ejaculate; those who can often have low sperm count and motility, and artificial reproductive technology may be needed
• C. Male fertility is not affected by spinal cord injury
• D. Fertility returns to normal within 1 year of injury

Answer: (B)

Fertility after spinal cord injury hinges on how ejaculation and semen are controlled. The injury disrupts the neural pathways that coordinate emission, ejaculation, and sperm transport. While some men with SCI can still ejaculate, it’s a relatively small proportion, and even when ejaculation occurs the semen often has low sperm count and reduced motility, making natural conception unlikely. In these cases, assisted reproductive technologies (ART) such as electroejaculation or vibratory stimulation to obtain semen, followed by IVF or ICSI, are commonly used to achieve pregnancy. Therefore the statement describing a small number who can ejaculate, with often reduced sperm quality and the likely need for ART, is the most accurate. The other ideas—that all men with SCI become infertile, that fertility is unaffected, or that fertility returns to normal within a year—don’t fit this pattern.

Fertility after spinal cord injury hinges on how ejaculation and semen are controlled. The injury disrupts the neural pathways that coordinate emission, ejaculation, and sperm transport. While some men with SCI can still ejaculate, it’s a relatively small proportion, and even when ejaculation occurs the semen often has low sperm count and reduced motility, making natural conception unlikely. In these cases, assisted reproductive technologies (ART) such as electroejaculation or vibratory stimulation to obtain semen, followed by IVF or ICSI, are commonly used to achieve pregnancy. Therefore the statement describing a small number who can ejaculate, with often reduced sperm quality and the likely need for ART, is the most accurate. The other ideas—that all men with SCI become infertile, that fertility is unaffected, or that fertility returns to normal within a year—don’t fit this pattern.