Semen Quality in Men Who Sustained a Spinal Cord Injury During the Prepubertal Period

Purpose: There are limited reports regarding the semen quality of men who sustained a spinal cord injury during the prepubertal period. We performed a retrospective chart review of 533 subjects with spinal cord injury to identify those injured during the prepubertal period and to characterize the semen quality of this population. To our knowledge this study is the first to formally evaluate semen parameters in this small but important subgroup of spinal cord injured subjects. Materials and Methods: A retrospective chart review was performed of all spinal cord injured subjects enrolled in the MFRP (Male Fertility Research Program) from 1991 through 2011. Prepubertal subjects were defined as those who sustained a traumatic spinal cord injury at or before the age of 11.9 years. Data collection included neurological level and completeness of injury, sexual responses, hormone profiles and semen quality. Results: Of 533 subjects 7 met the criteria for this study. Age at injury ranged from 4.4 to 11.9 years. Three subjects, injured before age 9 years, were azoospermic. One subject injured at age 10 years had a subnormal total sperm count, while those injured at age 11.9 years had normal total sperm counts, comparable to those of our subjects who sustained spinal cord injuries as adults. In most ejaculates with sperm, sperm motility was subnormal and comparable to that of subjects injured as adults. Conclusions: Spinal cord injury before the age of 9 years appears to interfere with spermatogenesis. In subjects injured near the age of 12 years semen quality in adulthood appears to be similar to that of subjects injured as adults.