Spinal cord injury (SCI) often results in erectile dysfunction and anejaculation along with impaired semen parameters. Fertility is a major concern in SCI adult males and some fear that the delay post-SCI may negatively affect sperm quality.
We aimed to i) assess semen parameters over time in SCI patients according to age at SCI, time post-SCI, and the SCI level and completeness and ii) measure markers in semen for inflammation (MSI) and marker of oxidative stress (MOS) to investigate their impact on sperm parameters.
A prospective, longitudinal, pilot study over 18 months. Thirty-five men with SCI from 18 to 60 years of age were enrolled. Their mean age was 29.4 ± 6.4 years. Semen retrieval was scheduled every six months, allowing analysis of four ejaculates, in association with measurement of granulocyte and seminal plasma elastase concentrations to assess MSI and spermatozoa DNA fragmentation to assess OS.
Based on reference limits, a normal total sperm number, decreased motility and vitality of the spermatozoa, and increased morphological abnormalities were found. Mean round cell and granulocyte concentrations were elevated in the semen. MSI and MOS were elevated in several semen samples compared to reference limits. However, neither the presence of MSI or OS, the completeness or the level of the spinal cord lesion, the age or the time post-SCI, had a negative impact on the semen quality over time.
There was no significant decline in semen quality in SCI patients over time within the limitations of this pilot study. Moreover, a chronic genital inflammatory status was not associated with impairment of semen quality.
The present findings are reassuring for men with SCI and could guide the management of their reproductive ability. According to these preliminary data, not all SCI patients who are able to ejaculate require systematic freezing of their sperm. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.