Sperm retrieval during critical illness.
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.
Powner
David J
DJ
Departments of Neurosurgery and Internal Medicine, University of Texas Health Sciences Center at Houston Medical School, 6431 Fannin Street, MSB 7.154, Houston, TX 77030, USA. david.j.powner@uth.tmc.edu
Rumohr
Jon A
JA
Lipshultz
Larry I
LI
D001926:Brain Death / Q000503:physiopathology; D003299:Cooperative Behavior; D003422:Critical Care / Q000941:ethics; D016638:Critical Illness; D004992:Ethics, Medical; D005260:Female; D005307:Fertilization in Vitro / Q000941:ethics; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence; D033183:Interdisciplinary Communication; D008297:Male; D010348:Patient Care Team; D011247:Pregnancy; D055101:Semen Analysis / Q000941:ethics; D020554:Sperm Injections, Intracytoplasmic / Q000941:ethics; D053625:Sperm Retrieval / Q000941:ethics; D013091:Spermatogenesis / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome