A Guide and Resource Directory to Male Fertility Following Spinal Cord Injury/Dysfunction

By Maria J. Amador, B.S.N., CRRNCharles M. Lynne, M.D.Nancy L. Brackett, Ph.D., HCLD

A publication funded by the Paralyzed Veterans of American Spinal Cord Injury Education and Training Foundation+


In the United States, there are 8,000 to 10,000 spinal cord injuries that occur each year. The majority of these injuries happen to men between the ages of 16 and 45 – typically the reproductive years. Many men with spinal cord injury/dysfunction (SCI/D) experience fertility problems related to their injury and want to know if they can become biological fathers.

There are two main problems men with SCI/D face when considering biological fatherhood. First, there is the medical condition called anejaculation which occurs in ninety percent of men with SCI/D. Anejaculation is the inability to ejaculate during sexual intercourse. A pregnancy is unlikely to happen during sexual intercourse if ejaculation does not occur.

The other problem that men with SCI/D face when considering biological fatherhood is poor semen quality. Scientists have learned that men with SCI/D make normal numbers of sperm, however, most of the sperm in the ejaculate are not moving. The average percent of motile (moving) sperm in semen samples from men with SCI/D is 20% compared to 70% in able-bodied men. Pregnancy is less likely with a low number of motile sperm in the ejaculate. This may explain why few men with SCI/D have fathered children through sexual intercourse.

While anejaculation and poor semen quality are obstacles to men with SCI/D who wish to achieve biological fatherhood, there are methods available to help accomplish this goal. This guide provides information about changes in sexual function and fertility that may accompany SCI/D, and outlines the options available to deal with such changes. In addition, this booklet includes a directory of clinics and centers that treat couples with infertility secondary to a male partner with SCI/D.