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.
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
David J
DJ
Powner
Jon A
JA
Rumohr
Larry I
LI
Lipshultz
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