Paralyzed Men Given Hope of Fatherhood

Paralyzed from the breast down in a motorcycle accident when he was 18, Erich Seehafer’s first thought when he regained consciousness was not whether he would walk again but whether he could ever have children.

So it was with more than a little amazement that Seehafer watched a few years ago when his doctors were able, with the help of a procedure called “electro-ejaculation,” to elicit his first semen in years.

“It was pretty wild,” recalled the 37-year-old congressional staffer. “It was kind of validating all I had done over the years, trying to keep healthy, eating well and so forth.”

The procedure used by Seehafer’s doctors at Washington’s National Rehabilitation Hospital is generating considerable interest in rehabilitative medicine because of the hope it may offer to many of the estimated 150,000 Americans with spinal-cord injuries.

Burning Question

“Of the hundreds of patients I have talked to over the years, this is probably the most burning question on their minds: ‘Can I have children?’ ” said Edward A. Eckenhoff, president of the National Rehabilitation Hospital, who himself was paralyzed in an automobile accident 25 years ago.

As recently as five years ago, Eckenhoff said, the answer was no. But as a result of the recent work on electro-ejaculation, that may change.

Electro-ejaculation refers to the insertion of a specially designed probe into the rectum (a procedure that is painless for spinal-cord-injured men, doctors say) and the generation of a mild electric current to injured nerves located in the prostate area.

Usually such stimulation would arise from the brain, but in a person with damaged nerves in the spinal column, normal signals can’t get through. The mild electrical stimulation, however, can sometimes allow erection and ejaculation of semen to occur within a few minutes. The resulting sperm is then available for insemination or to fertilize an egg in a petri dish.

The procedure, used sporadically and without much success in humans since the 1940s, is common in animal husbandry.

“This was (developed) for the benefit of animals,” said Stephen W. J. Seager, one of Seehafer’s doctors, “and it is just a secondary thing that humans will benefit.”

Seager is a specialist in veterinary medicine who has crisscrossed the world to obtain sperm from gorillas, giant pandas and other endangered species for use in artificial insemination of such animals.

Now Seager and his NRH colleague, Lauro S. Halstead, along with a few other experts around the country, are looking to use in humans the electro-ejaculation techniques that were perfected in animals. So far, the results appear encouraging, they said.

A handful of pregnancies were obtained through electro-ejaculation in England in the early 1980s, but the first pregnancy in the United States was not until 1986 at the University of Michigan. Since then, there have been 25 pregnancies, including 18 live births, according to Carol J. Bennett, a urologist at USC.

Bennett says the procedure is promising not only because of the demonstrated results in obtaining pregnancy, but also because of the general progress in other areas of reproductive technology.

At the University of Michigan, where she previously worked, Bennett said, researchers obtained sperm in 70% of the men with spinal-cord injuries who were receiving treatment. In nearly half of those cases, a pregnancy resulted from the sperm obtained through electro-ejaculation.

Seager and Halstead began working together on the procedure when they were in Texas several years ago--Seager at Texas A&M; University and Halstead at Baylor College of Medicine. Halstead arrived in Washington in 1986 and persuaded his friend to join him last year at the National Rehabilitation Hospital, where they established a fertility clinic for men with spinal-cord injuries.

‘Trial and Error’

The two make an unlikely pair: Halstead, a soft-spoken rehabilitation specialist, plays the straight man to Seager, a wise-cracking native of Ireland. Asked to explain his “technique,” Seager says, “A lot of it is by trial and error. . . . You don’t get an anatomy sketch of a giant panda and know where to probe.”

So far, the two doctors have seen about 30 patients at National Rehabilitation Hospital. No pregnancies have been reported from their efforts, although there were a couple of “near misses,” according to Seager.

“We don’t get ejaculation in everybody,” added Halstead. “In about 80% of the men, we get ejaculations.” But before the use of this technique, virtually none of these patients were able to ejaculate.

Infertility experts cautioned that electro-ejaculation is not a panacea. Often, men with spinal-cord injuries have fertility problems beyond an inability to ejaculate, according to Maria Bustillo of the Genetics & IVF Institute in Fairfax, Va., where in-vitro fertilization is done. For instance, the sperm generated can be of poor quality and not suitable for insemination.

There can also be complicating infertility problems in women. The Seehafers have fertilized “more than a few eggs” over the past three years, according to Seehafer’s wife, Terry. But they have been unable to have a pregnancy, despite the use of a variety of advanced reproductive techniques, including in-vitro fertilization.