Cauda epididymal sperm aspiration as a novel approach for spinal cord injury associated male infertility.

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord Pub Date : 2026-04-29 DOI:10.1038/s41393-026-01208-y

Yuya Makino, Atsushi Tanaka, Youichi Takemoto, Motoi Nagayoshi, Shigeki Fujimoto, Izumi Tanaka

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引用次数: 0

Abstract

Study design: Retrospective cohort study.

Objectives: To evaluate cauda epididymal sperm aspiration (CESA) as a sperm retrieval method for men with spinal cord injury (SCI) related paraplegia who were unable to ejaculate.

Setting: Retrospective observational study conducted at Saint Mother Clinic, a private fertility center in Japan, using data collected from 2010-2023.

Methods: CESA was performed in 69 men with complete lower-body SCI and anejaculation. Men were categorized according to successful or unsuccessful sperm retrieval. Clinical and hormonal characteristics, sperm quality, and ART outcomes were analyzed.

Results: CESA successfully retrieved sperm in 42 men (60.9%). Median FSH was 4.6 mIU/mL in successful cases and 12.9 mIU/mL in unsuccessful cases. FSH was the strongest predictor of successful retrieval, with a receiver operating characteristic-derived cutoff of 5.95 mIU/mL. Among successful cases, median sperm concentration was 32 million/mL and median motility was 56%. Among the 35 men who proceeded to ART after successful CESA, 56 clinical pregnancies and 45 live births were achieved across 146 embryo transfer cycles.

Conclusions: In selected men with SCI who are unable to ejaculate, CESA can retrieve large numbers of highly motile sperm suitable for cryopreservation and repeated ICSI use. By reducing the need for repeated surgical retrievals, CESA may offer a practical and less invasive alternative to testicular sperm extraction.

Trial registration: UMIN000055045, registered July 22, 2024. https: //center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000062867.

查看原文本刊更多论文

附睾尾部精子抽吸作为脊髓损伤相关男性不育症的新方法。

研究设计：回顾性队列研究。目的：探讨附睾尾部精子抽吸（CESA）作为脊髓损伤（SCI）相关截瘫男性不能射精的精子回收方法。背景：在日本私立生育中心Saint Mother Clinic进行回顾性观察研究，使用2010-2023年收集的数据。方法：对69例完全性下半身脊髓损伤伴射精的患者行CESA。根据成功或不成功的精子提取对男性进行分类。分析临床和激素特征、精子质量和ART结果。结果：CESA成功取精42例（60.9%）。成功病例中位FSH为4.6 mIU/mL，不成功病例中位FSH为12.9 mIU/mL。FSH是成功恢复的最强预测因子，接收器工作特性衍生的截止值为5.95 mIU/mL。成功病例中，精子浓度中位数为3200万/mL，活力中位数为56%。在35名在CESA成功后接受ART治疗的男性中，在146个胚胎移植周期中实现了56例临床妊娠和45例活产。结论：在选定的SCI不能射精的男性中，CESA可以检索到大量适合冷冻保存和重复ICSI使用的高运动精子。通过减少重复手术取出的需要，CESA可能为睾丸精子提取提供一种实用且侵入性较小的替代方法。试验注册：UMIN000055045，注册于2024年7月22日。https: / / center6.umin.ac.jp cgi-open-bin / ctr / ctr_view.cgi ? recptno = R000062867。

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来源期刊

Spinal cord 医学-临床神经学

CiteScore

4.50

自引率

9.10%

发文量

142

审稿时长

2 months

期刊介绍： Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews. Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.