Fertility Preservation Technique May Be Effective for Wounded Warriors

Seminal vesicle sperm aspiration (SVSA) could be an effective method to retrieve viable sperm for freezing and storage in wounded warriors, according to research presented at the American Society for Reproductive Medicine (ASRM) Annual Meeting.

Blast injuries to the lower extremities, pelvis, and perineum caused by improvised explosive devices (IEDs) have increased on the battlefield. The damage from the blasts and the timing of medical care limits the ability to retrieve sperm in men who wish to preserve it.

Researchers from Walter Reed National Military Medical Center assessed the type of pelvic injuries seen in these warriors and used SVSA, which was developed to address ejaculatory duct obstructions or the inability to ejaculate, to retrieve sperm.

“SVSA is a reasonable option to retrieve sperm in wounded warriors or in trauma patients with pelvic or perineal injuries,” Rebecca Sokol, MD, MPH, president of ASRM, said in a press release. 

“Tragically, an increasing number of our wounded service members have experienced these types of trauma. It is encouraging to know this sperm retrieval process is being offered to this patient population and holds promise for them.”

The researchers evaluated data from 6 patients with lower extremity, pelvic, and perineal injuries from IEDs who underwent SVSA within 5 to 12 days of the injury at the Walter Reed National Military Medical Center from 2012 to 2014. 

They analyzed patient age, date and type of injury, date of SVSA, fertilization rates, and live birth outcomes. The sperm samples were washed and cryopreserved. 

Results showed that 2 participants who underwent SVSA at 5 and 9 days after their initial injuries had in vitro fertilization with intra-cytoplasmic sperm injection (IVF/ICSI) cycles performed on the frozen samples.

For the first couple, 13 mature eggs were underwent ICSI with normal sperm that responded to a touch test with a fertilization rate of 38%. On the fourth day, 1 grade V embryo was transferred with a negative pregnancy test.

The second couple underwent 2 IVF/ICSI cycles. The first cycle had 4 sperm respond to pentoxifylline and 5 sperm that responded to the touch test for a 44% fertilization rate. On the fifth day, one blastocyst was transferred with a negative pregnancy test. In the second cycle, 8 of 17 mature eggs underwent ICSI with sperm that responded to pentoxifylline, yielding a 47% fertilization rate, with 2 blastocysts frozen.

With an overall fertilization rate of 43.5% for 3 cycles, SVSA may be an effective method for retrieving sperm for wounded warriors or trauma patients with pelvic or perineal injury, the researchers concluded.

Reference

1. Healy MW, Yauger B, James AN, Dean R. Abstract O-25. Seminal Vesicle Sperm Aspiration from Wounded Warriors: A Case Series. Presented at: ASRM Annual Meeting; Oct. 17-21, 2015; Baltimore.