Male infertility program for ejaculatory dysfunction

Background

Infertility is a common problem among men with neurologically impairing conditions such as spinal cord injury, multiple sclerosis, and diabetes . Among spinal cord injured men, for example, more than 90% are infertile. The major causes of infertility in these groups are poor sperm production and ejaculatory failure.

In the past, little could be done to treat these problems, but in the last two decades important advances have been made that are  directly benefiting men with neurological impairments. One of the most important developments being the application of techniques called Penile Vibratory Stimulation and Rectal Probe Electro stimulation. These procedures safely electrically stimulate nerves causing ejaculation.

The technique was first developed for use in veterinary medicine and has been attempted in spinal cord injured males for more than 40 years. Only recently has the technique being improved sufficiently to promote widespread use and success.

The first report birth in  the United States using electro-ejaculation equipment was during 1987. The first recorded birth in  South Africa achieved by Vitalab was achieved in 1994. Since then numerous births have been recorded.

This fertility programme at Vitalab is offered to men with neurological impairments who wish to father children or to determine whether they might be able to father children in the future.

This programme, currently one of the few offered in South Africa is open to men with:

    spinal cord injury

                multiple sclerosis

                diabetes

                spina bifida

                testicular cancer/retroperitoneal lymph node dissection (RPLND)

                other neurological impairments

The programme

Fertility evaluation is conducted at Vitalab on an outpatient basis. Participation begins with an educational overview of the procedure, and a comprehensive assessment and includes a medical and physical examination, psychosocial evaluation, and blood testing.

On subsequent visits, the electro stimulation procedure is performed to assess and improve fertility potential. Generally, between four and six 30 minute  visits are needed to produce optimal results.

Electro-emulation is a simple procedure that involves inserting a specially designed probe into the rectum adjacent prostate gland. Using a low level current, electrical stimulation is applied to the tissues and nerves adjacent to the prostate and seminal vesicles, often resulting in ejaculation. Sometimes electro ejaculation is ineffective in inducing ejaculation on the first attempt, and in approximately 10% of spinal cord injured men, ejaculation does not occur at all. Vibratory stimulation, whereby a handheld vibrator is brought into contact with the penis, may be attempted alone or in combination with other techniques.

Of note, sperm may not be of sufficient quality to perform artificial insemination. Vitalab in conjunction with their laboratory is equipped to perform IVF and ICSI as a backup to help these couples conceive.

Financial arrangements

All programme services are provided on a fee for service basis.

For further information please call +27 (0) 11 911 4700 to arrange an appointment.