Urologist Questions Spina Bifida

Is fertility reduced with spina bifida?

My husband has spina bifida and we have been discussing starting a family. Will his condition affect our odds?

21 Answers

To your husband: Have a spermogramme and assess.
Most men with SB are fertile and can successfully become fathers. Even is sexual dysfunction is present, as long as his sperm count is normal, you can achieve pregnancy
No not as bad as electrical cautery or laser treatment ask your doctor to use some lidocaine gel the numb the area
Fertility may be affected depending upon what level the spina bifida is affecting. For low-level lesions (lower lumbar and sacral), fertility may be fine. For higher level lesions, fertility may be significantly reduced, secondary to sperm production problems. I was happy to see your question since I was involved in one of the first studies to demonstrate this and there have been only a few since that time. So, it may or may not be affected, as it depends on the neurological defect level.

Dr. Robert Oates
Spina Bifida is a congenital problem associated with mechanical and anatomic issues that can make sexual function difficult. Some men can have erections, but will have difficulty ejaculating. However, there is no evidence that Spina Bifida affects the ability to produce sperm. Most couples with a partner with Spina Bifida will be able to be parents, some may need help if there are mechanical problems having sexual intercourse.
Nope. Spina bifida occulta has nothing to do with infertility as per the texts and I've never seen so in my experience as well.
A qualified NO to your question. Physically, a man's performance with spina bifida may be inhibited in sex. If an erection can occur and ejaculation happens it opens up a couple options for you. For example, if an erection can't occur, then one must rely on ejaculation through manipulation of the penis. By collection of normal semen when intercourse is not possible it can be then used for artificial insemination of you by the doctor's protocol. Spinal cord problems of your partner does not rule out attaining a pregnancy. You see, there are many medical issues associated with spina bifida that can only be discovered by working with specialists in infertility who can examine, diagnose, and discuss options for you.
Unfortunately, the risk of neural tube defect is increased in children of your husband. But there are available diagnostic tests that can be performed during your pregnancy to diagnose the condition in the fetus during the second trimester.
Not something I have encountered, but if he is able to make sperm, then should not be a problem. Recommend consultation with Reproductive specialist and maybe a semen analysis. However, you can just start with using a menstrual calendar and having regular intercourse during your fertile days and try for at least 6 months prior to going for an evaluation.
Can be, depending on severity.
It can, but may not necessarily, affect fertility. If you are under 35 with regular periods and he has normal ejaculation, I would trying for 1 year, then if no luck check in with an expert for both partners. Remember, intimacy every other day during the week of ovulation. Over the counter ovulation monitoring can be a big help
It should not unless he has other associated issues.
Fertility of a man is from his sperm making. The nerves of the spine affected may affect organs concerned but the way to check out the fertility is through his semenanalysis.
If the count and all tests done are normal then check the wife's fertility.
Yes it can, I will go to a MFM and have preconceptional counseling before getting pregnant.
Possibly, but the answer depends on the degree of function he has. If he requires aspiration of sperm from the epididymis or testes, then IVF with sperm injection will be required. These cases have very high success rates depending on the fertility of the female partner. You will want to receive counseling and testing from a certified fertility expert.
Spina bifida should not have any affect on your husband's fertility.
It shouldn't, unless it's severe enough to cause neurologic problems which could manifest as erectile dysfunction.
We do not know exactly what causes spina bifida, but we know that it is linked to folic acid and possibly other B vitamin deficiencies. The risk of spina bifida is very low, 1 in 1000 to 1 in 5000, however it is higher if a family member had spina bifida, as high as 1 in 25 (4%). The mother needs to take folic acid for 12 weeks before conception to help prevent spina bifida in the baby. Also testing the homocysteine levels, and if elevated, testing for the MTHFR gene in the mother can tell you whether the mother-to-be needs to take folate instead of folic acid.

Good luck!
Yes, ejaculation will be affected.
Congratulations, open discussion is the first step!

It would effect him only in his ability to have sex and ejaculate. If that is not a problem for him, then I do not suspect there would be a problem in achieving a pregnancy. There may be other genetic components that I am not aware of for your husband and can be questioned during a preconception counseling or fertility appointment. But as long as both of you are under the age of 30, then it would be fair to give it a year of attempting a pregnancy on your own. Open neural tube defect are usually multi-factorial and may not be reoccurring.

Best wishes and congratulations on starting your family.