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

OBJECTIVE: To study the factors that influence men's disposition towards post-mortem disposition of their cryopreserved gametes.

DESIGN: A retrospective chart review of sperm cryopreservations between June 2016 and January 2020 was performed. All patients ≥ 18 years of age were included. Samples intended for donation or records with an unspecified reason for preservation were excluded.

SETTING: A large academic health center.

PATIENTS: Participants' (n=217) mean age was 35.8 ± 10.8 years.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Patients' reason for undergoing sperm cryopreservation, method of retrieval, and whether they chose to have the sample preserved or discarded post-mortem.

RESULTS: A total of 217 men were analyzed; mean age was 35.8 ± 10.8 years. Of those, 176 (81.1%) men 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 should they die. There was no significant difference in disposition towards sample fate based on age or method of collection. However, there was a significant difference based on the "reason for cryopreservation" (p = 0.001). We found that compared to patients that underwent sperm cryopreservation due to cancer-related treatments, the patients that underwent sperm banking prior to vasectomy were more inclined to discard the sample (OR = 3.45, 95% CI: 1.16 - 10.27, p = 0.026). Men that collected the sperm as an in vitro fertilization backup were less willing to discard the sample (OR = 0.42, 95% CI: 0.18 - 0.97, p = 0.043).

CONCLUSIONS: It appears that men's disposition towards post-mortem disposition of their cryopreserved sperm are influenced by their reason for cryopreservation, rather than their age or method used for collection. As cryopreservation has become more common and affordable, understanding the factors that impact men's disposition towards the post-mortem disposition of the cryopreserved gametes is imperative, as this knowledge has the potential to influence institutional policies and legislation, and may help solve future legal conflicts and ethical dilemmas.