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Journal Article•DOI•

Posthumous sperm retrieval: analysis of time interval to harvest sperm

Shai Shefi1, Shai Shefi2, Gil Raviv1, Michael L. Eisenberg2, R. Weissenberg1, L. Jalalian2, Jacob Levron1, Gili Band1, Paul J. Turek2, Igael Madgar2, Igael Madgar1 •
Sheba Medical Center1, University of California, San Francisco2
01 Nov 2006-Human Reproduction (Oxford University Press)-Vol. 21, Iss: 11, pp 2890-2893
TL;DR: Viable sperm is obtainable with PSR well after the currently recommended 24-h time interval, and PSR should be considered up to 36 h after death, following appropriate evaluation.
Abstract: BACKGROUND: Current recommendations regarding posthumous sperm retrieval (PSR) are based on a small number of cases. Our purpose was to determine the time interval from death to a successful procedure. METHODS: Seventeen consecutive PSR procedures in 14 deceased and 3 neurologically brain-dead patients at two male infertility centres [Sheba Medical Center (SMC), Tel-Hashomer, Israel and University of California San Francisco (UCSF), San Francisco, CA, USA] were analysed. Main outcome measures were retrieval of vital sperm, pregnancies and births. RESULTS: PSR methods included resection of testis and epididymis (n = 8), en-block excision of testis, epididymis and proximal vas deferens with vasal irrigation (n = 6), electroejaculation (EEJ) (n = 2) and epididymectomy (n = 1). PSR was performed 7.5-36 h after death. Sperm was retrieved in all cases and was motile in 14 cases. In two cases, testicular and epididymal tissues were cryopreserved without sperm evaluation, and in one case, no motility was detected. IVF and ICSI were performed in two cases in which sperm had been retrieved 30 h after death, and both resulted in pregnancies and live births. CONCLUSIONS: Viable sperm is obtainable with PSR well after the currently recommended 24-h time interval. PSR should be considered up to 36 h after death, following appropriate evaluation. No correlation was found between cause of death and chance for successful sperm retrieval.
Citations
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Journal Article•DOI•
Indications and strategies for fertility preservation in men.

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Peter J. Stahl1, Doron S. Stember, Wayland Hsiao, Peter N. Schlegel•
Cornell University1
01 Dec 2010-Clinical Obstetrics and Gynecology
TL;DR: The reproductive toxicities of commonly encountered clinical threats to male fertility, including cancer, radiotherapy, chemotherapy, surgery, and nonmalignant diseases treated with immunosuppression are reviewed.
Abstract: Fertility preservation is feasible in the majority of men. Herein, we review the reproductive toxicities of commonly encountered clinical threats to male fertility, including cancer, radiotherapy, chemotherapy, surgery, and nonmalignant diseases treated with immunosuppression. Other scenarios, in which fertility preservation may be considered, such as Klinefelter syndrome, acute testicular injury, and sudden unexpected death, are also discussed. We provide an algorithmic approach to fertility preservation in men, and review strategies for sperm acquisition in cases of ejaculatory dysfunction and azoospermia. Lastly, emerging options for fertility preservation in prepubertal boys are discussed.

37 citations

Cites methods from "Posthumous sperm retrieval: analysi..."

  • ...Successful postmortem sperm retrieval (PMSR) has been reported up to 36 hours after death, though the likelihood of success is lower once 24 hours have transpired.(17) Several methods of PMSR have been reported, including epididymal harvest, irrigation or aspiration of the vas deferens, electroejaculation, and TESE....

