- Anooshirvan Kazemnejad
 - - Department of Biostatistics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Soraya Khafri
- - Department of Biostatistics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Mansoureh Movahedin
- - Anatomy Department, Faculty of Medical Sciences, Tarbiyat Modares University, Tehran, Iran
- Mohammad Reza Noroozi
- - Department of Urology, Emam Khomeini Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Seyyed Mehdi Hashemi
- - Department of Social Medicine, Semnan University of Medical Siences, Semnan, Iran
Received: 7/1/2004 Accepted: 7/1/2004 - Publisher : Avicenna Research Institute |
|
| Related Articles |
|
| Other Format |
|
|
|
Abstract
Introduction: Physicians and gynecologists have always attempted to treat the infertility problems of infertile couples. Spinal cord injuries above pelvic region affect male reproductive system and may cause infertility. Iran has one of the most common spinal cord injuries due to the recent war. Unsuccessful treatment of infertile war victims may cause psychological and other problems and it is thus, needed to identify the effect of different factors on successful infertility treatments. Materials and Methods: In this retrospective study, data from 381 infertile couples with male impotency due to spinal cord injury who referred to Koassar Fertility and Impotency Center in Tehran during 2000 till mid 2002, were collected. The data were observed with regard to Urology, Gynecology, and Laboratory for each treatment cycle and period by the professional staff. All the medical terms were recorded to be used in SPSS. Chi-square and multiple logistic regression analysis were used to analyze known predictors of pregnancy and psychological factors and their relationship with treatment outcome. Results: A significant relationship was observed between successful outcome of ICSI: (pregnancy) with infertility duration (P=0.049), percent of injury (P=0.018), type of catheter used (P=0.021), abnormal sperm parameters (P=0.001) and type of infertility (male factor, female factor and unexplained) (P=0.025). Conclusion: Despite the sperm count in spinal cord injured is similar to that in normal men, their sperm motility and morphology is significantly reduced and thus, their infertility treatment success rate is low. The study also showed that the success rate of treatment with ART techniques reduced with duration of infertility.
Keywords:
ICSI, Spinal cord injury, Infertility, Sperm motility, Assisted Reproductive Techniques To cite this article:References
- Kaufmann S.J. The application of neural networks in predicting the outcome of in-vitro fertilization. Hum Reprod.1997;12(7):1454-57.
- Bannister L.H., Berry M.M., et al. Gray’s Anatomy, Published by Churchill Livingstone, 1995;PP:38.
- Bors E., Commar A.E. Neurological disturban- ces of sexual function with special refrence to 529 patients with spinal cord injury. Urol Surv.1960; 10:191.
- Kolettis P.N., Lambert M.C., et al. Fertility outcomes after electroejaculation in men with spinal cord injury. Fertil Steril.2002;78(2):429-31.
- Momose H., Hirao Y., Yamamoto M., Yamada K., Okajima E. Electeroejaculation in patients with spinal cord injury: first report of a largescale experience from Japan. Int J Urol.1995;2:326-9.
- Wang Y.H., Chiang H.S., Wu CH., Lien I.N. Electroejaculation in spinal cord injured males. J Formos Med Assoc.1992;91(4):413-8.
- Bonne T.B., Kim E.D., Kim Y., et al. Erectile dysfunction & fertility, Technical aspects & clini-cal implications. Adv Rehabi Tech.1997;11:161.
- Beretta G., Chelo E., Zanollo A. Reproductive aspects in spinal cord injured males. Paraplegia. 1989;27(2):113-8.
- Ohi D.A., Denil J., et al. Fertility of spinal cord injured males: effect of genitouinary infection and bladder management on results of electroejacula-tion. J Am Paraplegia Soc.1992;15(2):53-9.
- Ver Voort S.M. Infertility in spinal cord injur-ed male. Urology.1987;29(2):157-65.
- Heruti R.J., Katz H., et al. Treatment of male infertility due to spinal cord injury using rectal probe electroejaculation: the Israeili experience. Spinal Cord.2001;39(3):168-75.
- Brackett N.L., Santa-Cruz C., Lynne C.M. Sperm from spinal cord injured men lose motility faster than sperm from normal men: the effect is exacerbated at body compared to room tempratu-re.J Urol.1997;157(6):2150-3.
- Barros A., Sousa M., Andrade M.J., Oliveira C., Silva J., Beires J. Birth after electroejaculation coupled to intracytoplasmic sperm injection in a gunshot spinal cord injured man. Arch Androl. 1998;41(1):5-9.
- Smeek J.M.J., et al. The effect of anxiety and depression on the outcome of in-vito Fertilization. Hum Reprod.2001;16(7):1420-23.
- Nancy L.B., Carlos S.C., Charles M.L. Sperm from spinal cord injured men lose motility faster than sperm from normal men: the effect is exacer-bated at body compared to room temprature. J Urol.1997; 152:2150-3.
- مـوحدين منصـوره و همكاران. روشـهاي عملـي و كنترل كيفيت در آزمايشگاه جنين شناسي انساني. چاپ اول، پايگان، تهران سال 1381، صفحه 8.
- Maduro M.R., Lamb D.J. Understanding new genetics of male infertility. Urology.2002;168(5): 2197-205.
- فروتن سيدكاظم و همكاران. بررسي آستنواسپرمي در اسپرمهاي بدست آمده به روش الكترواجاكولاسيون در جانبازان نخاعي جنگ تحميلي مراجعه كننده به مركز درمان ناباروري كوثر تهران (77-1372). دو ماهنامه علمي- پژوهشي دانشور، دانشگاه شاهد، سال 9 (1381)، شماره 38، صفحات: 44-41.
- حسيني سيدجليل، شافي حميد، كريميان ايلي. مقايسه ميزان لقاح و حاملگي روشهاي اخذ اسپرم از اپيديدم و بيضهTESE, MESA, PESA در بيماران آزواسپرمي تحت درمان ميكرواينجكشن. چكيده مقالات نهمين كنگره باروري وناباروري ايران(1380)، صفحه 191.
- John D., Dona A., Alan C.M., Laura M.K., Marcianna M. Functional characteristics of sperm obtained by elactroejaculation. J Urol.1992;147: 69-72.
- Sonksen J. Penile vibratory stimulation and electroejaculation in the treatment of ejaculatory dysfunction. Int J And.2002;25(6):324.
- Komiya A., Sato K., Ishidoh T., Tanaka K., Tomoda T. Clinical results of infertility treatment to male patients with spinal cord injury. Hinyokika Kiyo.2004;50(1):21-3.
- Naderi A.R., Safarinejad M.R., Endocrine pro-files and semen quality in spinal cord injured men. Clin Endocrinol.2003:58(2):177-84.
- Linsenmeyer T.A., Perkash I. Infertility in men with spinal cord injury. Arch Phys Med Rehabil.1991;72(10):747-54.
- Yamamoto M., Yamada K., Hirayama A., et al. Electroejaculation and assisted reproductive techniques in the patients with spinal cord injury, Nippon Hinyokika Gakkai Zasshi.1997;88(3):
- Sonksen J., Sommer P., Biering-Sorensen F., et al. Pregnancy after assisted ejaculation proce- dures in men with spinal cord injury. Arch Phys Med Rehabil.1997;78(10):1059-61.
- Templeton A., Morris J.K., Parslow W. Factors that affect outcome of in-vitro fertilization treatment. Lancet.1996;348:1402-6.