Many young men desire to have children after a spinal cord injury but have some difficulty with ejaculation or other chronic urinary tract problems, which may impact their fertility and sperm quality. Careful workups with an experienced urologist will determine the best approach to obtain sperm for use with the female partner. These approaches include vibratory stimulation, electro-ejaculation, and surgical sperm removal.
Depending on the amount and ease of obtaining sperm using these methods, the approach with the female partner may vary. If sperm counts are reasonable and the sperm can be easily obtained, then insemination on a monthly basis may produce pregnancy after one or more attempts. More often, the number of good sperm that can be obtained is limited and the method may be surgical or require anesthesia. In these instances, IVF cycles may be chosen more often than insemination.
Prior to either insemination or IVF, any female partner issues would need to be detected and addressed to increase the chances of pregnancy. These would involve hormonal testing and uterine evaluation.