Posthumous sperm retrieval (PSR), sometimes referred to as post-mortem sperm retrieval (PMSR), gives hope to partners aiming to become a parent after the sudden loss of their spouse. What exactly is posthumous sperm retrieval, what are the ethical and legal considerations, and what is a better alternative available for those wanting to become parents? Let’s dive in.
Key takeaways
- Posthumous sperm retrieval is the process of extracting sperm tissue from a recently deceased person, in order to use those sperm to fertilize their partner’s eggs through IVF.
- There are many ethical, logistical, financial, and medical issues to be considered before requesting posthumous sperm retrieval.
- Proactive sperm freezing is a better alternative to PSR — it reduces the risk of failure, is more cost-effective, and does not require the same legal and ethical considerations.
Posthumous sperm retrieval has been gaining awareness in the media in recent years. A New York Police Department officer’s wife made the news in 2017, after giving birth to a baby using sperm retrieved after her husband’s unexpected death. After the officer was shot and killed while on duty, his widow requested that doctors extract and freeze his sperm; three years later, his widow gave birth to a healthy girl using that sperm.
This appears to be an increasingly common request, especially among the military in Israel, where recently deceased soldiers’ families are requesting that their sperm be extracted shortly after their death. This follows a change in parliamentary legislation in March 2022, paving the way for this practice to become widespread.
What is posthumous sperm retrieval (PSR)?
Posthumous sperm retrieval is the process of collecting sperm from a recently deceased person, for use later to attempt pregnancy. It is often carried out to enable a widow to have children despite the unexpected death of their spouse.
The medical procedure is similar to some forms of testicular sperm retrieval, and involves surgically extracting potentially sperm-rich tissue from the testes of a person who has recently died. It’s usually performed by a urologist.
According to Human Reproduction, the first documented example of PSR was in 1980. But it would be another 19 years before the first baby conceived from sperm collected via posthumous sperm retrieval was born. PSR is not a widely available service, and there are varying guidelines available to direct those clinics and hospitals that do offer it.
What is the process for posthumous sperm retrieval?
Post-mortem sperm retrieval can be a complicated and time-sensitive procedure. Studies show that, in order to retrieve viable sperm, PSR needs to occur within 48–72 hours of death. According to a review of clinical data earlier this year, sperm retrieved post-mortem up to three days post-death can result in a successful live birth, but further studies are required to clarify the success rates, most effective techniques, and to consider the well-being of the parties involved.
A review of posthumous sperm retrieval in 2019 highlights several logistical issues that need to be addressed before the retrieval process may begin. Once death has occurred, paperwork must be completed. Sometimes, depending on the cause of death, an autopsy must be concluded before the body can be transported to the location where the surgical team will perform the procedure.
Before retrieval can occur, a full medical history will be taken, and infectious disease testing must be completed by having blood drawn from the deceased. This is because the extracted material will be stored and eventually used to create embryos, so it’s important to ensure it’s free from infection.
The posthumous sperm retrieval process itself is typically similar to a testicular biopsy or aspiration. Portions of testicular tissue that are likely to contain sperm can be removed with a needle or scalpel. Then, the tissue can be examined under the microscope to identify sperm.
Following the sperm retrieval process, the sperm will be warmed in an incubator and examined for viability. If the retrieval has resulted in viable sperm, the sample will be cryopreserved, or frozen, immediately and stored to be used at a later stage for fertilization of the spouse’s egg via IVF.
How can you use sperm that is retrieved posthumously?
Best posthumously extracted sperm is taken from the testes, it must be used through intracytoplasmic sperm injection (ICSI). This is an assisted reproductive technology (ART) used with in vitro fertilization (IVF) to achieve pregnancy. During ICSI, a single sperm is injected directly into the egg to facilitate fertilization.
ICSI increases the chance of fertilization when sperm motility is low — such as when sperm comes directly from the testes — or when quantities of sperm are very limited. Both are at play when using posthumously retrieved sperm.
Whether the sperm-producing person was living or deceased at the time of retrieval does not appear to impact the success rate of IVF, although complex factors may affect this, including the length of time between the death and the posthumous sperm extraction.
What is the cost of posthumous sperm retrieval?
The cost of posthumous sperm retrieval varies depending on where you are in the world, and again, this isn’t a common procedure. It may cost around $3,000 for the surgical procedure itself, not including any legal or logistical prerequisites.
Additionally, you must add this to the price of the necessary IVFand ICSI to follow, which costs around $10,000–$15,000 or more.
What are the legal and ethical considerations regarding posthumous sperm retrieval?
Post-mortem sperm retrieval remains a controversial practice, even though requests and retrievals in the US have increased in frequency. At present, there are no national guidelines, restrictions, or regulations related to posthumous sperm retrieval. This perpetuates many issues when evaluating the eligibility of requests for posthumous sperm preservation, which need to consider the legal, medical, logistical, ethical, and consent issues relating to each individual case.
Some recurring legal issues need to be analyzed when evaluating a posthumous sperm retrieval request:
1. According to guidelines stipulated by the Weill Cornell Medicine Department of Urology, posthumous sperm retrieval should only be considered when the deceased’s spouse requests it. They are the only person with the right to use the extracted sperm for procreation. However, in some cases, the deceased’s family may request the retrieval, which can complicate matters.
2. There is a lack of consent by the deceased in most cases of unexpected death. Without permission, does the spouse have the legal right to request posthumous sperm retrieval? This is a common reason that a request for posthumous sperm retrieval may be denied. It is usually a requirement that the deceased has expressed in written form, or in some way provided evidence, of a desire to procreate with their spouse before their untimely death.
3. Some religions prohibit or discourage postmortem sperm retrieval, including Roman Catholicism and Judaism.
4. If the procedure is successful and results in a birth, there may be issues involving the living parent and their child’s legal rights, such as inheritance, citizenship, or right to Social Security or other benefits. In some countries, such as the UK and Israel, there is a time limit on the use of posthumously extracted sperm, after which the father is not allowed to be legally recognized on a child’s birth certificate.
What is a better alternative to posthumous sperm retrieval?
If a person wants to ensure their legacy continues — even after their death — a better alternative to posthumous sperm retrieval exists: proactive sperm freezing. There are many benefits to choosing sperm freezing:
- It is more reliable than posthumous sperm retrieval, and affords patients the option to freeze more sperm.
- It provides more options for using the sperm, such as IUI, IVF, or ICSI, rather than restricting your choice to just ICSI-IVF (as with posthumous sperm retrieval).
- It provides the comfort of having a backup plan no matter what happens in life, protecting your fertility plans regardless of aging, illness, or untimely accidents.
This is why today, many in high-risk jobs such as the military or policing may choose to freeze their sperm ahead of time. Legacy works with organizations such as the US Navy SEALS, the Green Berets, and the New York Police Department to offer lower-cost or even free sperm cryopreservation.
