Saturday, November 1, 2014
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Disability and Sexual Complications

Disability or illness can potentially impact any aspect of a person’s sexuality. Learn what factors can affect sexual function and how to manage them.

My fiance is a paraplegic. He has a c-7 spinal cord injury. We both want children, but we aren't sure if he can have children. I wanted to know if there is anyway to find out if he is able to conceive?

Mitch Tepper at Sexualhealth.com: Thanks for your question. There certainly is a way to find out if you fiance is able to father a child. The first step toward exploring his fertility is to retrieve some sperm. If he is unable to ejaculate through manual stimulation, there are two widely used and accepted methods: electrical and penile vibratory stimulation (PVS).

Electrical stimulation, otherwise known as electroejaculation stimulation (EES), is usually performed under anesthesia in a hospital setting or clinic. An electric probe is inserted into the rectum to stimulate the nerves responsible for controlling emission and ejaculation. Vibratory stimulation--applying a vibrator to the penis--is less invasive than electrical stimulation, does not require anesthesia, can be done at home, and often feels good whether you ejaculate or not. In addition, studies at the Miami Project demonstrate better sperm quality in samples obtained by vibratory stimulation. Although many clinics still use only electrical stimulation because it is more dependable, the American Urological Association recommends vibratory stimulation as the first line of treatment for people with SCI.

Once a sample is obtained, sperm quality should be assessed for several factors: sperm count, motility, morphology, viscosity, volume and ability to penetrate mucus. An average sperm count is about 100 million per milliliter. Motility represents the percentage of sperm that are moving, and at least 50 percent "swimmers" is considered normal. Morphology refers to the shape of the sperm. Typically, only 50 percent to 80 percent are normal, but malformations do not necessarily cause malformations in the fetus. Viscosity is the thickness of the semen. Volume, as opposed to sperm count, measures the total amount of ejaculate and may vary from 1 to 5 milliliters, or about a teaspoon.

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