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.
Neurocrit Care. 2010 Jun;12(3):445-9. doi: 10.1007/s12028-010-9333-6.
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.
本研究的目的是回顾在适当的家庭请求后，从重症/受伤患者中获取精子的技术方法、重症监护病房药物或合并症对精子产生/功能可能产生的有害影响，以及为医院和护理提供者提供这种资源的伦理考虑。本研究采用的设计包括：文献回顾、PubMed 1998-2009 年和作者档案。没有干预措施。总之，尽管有报道称从重症患者中取出精子后成功和不成功的妊娠，但对于任何结果都没有确定的概率预测。影响下丘脑-垂体-性腺轴的急性和慢性疾病以及重症监护病房常见的多种药物可能会降低精子的产生或功能。心肺死亡前后的采集方法不同，通常需要胞浆内精子注射或其他体外受精技术来实现随后的妊娠。强烈建议积极制定协作政策/程序，以确定医院、其员工以及附属重症监护和泌尿科医生的适当角色。
