Posthumous reproduction: current and future status

Land, Spencer; Ross, Lawrence S.

doi:10.1016/s0094-0143(02)00082-4

Cited by 19 publications

(15 citation statements)

References 34 publications

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“…Sperm removal during a persistent vegetative state and following brain death may include removal of the foley catheter and ejaculatory assistance using vibratory stimulation or transrectal electroejaculation [2,4,8,9]. Some medications commonly used in the ICU (Table 1), however, may interfere with erectile and/or ejaculatory function and limit retrieval using these methods.…”

Section: Methodsmentioning

confidence: 99%

“…Some medications commonly used in the ICU (Table 1), however, may interfere with erectile and/or ejaculatory function and limit retrieval using these methods. Alternatively, testicular sperm extraction following a large open biopsy, epididymal sperm extraction and/or aspiration, and aspiration/irrigation of the vas deferens may be attempted [2,4,8,10,11]. These techniques, of course, are best performed by an experienced urologist familiar with those methods.…”

Section: Methodsmentioning

confidence: 99%

“…Most authors recommend that orchiectomy or biopsy be performed soon after death or up to 24 h [4], but others allow up to 36 h [2]. The procedure of sperm removal directly from the testis is usually very successful, but the sperm are potentially less mature, since maturation occurs in the epididymis [12].…”

Section: Methodsmentioning

confidence: 99%

“…The first successful pregnancy after postmortem sperm retrieval, however, was not reported until 1998 [2,3]. Thereafter, only anecdotal reports of both successful and unsuccessful pregnancies have been published [2][3][4]. Therefore, no statistical probability for either outcome is available for family counseling.…”

Section: Efficacymentioning

confidence: 99%

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Sperm Retrieval During Critical Illness

2010

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Objective of this study is to review technical methods to retrieve sperm from critically ill/injured patients after an appropriate family request, possible harmful effects on sperm production/function by ICU medications or concurrent illnesses, and ethical considerations for hospitals and care providers in providing this resource. Design used for this study includes: literature review, PubMed 1998-2009, and authors' files. There are no interventions. In conclusion, although successful and unsuccessful pregnancies following sperm removal from critically-ill patients are reported, no firm probability predictions for either result are known. Acute and chronic diseases that effect the hypothalamic-pituitary-gonadal axis and multiple medications common to the ICU may reduce sperm production or function. Retrieval methods before and after cardio-respiratory death differ and often require intracytoplasmic sperm injection or other in vitro fertilization techniques to achieve a subsequent pregnancy. The proactive development of a collaborative policy/procedure to identify appropriate roles for the hospital, its employees, and affiliated critical care and urology physicians is strongly recommended.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Efficacymentioning

confidence: 99%

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Sperm Retrieval During Critical Illness

2010

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“…A few reports have now documented pregnancies and live births using sperm retrieved posthumously [19,20]. However, in all cases, the pregnancies were achieved through ICSI.…”

Section: Posthumous Collected Spermmentioning

confidence: 99%

Sperm Preparation for Artificial Insemination

Christensen

2010

Reproductive Endocrinology and Infertility

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Intrauterine insemination (IUI) is a common treatment for couples with infertility issues. In order to operate a good IUI program, several elements are necessary. This chapter attempts to provide a comprehensive description of these elements including: aspects of patient education, communication between the laboratory and the referring physician, employee training, safety, sample identification, and documentation procedures. It also describes supplies and reagents needed for IUI, multiple techniques for the preparation of sperm, and advantages of the different preparations. A discussion of special considerations such as the use of positive samples for infectious disease, use of sex-selected sperm, and chemical motility enhancement is included. Keywords IntroductionDue to increased social acceptance and the successful range of infertility therapies now available, more people than ever are seeking treatment for infertility. A broad range of conditions, affecting both the male and female, contribute to infertility. Many circumstances, such as severe oligozoospermia or blocked fallopian tubes, are immediate indications that more aggressive therapies, such as in vitro fertilization (IVF), are needed to be pursued for a reasonable chance of success. However, the majority of patients with less severe or unexplained forms of infertility have a reasonable chance of success with less invasive intrauterine insemination (IUI). While the decision of which infertility therapy to pursue depends on a number of factors including infertile pathologies, age, and finances, for many couples IUI will be the first and only therapy needed.Several factors can contribute to the success rates of IUI, including sperm quality, insemination timing and number of inseminations, age, and the use of ovarian stimulation [1][2][3]. One of the major male factors influencing the rates is the concentration of motile sperm in the prepared sample used for insemination, with pregnancy rates falling off quickly when less than 5 million motile sperm are inseminated [4,5]. Normal sperm morphology has also been evaluated, though the correlation with pregnancy rates is less clear. On average, the pregnancy rate per IUI cycle is about 10-15% when motile sperm are available, though higher rates have been reported, especially when combined with the use of gonadotropins [6].Under normal circumstances, sperm must pass through the cervical mucus to reach the uterus, a process that limits uterine entrance to only the healthiest sperm and prevents dead sperm, debris, and seminal fluid from getting in. Due to the presence of prostaglandins and microbes in the seminal fluid, semen cannot be placed directly into the uterus without the potential of inducing painful cramping and infection. With the advent of sperm preparation techniques to remove seminal fluids, nonmotile cells, and debris, sperm can be placed directly into the uterus with minimal risk. In instances where sperm quality is less than optimal or adverse mucus or cervical conditions exist, IUI can b...

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