Treatment by assisted conception of severe male factor infertility due to spinal cord injury or other neurologic impairment

1995 ◽  
Vol 12 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Nancy L. Brackett ◽  
Mick Abae ◽  
Osvaldo F. Padron ◽  
Charles M. Lynne
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Male Factor Infertility ◽  
Assisted Conception ◽  
Male Factor ◽  
Neurologic Impairment ◽  
Cord Injury

Spinal cord perfusion pressure predicts neurologic recovery in acute spinal cord injury

Neurology ◽  
2017 ◽  
Vol 89 (16) ◽  
pp. 1660-1667 ◽  
Author(s):  
Jordan W. Squair ◽  
Lise M. Bélanger ◽  
Angela Tsang ◽  
Leanna Ritchie ◽  
Jean-Marc Mac-Thiong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Relative Risk ◽  
Perfusion Pressure ◽  
Strong Predictor ◽  
Acute Spinal Cord Injury ◽  
Neurologic Outcome ◽  
Neurologic Recovery ◽  
Neurologic Impairment ◽  
Cord Injury

Objective:To determine whether spinal cord perfusion pressure (SCPP) as measured with a lumbar intrathecal catheter is a more predictive measure of neurologic outcome than the conventionally measured mean arterial pressure (MAP).Methods:A total of 92 individuals with acute spinal cord injury were enrolled in this multicenter prospective observational clinical trial. MAP and CSF pressure (CSFP) were monitored during the first week postinjury. Neurologic impairment was assessed at baseline and at 6 months postinjury. We used logistic regression, systematic iterations of relative risk, and Cox proportional hazard models to examine hemodynamic patterns commensurate with neurologic outcome.Results:We found that SCPP (odds ratio 1.039, p = 0.002) is independently associated with positive neurologic recovery. The relative risk for not recovering neurologic function continually increased as individuals were exposed to SCPP below 50 mm Hg. Individuals who improved in neurologic grade dropped below SCPP of 50 mm Hg fewer times than those who did not improve (p = 0.012). This effect was not observed for MAP or CSFP. Those who were exposed to SCPP below 50 mm Hg were less likely to improve from their baseline neurologic impairment grade (p = 0.0056).Conclusions:We demonstrate that maintaining SCPP above 50 mm Hg is a strong predictor of improved neurologic recovery following spinal cord injury. This suggests that SCPP (the difference between MAP and CSFP) can provide useful information to guide the hemodynamic management of patients with acute spinal cord injury.

scholarly journals Multivariate Analysis of MRI Biomarkers for Predicting Neurologic Impairment in Cervical Spinal Cord Injury

2016 ◽  
Vol 38 (3) ◽  
pp. 648-655 ◽  
Author(s):  
J. Haefeli ◽  
M.C. Mabray ◽  
W.D. Whetstone ◽  
S.S. Dhall ◽  
J.Z. Pan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Multivariate Analysis ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Neurologic Impairment ◽  
Cord Injury

Parathyroid hormone suppression in spinal cord injury patients is associated with the degree of neurologic impairment and not the level of injury

1997 ◽  
Vol 78 (7) ◽  
pp. 692-696 ◽  
Author(s):  
Jeffrey L Mechanick ◽  
Ferne Pomerantz ◽  
Steven Flanagan ◽  
Adam Stein ◽  
Wayne A. Gordon ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Parathyroid Hormone ◽  
Neurologic Impairment ◽  
Cord Injury

scholarly journals Infertility in Men with Spinal Cord Injury: Research and Treatment

Scientifica ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Nancy L. Brackett
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Erectile Dysfunction ◽  
Pregnancy Outcomes ◽  
Semen Quality ◽  
Sperm Concentration ◽  
Toxic Substances ◽  
Male Factor ◽  
Sperm Retrieval ◽  
Cord Injury

Spinal cord injury (SCI) occurs most often to young men. Following SCI, most men are infertile due to a combination of erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Erectile dysfunction may be treated by the same therapies that are used in the general population. Similarly, the same treatments that are effective to assist conception in couples with non-SCI male factor patients are effective in assisting conception in SCI male-factor patients. The most apparent differences in male-factor symptoms between SCI and non-SCI patients are the high occurrences of anejaculation and atypical semen profiles in men with SCI. Methods available to assist ejaculation in men with SCI include penile vibratory stimulation and EEJ. Use of surgical sperm retrieval as the first line of treatment for anejaculation in men with SCI is controversial. Most men with SCI have a unique semen profile characterized by normal sperm concentration, but abnormally low sperm motility. Toxic substances in the semen contribute to this problem. Despite impaired sperm parameters, pregnancy outcomes using sperm from men with SCI are similar to pregnancy outcomes using sperm from non-SCI men. Future studies should focus on improving natural ejaculation and improving semen quality in these men.

scholarly journals Male factor of infertility in spinal cord injury

2021 ◽  
Vol 22 (4) ◽  
pp. 22-26
Author(s):  
M. N. Korshunov ◽  
M. V. Sonina ◽  
Z. A. Kadyrov ◽  
E. S. Korshunova ◽  
R. V. Salyukov
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Assisted Reproductive Technologies ◽  
Intrauterine Insemination ◽  
Reproductive Technologies ◽  
Male Factor ◽  
Female Reproductive Health ◽  
Standard Procedures ◽  
Cord Injury ◽  
Fertility Disorders

Currently, traumatic spinal cord injury disease is a common problem in men of sexual and reproductive active age. The result may be disturbance of erectile and ejaculatory functions, which often leads to inability of natural conception. Vibrostimulation, electrical stimulation or surgical sperm extraction, intrauterine insemination procedures and assisted reproductive technologies are the standard procedures in the treatment of fertility disorders in men with spinal cord injury and dysejaculation. The effectiveness of the techniques directly depends on the quality of sperm and the female reproductive health. Currently, the potential mechanisms of the disorders of spermatogenesis in patients with spinal cord injury are not clearly learned. The literature review of sexual dysfunction and pathogenetic aspects of pathospermia in men with spinal cord injury is provided.

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