title: Postmortem sperm retrieval: the effect of instituting guidelines.
abstract: OBJECTIVE
  Postmortem sperm retrieval (PMSR) raises serious medical and ethical concerns. In this study we report the effect of intra-institutional guidelines developed for the permissibility of the procedure on the number of procurement procedures performed.
  
  
  METHODS
  The family members of 22 men who died suddenly sought PMSR. We performed an institutional review board approved chart review of the requests for PMSR from 1994 to 2002. A set of guidelines addressing PMSR was developed by a panel of experts at our institution. Key elements included 1) evidence of intended paternity for the deceased man, 2) next of kin/legal consent (i.e. only the wife can give consent for PMSR), 3) the death was sudden (permitting retrieval less than 24 hours post mortem) and 4) consent to a 1-year waiting period for bereavement and assessment of recipient.
  
  
  RESULTS
  Of the 22 families who sought PMSR 18 were not candidates for retrieval based on the criteria established by the guidelines. Four men 29 to 36 years old underwent PMSR after death and maintained on a respiratory (2) or within the first 24 hours after death (2). Procedures performed included vasal aspiration in 3 patients and epididymal/testicular retrieval in 1. Average specimen volume (including medium) was 2.1 cc, the average number of vials cryopreserved per patient was 3, sperm count was 17.6 million per ml and motility was 8.7%. All specimens demonstrated post-thaw motility. Only 1 wife used retrieved sperm for an in vitro fertilization cycle, and no pregnancy was obtained.
  
  
  CONCLUSIONS
  The exclusionary guidelines presented provide a framework utilized at 1 institution for consideration of requests for PMSR and dramatically decreased the number of postmortem sperm retrievals performed.
authors.affiliation: James Buchanan Brady Urology Foundation, Department of Urology, New York-Presbyterian Hospital/Weill Medical College of Cornell University, 525 East 68th Street, Starr 900, New York, NY 10021, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Tash
authors.forename: Linda D
authors.initials: LD
authors.lastname: Applegarth
authors.forename: Susan M
authors.initials: SM
authors.lastname: Kerr
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Fins
authors.forename: Zev
authors.initials: Z
authors.lastname: Rosenwaks
authors.forename: Peter N
authors.initials: PN
authors.lastname: Schlegel
mesh_terms: D000328:Adult; D015925:Cryopreservation; D003645:Death, Sudden; D017041:Ethics Committees; D028744:Ethics Committees, Research; D004991:Ethics, Institutional; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007317:Insemination, Artificial, Homologous / Q000941:ethics*; D008297:Male; D017410:Practice Guidelines as Topic; D012662:Semen Preservation; D013048:Specimen Handling / Q000941:ethics* / Q000379:methods; D020554:Sperm Injections, Intracytoplasmic / Q000941:ethics* / Q000331:legislation & jurisprudence; D013081:Sperm Motility / Q000502:physiology; D013094:Spermatozoa; D014019:Tissue Donors / Q000941:ethics* / Q000331:legislation & jurisprudence; D014481:United States