Necrospermia and chronic spinal cord injury

Objective: To determine whether improvement in quality of semen over 3 consecutive days of electroejaculation in men with chronic spinal cord injury (SCI) was consistent with epididymal necrospermia. Design: Prospective study of a random sample of men with SCI. Setting: A southeastern Australian SCI management center in collaboration with the specialist andrology service of a university-based department of obstetrics and gynecology in a tertiary referral hospital. Patient(s): Nine men with chronic spinal cord injury. Intervention(s): Semen samples were obtained by using electroejaculation, and testicular biopsy samples were obtained by using fine-needle tissue aspiration. Main Outcome Measure(s): Semen analysis was performed according to World Health Organization criteria. Testicular biopsy and electron microscopy were done by using standard techniques. Result(s): During up to 3 days of consecutive-day electroejaculation, sperm motility and viability in semen obtained from men with chronic SCI increased by an average of 23% on days 2 and 3. The severity of the degenerative changes and the numbers of spermatozoa affected on day 1 became less marked by day 4, The changes were not present in late spermatids obtained from testicular biopsies. Conclusion(s): The asthenospermia of chronic SCI is similar to epididymal necrospermia and can be improved by consecutive-day electroejaculation. (C) 2000 by American Society for Reproductive Medicine.