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Book Chapter•DOI•
Physiology of Sperm Maturation and Fertilization

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Trevor G Cooper, Ching-Hei Yeung
01 Jan 2010
TL;DR: The primary sex organ, the testis, concerned with the manufacture of androgens and spermatozoa, is in continuity with its extra-testicular pathways (the ductuli efferentia, epididymis and ductus deferens), that transmit sperm to the urethra.
Abstract: The primary sex organ, the testis, concerned with the manufacture of androgens and spermatozoa, is in continuity with its extra-testicular pathways (the ductuli efferentia, epididymis and ductus deferens), that transmit sperm to the urethra. Also discharging their secretions into the urethra are the more distal secondary sexual organs, the prostate and seminal vesicles, and the periurethral glands (of Littre) and bulbourethral glands (of Cowper) (Fig. 4.1).

35 citations

Journal Article•DOI•
A discussion supporting presumed consent for posthumous sperm procurement and conception.

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Kelton Tremellen1, Julian Savulescu1•
University of Oxford1
01 Jan 2015-Reproductive Biomedicine Online
TL;DR: It is suggested that a deceased man can benefit from posthumous conception (continuation of his 'bloodline', allowing his widow's wishes for a child to be satisfied), and has a moral duty to allow his widow access to his sperm, if she so wishes.
Abstract: Conception of a child using cryopreserved sperm from a deceased man is generally considered ethically sound provided explicit consent for its use has been made, thereby protecting the man's autonomy. When death is sudden (trauma, unexpected illness), explicit consent is not possible, thereby preventing posthumous sperm procurement (PSP) and conception according to current European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine guidelines. Here, we argue that autonomy of a deceased person should not be considered the paramount ethical concern, but rather consideration of the welfare of the living (widow and prospective child) should be the primary focus. Posthumous conception can bring significant advantages to the widow and her resulting child, with most men supporting such practice. We suggest that a deceased man can benefit from posthumous conception (continuation of his 'bloodline', allowing his widow's wishes for a child to be satisfied), and has a moral duty to allow his widow access to his sperm, if she so wishes, unless he clearly indicated that he did not want children when alive. We outline the arguments favouring presumed consent over implied or proxy consent, plus practical considerations for recording men's wishes to opt-out of posthumous conception.

33 citations

Cites background from "Posthumous sperm retrieval: analysi..."

  • ...Almost all requests for PSP from a widow or defacto partner should be honoured by prompt recourse to surgical sperm extraction, preferably within 36 h of death, so as to obtain optimal quality sperm (Shefi et al., 2006)....

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  • ...Reports suggest that only a small proportion of widows who request PSP actually proceed with fertility treatment (Bahadur, 2002; Kroon et al., 2012; Raziel et al., 2010; Shefi et al., 2006), and when combined with the low proportion of cases of sudden deaths that actually proceed to PSP, the result in a relatively small numbers of babies born from posthumous conception....

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  • ..., 2012), a figure which seems to be generally representative of the small number of posthumous conceptions reported in other countries that do allow for PSP (Bahadur, 2002; Hurwitz and Batzer, 2004; Shefi et al., 2006)....

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  • ...Sperm is generally surgically obtained from the male reproductive tract by either needle aspiration of sperm or testicular tissue, open biopsy of the testicle or surgical removal of the entire epididymis and testicle (Hurwitz and Batzer, 2004; Shefi et al., 2006)....

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  • ...As sperm DNA integrity declines after death, it has been advised that surgical sperm procurement should occur within 36 h of death to give optimal chances of successful pregnancy (Shefi et al., 2006)....

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Journal Article•DOI•
Posthumous assisted reproduction: a survey of attitudes of couples seeking fertility treatment and the degree of agreement between intimate partners

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Gary S. Nakhuda1, Jeff G. Wang1, Mark V. Sauer1•
Columbia University1
01 Dec 2011-Fertility and Sterility
TL;DR: Although most individuals presenting for fertility treatment would agree to PAR, there was also a notable portion that stated that they would not consent with the process, and although most couples had concordant attitudes, discordance was also prevalent.

32 citations

Cites background from "Posthumous sperm retrieval: analysi..."

  • ...Gamete retrieval from moribund individuals also provides a potential opportunity to initiate PAR (1, 2)....

