A person dies in a fairly predictable way: They fade as their blood supply declines, and their body begins to cool. But what happens to their sperm?
People who want to use a dead man’s sperm have to be ready for some complicated legal issues. Harvard Law professor Glenn Cohen explains.
Needle Extraction
When a man dies unexpectedly, they often don’t have the opportunity to bank their sperm or make any clear instructions about how they want their body used after death. For that reason, hospitals’ policies on postmortem sperm retrieval (PMSR) are spotty and inconsistent.
A PMSR is a surgical procedure performed by a trained Urologist where potentially sperm-rich tissue is removed from a man’s testicles. The tissue is then frozen for future use. It’s most often done in cases where a deceased man’s loved ones wish to give him children after his death.
In the case of Peter Zhu, a 21-year-old cadet at West Point who died in a ski accident, his parents sought a court order to have his sperm retrieved from his body while it was still viable. They argued that sperm was different than blood, bone marrow, or organs and that sperm carries the “potential to create life.”
Hospitals generally follow a policy set forth by the urology department at Cornell University that outlines guidelines for when sperm can be retrieved after a patient’s death. The guidelines say that only a deceased man’s spouse or significant other is eligible to request sperm from his body, and that the sperm may only be retrieved with the consent of both the woman and the hospital. Despite those restrictions, many hospitals are open to considering these requests.
Surgical Extraction
Surgical extraction can be performed in the morgue, medical examiner’s office or even in a funeral home. The sperm is then transferred to a container, which can be sealed or frozen, and then stored the same way fertility clinics freeze semen from a living donor. Once the sperm is ready, it can be used in intrauterine insemination for the deceased man’s partner or by the widow to get pregnant through her own insemination.
For the last few decades, Los Angeles urologist Cappy Rothman has been performing the most complicated postmortem sperm retrieval. He has a deep understanding of male reproductive anatomy, extensive experience in the procedure and a network of contacts with families interested in posthumous fathering.
In some cases, a family member has gotten court orders to have the deceased’s sperm retrieved and preserved for a future child. But the legal and ethical precedent is unclear. Some countries, including France and Germany, prohibit postmortem sperm retrieval, while others have very restrictive laws.
Most US hospitals don’t have specific policies about sperm retrieval, and many doctors aren’t familiar with the procedure. Those who have seen requests are often uneasy. Some argue that a deceased person can’t give consent for the retrieval of his sperm, and that it’s unfair to force such a request on grieving loved ones.
Freezing
The freezing process, or cryopreservation, is the final step in the sperm banking process. The preparation varies depending on the clinic, but typically involves health checks to prevent any condition from being passed to the future child or mother (for example, routine HIV and hepatitis testing).
After the sample has been tested and analyzed, it is frozen using either slow or rapid freeze techniques. Both methods use a special cryoprotectant to control the damage caused by freezing. Regardless of the method used, freezing reduces the quality of the semen, affecting motility and morphology.
Once the sperm has been frozen, it is stored in a lab until it’s needed for fertility treatment or donation. The samples are stored in a liquid nitrogen freezer at minus196 degrees Celsius until they are needed for use in intrauterine insemination or in vitro fertilization.
For many people, the idea of using their own sperm in insemination after they die seems like an impossibility. However, some men have consented to have their sperm preserved after their death to give their widows or other family members the opportunity to get pregnant. This is often done for cancer patients undergoing radiation or chemotherapy, as these treatments can damage the testicles, which can cause infertility. This is also an option for people in high-risk professions, such as soldiers and fire fighters.
Storage
When taken out of a man’s body, sperm quickly dies without the proper conditions. It needs warmth and moisture, but outside of a man’s body, it can’t get them. Sperm survive only a few minutes on the outside of the body, or five days in cervical mucus around the time of ovulation, when it can reach an egg.
Once a man has given consent to postmortem sperm retrieval (PMSR), fertility clinics can store it the same way they would store semen from a living donor. Then, if a woman wants to use the sperm, she can do so by in vitro fertilization.
Whether the sperm can work depends on several factors, including a man’s sperm count and quality when he died, his health history and lifestyle, and how much time elapsed between death and the process of PMSR. A recent study found that a deceased man’s sperm has about a 10% chance of fertilizing an egg, but that figure can be higher or lower depending on those factors.
The Christys’ case and others like it expose a legal, ethical, and medical debate about when it is okay to treat a dead man as if he were alive. Harvard law professor Glenn Cohen explains how this issue is being played out in the courts and in families’ lives.
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