Abstract
Introduction
Spinal cord injury (SCI) occurs most often to young men
at the peak of their reproductive health. In the United
States, 80% of new injuries occur to men between the ages
of 16 and 45.1 Around the world, similar statistics are
found.2-8 The most common causes of SCI are motor vehicle accidents, violence, sports-related injuries, and falls.1 It
is assumed that more men than women are injured because
men engage in more risk-taking behavior that leads to
injury. The actual cause for the disproportionately high
percent of injured men, however, is unknown. Recent evidence suggests that sex hormones may play a role in this
discrepancy, i.e., that estrogen may be neuroprotective
and/or that testosterone may be neurotoxic after injury.9,10
Following SCI, fertility is severely impaired in men, but
not in women. For example, 90% of men with SCI cannot
father a child via sexual intercourse.11 Women with SCI,
however, can conceive and deliver children with nearly the
same success rate as the general population.12 Reproductive
function is of great importance to men with SCI.13,14
Regaining sexual function has been identified as the highest
priority among individuals with paraplegia.13 Most men
with SCI require medical assistance to father children due to
impairments in erection, ejaculation, and semen quality.15