Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel.
IVF Department, Shamir Medical Center, Zrifin, Israel.
J Assist Reprod Genet. 2022 Jul;39(7):1661-1665. doi: 10.1007/s10815-022-02535-8. Epub 2022 Jun 11.
To describe spermatozoa extraction rate by testicular sperm extraction (TESE) for posthumous sperm retrieval (PMSR) and examine harvest time impact on sperm motility; to compare long-term sperm usage between married vs. single deceased men.
This retrospective study included all PMSR cases in Shamir Medical Center during 2003-2021. We evaluated sperm cryopreservation according to latency time after death. Then, we assessed sperm usage according to Israeli PMSR regulations.
The study included 69 (35 married and 34 singles) deceased men with average age of 30.3 ± 7.8 years. Sperm was cryopreserved in 65 cases (94.2%) after maximum and average harvest time of 40 and 16.5 ± 8.1 h, respectively. Motile sperm extraction was associated with significantly shorter harvest time compared with non-motile sperm (13.8 ± 7.3 vs. 18.7 ± 8.1 h, p = 0.046). Sperm usage among married deceased was significantly higher than single (15.6% vs. 0%, p = 0.05). Disposal requests were lower among single compared to married men relatives without reaching statistical difference. Eventually, single men had significantly higher rate of non-used cryopreserved samples (93.8% vs 69.6%, p = 0.01).
This large long-term cohort study demonstrates high efficacy of PMSR. We found significant harvest latency time difference between motile and non-motile preserved sperm. Clinical sperm usage rate justifies the efforts for PMSR among married deceased. However, contradicting policy on the topic of single men (which implies liberal sperm preservation but rigid prevention of usage) results with high non-used sperm rate and relatives' extremely sophisticated emotional burden.
描述通过睾丸精子提取术（TESE）进行死后精子采集（PMSR）的精子提取率，并研究采集时间对精子活力的影响；比较已婚和单身已故男性的长期精子使用情况。
本回顾性研究纳入了 2003 年至 2021 年期间在 Shamir 医疗中心进行的所有 PMSR 病例。我们根据死后的潜伏期来评估精子的冷冻保存情况。然后，我们根据以色列的 PMSR 规定来评估精子的使用情况。
该研究纳入了 69 名（35 名已婚和 34 名单身）已故男性，平均年龄为 30.3±7.8 岁。在 65 例（94.2%）病例中成功冷冻保存了精子，最大和平均采集时间分别为 40 小时和 16.5±8.1 小时。与非活力精子相比，活力精子的采集时间明显更短（13.8±7.3 小时 vs. 18.7±8.1 小时，p=0.046）。已婚已故男性的精子使用比例明显高于单身（15.6% vs. 0%，p=0.05）。单身男性的亲属提出丢弃请求的比例明显低于已婚男性，但未达到统计学差异。最终，单身男性未使用的冷冻保存样本比例明显更高（93.8% vs. 69.6%，p=0.01）。
这项大规模的长期队列研究表明，PMSR 的效果非常高。我们发现，活力精子和非活力精子的保存时间存在显著差异。临床精子使用率证明了已婚已故男性进行 PMSR 的努力是合理的。然而，对于单身男性（这意味着精子可以自由保存，但使用却受到严格限制），这种政策导致了高比例的未使用精子和亲属们极其复杂的情感负担。
