Posthumous sperm retrieval

Posthumous sperm retrieval (PSR) is a procedure in which spermatozoa are extracted from a human male after he has been pronounced legally brain dead. There has been significant debate over the ethicality and legality of the procedure, and on the legal rights of the child and surviving parent if the gametes are used for impregnation. Posthumous sperm retrieval (PSR) is a procedure in which spermatozoa are extracted from a human male after he has been pronounced legally brain dead. There has been significant debate over the ethicality and legality of the procedure, and on the legal rights of the child and surviving parent if the gametes are used for impregnation. Cases of post-mortem conception have occurred ever since human artificial insemination techniques were first developed, with sperm donated to a sperm bank being used following the death of the donor. While religious arguments have been brought against the process even under these circumstances, far more censure has arisen from a number of quarters with regards to invasive retrieval from fresh cadavers or patients either on life support or in a persistent vegetative state, particularly when the procedure is carried out without explicit consent from the donor. The first successful retrieval of sperm from a cadaver was reported in 1980, in a case involving a 30-year-old man who became brain dead following a motor vehicle accident and whose family requested sperm preservation. The first successful conception using sperm retrieved post-mortem was reported in 1998, leading to a successful birth the following year. Since 1980, a number of requests for the procedure have been made, with around one third approved and performed. Gametes have been extracted through a variety of means, including removal of the epididymis, irrigation or aspiration of the vas deferens, and rectal probe electroejaculation. Since the procedure is rarely performed, studies on the efficacy of the various methods have been fairly limited in scope. While medical literature recommends that extraction take place no later than 24 hours after death, motile sperm has been successfully obtained as late as 36 hours after death, generally regardless of the cause of death or method of extraction. Up to this limit, the procedure has a high success rate, with sperm retrieved in nearly 100% of cases, and motile sperm in 80–90%. There is currently little precedent for successful insemination using sperm harvested after 36 hours. New technologies are being researched that could make this a routine reality, in turn creating new ethical dilemmas. If the sperm is viable, fertilisation is generally achieved through intracytoplasmic sperm injection, a form of in vitro fertilisation. The success rate of in vitro fertilisation remains unchanged regardless of whether the sperm was retrieved from a living or dead donor.