Despite the belief that people who suffer an SCI can’t have children, it is possible for both men and women with SCIs to have children post-injury
Fertility refers to the ability to conceive children. Until the 1990s, it was generally thought that it was nearly impossible for an individual with an SCI to become a parent, especially through intercourse.
Apart from a cessation of the menstrual period for three to six months post-injury, SCI has no direct effect on female fertility. For males it is a little more complicated, but in the past few decades the prospects have improved significantly.
SCI affects a man’s ability to achieve an erection and ejaculation. The sperm count in the ejaculate is also reduced. As the ejaculate contains more than just sperm, the volume of the ejaculate is not necessarily proportionate to the number of sperm. Often there are a number of challenges that impair fertility in 90 to 95 percent of men with SCI.
However, due to medical advances in the field of assisted reproduction over the past few decades, many of these problems have been overcome. Since these advances, about 80 percent of all men with an SCI have the potential to become biological fathers.
There are numerous methods to obtaining sperm without ejaculation; the methods for artificial insemination have improved. Men with an SCI have roughly the same chance of becoming a biological father as do the rest of the male population.
The first option is the do-it-yourself method, where the male attempts to increase his sperm count. Medication or a vacuum pump can be used to assist in getting an erection. During the orgasmic phase, a vibrator is placed under the penis to assist the ejaculation of more sperm and thus increase the likelihood of conception.
Vibratory stimulation is the most cost-effective and convenient method, and should be the first method that a couple attempts.
The second option is medical intervention. If the method with the vibrator doesn’t work, there are other more expensive and invasive methods. A consultation with a urologist or fertility expert is recommended to do the necessary tests and find the option that fits your unique situation best.
Electro-ejaculation and a punch biopsy are two popular options. In electro-ejaculation a long instrument is placed adjacent to the prostate and electrical stimulation causes the hypogastric nerve to trigger ejaculation.
In a punch biopsy, a sample of testicular tissue is surgically removed and used to harvest sperm microscopically. Sperm can also be withdrawn from the vas deferens with a thin needle.
The next step is usually in vitro fertilisation, during which an egg is fertilised in a test tube and reinserted into the woman’s uterus. There is also a modern type of in vitro fertilisation called intracytoplasmic sperm injection, where the sperm is injected directly into the egg. The aim is ultimately to make it as easy as possible for the sperm to fertilise the egg.
Danie Breedt is a passionate scholar-practitioner in the field of psychology. He divides his time between training future psychologists, research and clinical practice. Danie works from an integrative interactional approach in therapy dealing with a wide range of emotional difficulties. He is currently working as a psychologist at numerous physical rehabilitation hospitals across Gauteng for Charis Psychological Services where he does supportive counselling as well as sexual education for patients with disabilities. Column courtesy of Charis Psychological Services.