After a man’s heart stops and his brain shuts down, his body dies in parts. One of those parts, his sperm, can still be used to reproduce.
For decades, hospitals have retrieved a dead man’s sperm and conceived children using it. But this gruesome natural process is fraught with ethics and law.
What happens in the hours before death?
At the end of life, a person’s senses begin to shut down. They may become vague and sleepy, or have hallucinations. They may lose the ability to speak or understand language, and their skin might look mottled or blotchy. Eventually, they will die from lack of oxygen to their brain. They will likely become unconscious a few hours before death.
When a man dies, his sperm is usually viable for just a few hours. Ideally, the sperm is retrieved within 48 hours of death. A surgically trained urologist can perform a post-mortem sperm retrieval (PMSR).
This is a delicate and complex process, because a man’s sperm must be retrieved before it begins to degrade. Depending on the cause of death, his health and lifestyle, and age, the sperm count and quality could decline rapidly.
Hospitals have different policies regarding this procedure. Many do not have a specific protocol in place and must follow the decision of their medical ethics board. Others have specific guidelines, and some even offer a PMSR service.
Often, the requests for this service come from family members who were unaware of their loved one’s wishes. This can create a difficult situation, especially if a loved one did not make a living will. Typically, a living will states whether or not you want to donate your organs or body, and if you do, how you would like that to be done. It can also include your wishes regarding your sperm and eggs, if you wish.
What happens in the hours after death?
The body’s muscles relax (primary flaccidity), the eyes lose their tension, the jaw may fall open and joints and limbs are flexible. This is known as the rigor mortis stage. As a result, the blood vessels in the skin begin to shrink and the body becomes cold, although a few hours after death, the chemical bonds that cause this stiffness break down, so the body softens again.
Sperm can live up to 72 hours outside the body, but the environment is key to their survival. They need warmth and moisture to survive, so if they’re exposed to air or semen begins to dry out, they’ll die. Inside a woman’s uterus and cervix, they can last for up to five days in the sperm-friendly cervical mucus that forms around the time of ovulation.
While it’s possible to retrieve a dead man’s sperm and fertilize an egg, the procedure isn’t without its ethical concerns. It’s difficult to determine whether a deceased person consented to the sperm retrieval and use of their DNA, and many hospitals and fertility clinics have varying guidelines as to who can request the service. Additionally, it can be challenging to transport a body between a morgue and urologist. This can lead to a delay in the time needed for PSR, which can decrease the chances of a successful pregnancy.
What happens in the days after death?
In the days after death, the body begins to cool and halt its processes. During this process, the sperm inside the testis is able to survive. Usually, doctors will extract the sperm and freeze it within 24 hours of death but it’s possible to do this even after that time frame. Rothman notes that “everybody’s sperm is different,” and he has seen a man who died kayaking in cold water whose sperm was still viable two days after his death.
Once the sperm is in the freezer, it’s ready to be used. The procedure is called posthumous sperm retrieval, or PSR, and it’s been around for decades with the first baby born as a result of the process occurring in 1999. But not every hospital has a PSR protocol, and those that do have varying guidelines on when to perform the procedure, what can be retrieved, and who is eligible to make the request.
Lipshultz says that many end-of-life decisions are complex, but deciding whether or not to retrieve a man’s sperm after his death may be one of the most complicated ones yet. The concept of proxy consent—when a loved one makes decisions for someone else—is difficult to apply in this situation because the man who’s sperm is being collected will not be there to express his wishes.
What happens in the months after death?
If a person dies while a donor for organs, those organizations will want their organs retrieved within a certain time period. That could interfere with a family’s wishes to retrieve his sperm and attempt pregnancy after death, known as posthumous sperm retrieval (PSR). The process is difficult, since the decedent typically needs to have been on his way to the hospital or at least in the hospital before death for the procedure to be feasible. Orchestrating all the moving pieces—consults, paperwork, sperm retrieval, and lab work—typically takes up to 12 hours.
During ejaculation, sperm travel from the penis through the vaginal opening and fallopian tubes to the uterus where an egg can be fertilized. Along the way, they are exposed to a range of conditions—including pH levels and nutrients—that can kill them, and only a small percentage of sperm actually make it to an egg to fertilize it.
Because of these conditions, most urologists do not recommend this procedure for the general public. Moreover, it can be difficult for the widow of a deceased man to establish that her husband intended to have children from posthumous conception, and hospitals may not have clear policies on whether to honor such requests. Lipshultz’s research has found that even among institutions that do have a PMSR policy, many do not enforce them strictly, and 60 percent of the hospitals he surveyed did not have any policies at all.
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