What can we learn about posthumous sperm retrieval after extra long-term follow-up?
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Published on: May 27, 2022
Itai Gat1,2,3, Ana Umanski4, Sarita Kaufman4
1Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel. itaigatmd@gmail.com.
Purpose:
To describe spermatozoa extraction rate by testicular sperm extraction (TESE) for posthumous sperm retrieval (PMSR) and examine harvest time impact on sperm motility; to compare long-term sperm usage between married vs. single deceased men.
Methods:
This retrospective study included all PMSR cases in Shamir Medical Center during 2003-2021. We evaluated sperm cryopreservation according to latency time after death. Then, we assessed sperm usage according to Israeli PMSR regulations.
Results:
The study included 69 (35 married and 34 singles) deceased men with average age of 30.3 ± 7.8 years. Sperm was cryopreserved in 65 cases (94.2%) after maximum and average harvest time of 40 and 16.5 ± 8.1 h, respectively. Motile sperm extraction was associated with significantly shorter harvest time compared with non-motile sperm (13.8 ± 7.3 vs. 18.7 ± 8.1 h, p = 0.046). Sperm usage among married deceased was significantly higher than single (15.6% vs. 0%, p = 0.05). Disposal requests were lower among single compared to married men relatives without reaching statistical difference. Eventually, single men had significantly higher rate of non-used cryopreserved samples (93.8% vs 69.6%, p = 0.01).
Conclusion:
This large long-term cohort study demonstrates high efficacy of PMSR. We found significant harvest latency time difference between motile and non-motile preserved sperm. Clinical sperm usage rate justifies the efforts for PMSR among married deceased. However, contradicting policy on the topic of single men (which implies liberal sperm preservation but rigid prevention of usage) results with high non-used sperm rate and relatives' extremely sophisticated emotional burden.
Insights
Posthumous sperm retrieval (PMSR) is highly effective, with shorter harvest times yielding motile sperm. Clinical use of retrieved sperm is higher in married men, while single men
Area of Science:
- Reproductive Medicine
- Andrology
- Medical Ethics
Background:
- Posthumous sperm retrieval (PMSR) allows for the use of sperm after a man's death.
- Understanding factors influencing sperm quality and usage is crucial for effective application of PMSR.
Purpose of the Study:
- To determine the success rate of sperm extraction using testicular sperm extraction (TESE) for PMSR.
- To analyze the impact of harvest time on sperm motility.
- To compare the long-term usage of cryopreserved sperm between married and single deceased men.
Main Methods:
- A retrospective analysis of all PMSR cases at Shamir Medical Center from 2003 to 2021.
- Evaluation of sperm cryopreservation based on post-mortem latency time.
- Assessment of sperm usage in accordance with Israeli PMSR regulations.
Main Results:
- Sperm was cryopreserved in 94.2% of cases (n=69), with an average harvest time of 16.5 hours.
- Shorter harvest times were significantly associated with the extraction of motile sperm (13.8 vs. 18.7 hours).
- Sperm usage was significantly higher in married (15.6%) versus single (0%) deceased men, with a higher rate of non-used samples in single men (93.8%).
Conclusions:
- PMSR demonstrates high efficacy, with harvest time being a critical factor for obtaining motile sperm.
- Clinical usage rates justify PMSR for married deceased individuals.
- Current policies for single men lead to a high rate of non-used sperm and emotional distress for relatives.
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