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Journal Article•DOI•
Population-based study of attitudes toward posthumous reproduction.

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Sara E. Barton1, Katharine F. Correia1, Shirley Shalev2, Stacey A. Missmer2, Stacey A. Missmer1, Lisa Soleymani Lehmann1, Divya K. Shah1, Elizabeth S. Ginsburg1 •
Brigham and Women's Hospital1, Harvard University2
01 Sep 2012-Fertility and Sterility
TL;DR: Almost 50% of the general population support posthumous reproduction in men and women, and the majority favored prior consent from the deceased, which caution against emergency gamete harvesting without prior consent.

24 citations

Cites background from "Posthumous sperm retrieval: analysi..."

  • ...Successful cases of postmortem sperm extraction have been described and live births after use of the previously preserved gametes reported (2)....

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References
More filters
Journal Article•DOI•
Evaluation of the one‐step eosin‐nigrosin staining technique for human sperm vitality assessment

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Lars Björndahl1, Inger Söderlund, Ulrik Kvist•
University of Birmingham1
01 Apr 2003-Human Reproduction
TL;DR: The one-step eosin-nigrosin staining technique gave valid results when evaluated with sperm motility data obtained according to World Health Organization standard (1992, 1999) and should be recommended in the basic semen analysis when sperm vitality is to be assessed.
Abstract: BACKGROUND: The one-step eosin-nigrosin staining technique for assessment of sperm vitality was developed in the 1950s for various mammalian species. Although commonly used on human sperm in semen, a validation for this use has not previously been published. METHODS: The technique was evaluated on 1235 consecutive semen samples. RESULTS: The one-step eosin-nigrosin staining technique gave valid results when evaluated with sperm motility data obtained according to World Health Organization standard (1992, 1999). The mean for the sums of stained (i.e. supposedly dead) and motile sperm using the one-step eosin-nigrosin technique was 91% (SD 6 10%). The distribution of sums for percentage stained and percentage motile sperm was similar, regardless of whether the samples had many or few dead sperm. CONCLUSIONS: Standardization and quality control of basic semen analysis demands robust, reliable and simple techniques that are easy to learn, and easy to continue to perform in the same way. The one-step eosin-nigrosin technique does not need negative phase contrast optics but can be run with ordinary bright-field microscopy. Since it also includes fewer methodological steps to control, it seems preferable in terms of standardization and quality control management. It should therefore be recommended in the basic semen analysis when sperm vitality is to be assessed.

319 citations

"Posthumous sperm retrieval: analysi..." refers methods in this paper

  • ...which data were not available, all cases included an evaluation of sperm motility, and one included an assessment of sperm viability with eosin Y (Bjorndahl et al., 2003)....

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  • ...Except for two cases in which data were not available, all cases included an evaluation of sperm motility, and one included an assessment of sperm viability with eosin Y (Bjorndahl et al., 2003)....

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Journal Article•DOI•
Effect of epididymis handling conditions on the quality of ram spermatozoa recovered post-mortem.

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M. Kaabi1, Paulino de Paz1, Mercedes Alvarez1, E. Anel1, J.C. Boixo1, H. Rouissi, Paz Herraez1, Luis Anel1 •
University of León1
15 Oct 2003-Theriogenology
TL;DR: A good protocol for post-mortem semen collection in rams when epididymal spermatozoa cannot be collected immediately, is to preserve the epididcyis at 5 degrees C and process the samples in the first 24h after the animal's death.

144 citations

"Posthumous sperm retrieval: analysi..." refers background in this paper

  • ...Viable sperm has been found in rams 48 h post-mortem and in deer 40 h postmortem (Kaabi et al., 2003; Soler and Garde, 2003)....

