Paraplegic men and assisted reproductive technology Paraplegia masculina e procriação medicamente assistida - a nossa experiência

Overview and Aims: Infertility in paraplegic men may be due to an ejaculatory disorder or poor sperm quality. Couples facing this situation still have the opportunity to conceive with the use of methods for assisted ejaculation or testicular sperm extraction in association with assisted reproductive technology (ART). The aim of this study was to evaluate the success of ART in couples with spinal cord injured (SCI) men. Study Design: Retrospective observational study. Population: Fifteen couples with SCI men. Methods: The clinical files of all couples with SCI men submitted to ART between July 2005 and July 2010 were reviewed. The total number of cycles carried out, the sperm retrieval technique, the sperm sample cryopreservation and the pregnancy rate and outcome were analyzed. Results: Fifteen couples with SCI men were submitted to a total of 31 cycles. Fourteen men had SCI due to traumatic cau ses and one due to non-traumatic causes. In 16 cycles sperm was obtained by electroejaculation, in 14 cycles by testicular biopsy and one couple was submitted to a donor sperm program due to azoospermia in the testicular biopsy. Five IVF and 26 ICSI cycles were carried out, 13 with fresh and 18 with cryopreserved sperm samples. Seven of the 15 couples achieved pregnancy (47%), presenting a successful pregnancy rate per cycle of 23% (up to 4 cycles per couple). One twin and 6 sin gleton pregnancies presented with full-term newborns. Conclusion: In most cases, it is possible for paraplegic men to start a family. As shown by our results a high successful pregnancy rate is possible, thanks to the close collaboration between gynecologists, andrologists, embriologists and physiatrists.