Ejaculation may also be impaired in young, fertile men who have undergone testicular cancer surgery or colon surgery and men with nerve diseases, like multiple sclerosis and diabetes. However, they would require general anesthesia before undergoing electroejaculation, according to Dr. Lerner.
The MacDonalds began their quest for parenthood by seeking the help of of Dr. Allan Levine, a University of Maryland Medical Center orthopedist. Dr. Levine had followed Mr. MacDonald's case all the way from the Maryland Shock Trauma Center, where Mr. MacDonald was treated after his accident.
"Brenda had clipped an article on electroejaculation therapy that was being offered in Chicago. So we knew that it was possible," said Mr. MacDonald. "Levine led me to Lerner. I was his second patient, but the first to become a father."
Since Dr. Lerner has been doing electroejaculation therapy, he has had 12 patients. The wives of two of these patients are expected to be artificially inseminated soon, he said.
His patients undergo electroejaculation once a month for up to six months. It usually takes at least four stimulations to get the healthy sperm needed for fertilization. Since sperm in spinal-cord injury patients lies dormant for a number of years due to ejaculatory failure, the sperm initially released may be infected and inadequate in number.
Dr. Lerner charges about $575 for each stimulation, so the bill for the electroejaculation alone could cost more than $3,400. In addition, a couple would have to pay separate artificial insemination costs and any laboratory fees, which could add up to another $2,000.
"I'm not interested in getting wealthy by doing this procedure," said Dr. Lerner. "I'm interested in helping people have families. Since this is a new procedure and since perhaps only one or two insurance carriers are reimbursing for it, we are willing to work things out with our patients.
"We are not about to put a financial burden on these families who already are fiscally strained," he said.
As of Jan. 1, Blue Cross-Blue Shield of Maryland has said it will cover electroejaculation, Dr. Lerner said, but the extent of the coverage will probably depend on an individual's policy.