Comparison of intracytoplasmic sperm injection outcomes in men with spinal cord injury using sperm retrieved by electroejaculation and testicular sperm extraction methods: A retrospective cohort study

Saeid Haghdani, Haghdani S, Vahidi S, Serajoddin Vahidi, Sadeghi A, Ali Sadeghi, Narges Gholami Banadkuki, Gholami Banadkuki N
International journal of reproductive biomedicine · 2026 · vol. 24(5) , pp. 413–420 · doi:10.18502/ijrm.v24i5.21290 · PMID:42516821 · PMC13402957
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This retrospective cohort study compared intracytoplasmic sperm injection outcomes in men with spinal cord injury, finding no significant differences in pregnancy or live birth rates between electroejaculation and testicular sperm extraction methods.

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This retrospective cohort study compared intracytoplasmic sperm injection (ICSI) outcomes in 37 men with spinal cord injuries using sperm retrieved via electroejaculation or testicular sperm extraction. The researchers found no statistically significant differences between the two methods regarding chemical pregnancy, clinical pregnancy, and live birth rates when performed under uniform laboratory conditions. Although previous literature suggested potential quality advantages for one method over the other, this data indicates that modern ICSI protocols can mitigate sperm-related issues to achieve similar reproductive success regardless of the retrieval technique used. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

BACKGROUND: Individuals with spinal cord injury (SCI) face fertility concerns due to various causes, such as low sperm quality and ejaculatory dysfunction. Consequently, different sperm retrieval techniques are used for these cases, including testicular sperm extraction (TESE) and electroejaculation (EE). Clinical and neonatal outcomes have been reported inconsistently between these 2 methods. OBJECTIVE: This study aimed to compare the chemical pregnancy, clinical pregnancy, and live birth rate in men with SCI undergoing intracytoplasmic sperm injection using sperm obtained via EE vs. TESE. MATERIALS AND METHODS: This retrospective cohort study was conducted between 2017 and 2023. 37 men with SCI underwent 2 different sperm retrieval techniques. Sperm was retrieved using EE in 18 cycles, while TESE was performed in 36 cycles. Then, chemical, clinical, and live birth rates were reported. RESULTS: Overall, 21 (38.8%) chemical pregnancies were obtained. Moreover, 19 (35.18%) clinical pregnancies were achieved. The live birth rate was 20.3%. No statistically significant differences were observed between the EE and TESE groups in terms of chemical pregnancy (44.4% vs. 36.1%, p = 0.55), clinical pregnancy (33.3% vs. 36.1%, p = 0.89), or live birth rates (22.2% vs. 19.4%, p = 0.81). CONCLUSION: Both retrieval techniques, EE and TESE, can be applicable strategies for intracytoplasmic sperm injection procedures in men with SCI with no discrepancy in pregnancy outcomes.
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S. Haghdani: Conceptualized and designed the study; participated in patient recruitment and clinical data collection; contributed to data analysis and interpretation; and participated in manuscript drafting and revision. S. Vahidi: Conceptualized and designed the study; supervised the project; contributed to data interpretation; and critically revised the manuscript for important intellectual content. A. Sadeghi: Performed the sperm retrieval procedures and provided technical expertise for both EE and TESE; assisted in methodology design and reviewed the manuscript for accuracy and clarity. N. Gholami Banadkuki: Conducted data analysis and statistical evaluation; prepared the initial draft of the manuscript; contributed to literature review and referencing; and assisted in final manuscript editing.

Coi Statement

The authors declare that there is no conflict of interest.

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