Desai Sethi Institute of Urology, University of Miami
Introduction: Post-mortem sperm retrieval (PMSR) has been demonstrated to produce viable offspring, however, there is scarce evidence about how long after death sperm remains viable. PMSR raises several ethical dilemmas including consent, justifiability, and sperm donation, and consequently, laws surrounding PMSR vary widely by country. Some countries ban the procedure in its entirety, while Israel has an opt-in for PMSR when enlisting in the military in Israel. Even within the US, laws vary by state. We hypothesize that sperm viability is more robust than previously reported in the literature. The objective of this study is to report sperm motility and viability based on extraction time post-mortem. Methods: Patient lists from the Miami-Dade County Medical Examiner Department were analyzed daily in search of a patient who fit criteria of being a male between the ages of 15-60 with sudden death, no hospitalization and without comorbidities. Once a patient was identified, informed consent was obtained from their next of kin. The patient’s testicle was removed and biopsied, and four samples were collected and placed into separate vials containing sperm wash. After initial biopsy, the testicle was stored in a 45F refrigerator. Semen analysis was conducted to determine the viability of the spermatozoa. Biopsies and semen analyses were continued daily until the spermatozoa were no longer viable. Last surgically extracted samples contained minced epididymis and vas deferens, and the testicular collected fluid were cryopreserved using the fast-freezing technique with the aid of a cryoprotector media. Post-thaw was done at 24 hours time point on the postmortem samples. Results: The patient’s testicles were biopsied and analysis was conducted at 13, 34, 58, 82, and 106 hours postmortem. The average spermatozoa viability at each interval was 67%, 57%, 47%, 34% and 22% respectively. Motility with pentoxifylline were also reported at those times: 26%, 19%, 7%, 11%, and 5%. Post-thaw viability and motility at 106 hours postmortem were 5% and 1% respectively. Conclusions: Our study demonstrated that there are motile and viable sperm from human testes even 100 hours post mortem. This is the first study to demonstrate viable or motile sperm after such a long time after death. These findings will have implications on duration after death at which post-mortem sperm retrieval future can be performed successfully. SOURCE OF Funding: NIH Grant R01 DK130991 and Clinician Scientist Development Grant from the ACS to Dr. Ranjith Ramasamy