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Journal Article•DOI•
Assisted fertility using electroejaculation in men with spinal cord injury―a review of literature

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Pak H. Chung1, Timothy R. Yeko1, J.C. Mayer1, Edgar Sanford1, George B. Maroulis1 •
University of South Florida1
01 Jul 1995-Fertility and Sterility
TL;DR: An increasing number of spinal cord-injured patients desiring fertility can achieve pregnancy through combined use of electroejaculation and assisted reproductive techniques, although results are encouraging, pregnancy rates cannot be accurately estimated because of the lack of large series in the literature.

79 citations

Journal Article•DOI•
A method for obtaining viable sperm in the postmortem state.

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Cappy Miles Rothman1•
University of California, Los Angeles1
01 Nov 1980-Fertility and Sterility

77 citations

"Posthumous sperm retrieval: analysi..." refers background in this paper

  • ...Sperm obtained in the post-mortem state was first reported in 1980 (Rothman, 1980; Batzer et al., 2003); since then, only a few pregnancies and births attributed to PSR-derived sperm have been reported (Check et al., 1999, 2002; Belker et al., 2001; Batzer et al., 2003)....

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  • ...Sperm obtained in the post-mortem state was first reported in 1980 (Rothman, 1980; Batzer et al., 2003); since then, only a few pregnancies and births attributed to PSR-derived sperm have been reported (Check et al....

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Journal Article•DOI•
Death and conception

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G. Bahadur
01 Oct 2002-Human Reproduction
TL;DR: It is concluded that there appears to be no adverse effect of posthumous assisted reproduction, but this finding might be premature; the report asserts the need for responsible accounting on the part of fertility clinics and calls for fairness, transparency and patience to help the bereaved reach an unbiased yet informed decision.
Abstract: The complex moral, ethical and legal concerns that have arisen as a result of posthumous assisted reproduction (PAR) are examined in this report. Difficult questions such as what constitutes informed consent, and whether it is ethical to retrieve spermatozoa from patients who are in a coma, are considered. Legal issues, such as whether gametes can be considered as property and the need to clarify the legal definition of paternity in cases of children born in such circumstances, are also discussed, while other points regarding the advisability of PAR, respecting the wishes of the deceased donor and the need to protect the interests of the unborn child, are outlined. The motives of the gestating women, viewing their desire for PAR perhaps as part of the grieving process, and the effects on the children concerned are examined; it is concluded that there appears to be no adverse effect, but this finding might be premature. The report also asserts the need for responsible accounting on the part of fertility clinics, and calls for fairness, transparency and patience to help the bereaved reach an unbiased yet informed decision. This may be achieved by offering ample time for informed and support counselling. Finally, consideration should be expressed for the welfare of unborn child, in a balanced, pragmatic and sensible manner.

61 citations

"Posthumous sperm retrieval: analysi..." refers background in this paper

  • ...Despite the increased feasibility of using retrieved sperm with modern ART protocols, medico-legal, moral and ethical issues abound and limit the number of PSR procedures performed (Kerr et al., 1997; Kahan et al., 1999; Finnerty et al., 2001; Bahadur, 2002; Land and Ross, 2002; Orr and Siegler, 2002; Batzer et al., 2003; Hill, 2003; Tash et al., 2003)....

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  • ...…with modern ART protocols, medico-legal, moral and ethical issues abound and limit the number of PSR procedures performed (Kerr et al., 1997; Kahan et al., 1999; Finnerty et al., 2001; Bahadur, 2002; Land and Ross, 2002; Orr and Siegler, 2002; Batzer et al., 2003; Hill, 2003; Tash et al., 2003)....

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  • ...Modern assisted reproductive technologies (ARTs) have reinforced the feasibility of PSR but have also brought to light many moral, ethical, legal and social issues (Bahadur, 2002; Land and Ross, 2002; Orr and Siegler, 2002; Batzer et al., 2003)....

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Trending Questions (2)
What is the time duration in which a viable sperm can be retrieved after death?

Viable sperm can be retrieved up to 36 hours after death.

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How to increase sperm count after 60?

Viable sperm is obtainable with PSR well after the currently recommended 24-h time interval.

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