Evaluation of sperm morphology of electroejaculates of spinal cord-injured men by strict criteria

Objective: To compare sperm morphology of electrostimulated ejaculates of spinal cord-injured (SCI) men with that of manual ejaculates of an able-bodied population. Design: Retrospective study. Patients: Spinal cord-injured men (n = 21) participating in a reproductive rehabilitation program and able-bodied men (n = 163) attending a male fertility clinic. Setting: Male fertility clinic of a university urology practice. Main Outcome Measures: Morphological characteristics of sperm evaluated by strict criteria. Results: Electroejaculates of SCI men had significantly higher percentages of small sperm heads, vacuolated sperm heads, and sperm with tail defects than found in manual ejaculates of able-bodied men. Cellular elements of nongerminal origin (white blood cells, red blood cells, epithelial cells) were also more likely to be present in electroejaculates. Conclusion: When evaluated by strict criteria, electroejaculates exhibit specific defects in sperm morphological profile. A pervasive pattern of teratozoospermia exists that may reflect underlying defects contributing to decreased fertility in SCI men.