The reproductive function of spinal cord injured males is not the primary concern of health professionals responsible for the management of these young adults. However, the fertility of these patients is threatened right from the first days after trauma, as indicated by abnormalities of the sperm count, reflecting the histological alterations observed on testicular biopsy. The factors predisposing to asthenoteratospermia, responsible for impaired fertility, are analysed and discussed. Urinary tract infection is the leading factor. This acute situation must be managed early, by preventing urinary tract infection and by obtaining a semen donation as soon as possible, after improvement of the general status.