Factors influencing postmortem disposition of cryopreserved sperm in men undergoing fertility preservation

OBJECTIVE: To study the factors that influence men’s disposition toward postmortem disposition of their cryopreserved gametes. DESIGN: Retrospective chart review. SETTING: Large academic health center. PATIENT(S): All patients ≥18 years of age who underwent sperm cryopreservation from June 2016 to January 2020 were included. Samples intended for donation or records with an unspecified reason for preservation were excluded. INTERVENTIONS(S): Not applicable. MAIN OUTCOME MEASURE(S): Patients’ reasons for undergoing sperm cryopreservation, method of retrieval, and whether they chose to have the sample preserved or discarded postmortem. RESULT(S): A total of 217 participants were included, with a mean age of 35.8 ± 10.8 years. Of these, 176 (81.1%) decided to preserve their sperm for a spouse and 41 (18.9%) elected to have the sample discarded when choosing the fate of their cryopreserved sample after their death. There was no significant difference in disposition toward sample fate based on age or method of collection. However, there was a significant difference based on the “reason for cryopreservation.” We found that compared with patients who underwent sperm cryopreservation because of cancer-related treatments, the patients who underwent sperm banking before vasectomy were more inclined to discard the sample. Men whose sperm was collected as in vitro fertilization backup were less willing to discard the sample. CONCLUSION(S): It appears that men’s dispositions toward postmortem disposition of their cryopreserved sperm are influenced by reason for cryopreservation, rather than age or method used for collection. As cryopreservation has become more common and affordable, understanding the factors that affect men’s disposition toward the postmortem disposition of the cryopreserved gametes is imperative, because this knowledge has the potential to influence institutional policies and legislation, and may help in resolving future legal conflicts and ethical dilemmas.