Objective: To determine the preferred technique for surgical sperm retrieval from an-ejaculatory males with spinal injury requiring assisted reproduction.
Design: A case study with literature review.
Setting: PIVET Medical Centre, a private facility providing comprehensive services over 38 years in gynaecology, andrology and reproductive endocrinology for infertility and recurrent pregnancy loss.
Patients: Case report of a couple where the 34-year old male is paraplegic from a complete T12 spinal lesion occurring at age 27 years from a skiing accident. He remained an-ejaculatory despite conservative treatments. This case is examined in the setting of extensive experience by the 3 authors ranging 20-40 years in managing spinal-injured males.
Intervention: Applying microsurgical techniques, open scrotal sperm recovery from the Vas, the epididymis and the testis undertaken.
Main outcome measure: Details of sperm recovery, sperm cryopreservation, subsequent IVF and resultant pregnancies. Best sperm samples from Vasal Flush.
Results: Conception 4 months after following a single blastocyst transfer where fertilization was achieved using sperm retrieved from the Vasal Flush technique. The resultant pregnancy was entirely normal and a healthy male was delivered from spontaneous vaginal delivery with birth weight 3600g.
Conclusion: The Vasal Flush technique provided the best sperm samples and is recommended for an-ejaculatory males regardless of the underlying disorder. The technique can be performed as an isolated minimally invasive surgical method of sperm retrieval, potentially under local anaesthesia