{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:36:06Z","timestamp":1790757366790,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>STUDY QUESTION<\/jats:title>\n                    <jats:p>What are the clinical and logistical predictors of sperm viability in posthumous sperm retrieval (PHSR), and how do post-mortem interval (PMI), body refrigeration, and mechanism of death affect outcomes?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SUMMARY ANSWER<\/jats:title>\n                    <jats:p>Shorter PMI and body refrigeration significantly enhance post-mortem sperm viability, with the mechanism of death modulating viability patterns in a time-dependent manner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT IS KNOWN ALREADY<\/jats:title>\n                    <jats:p>PHSR has gained increasing prominence in reproductive medicine, yet technical aspects remain under-researched. Key questions regarding optimal timing, storage conditions, and cause of death effects on sperm quality lack systematic investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title>\n                    <jats:p>Retrospective observational study of 28 PHSR procedures performed between October 2023 and December 2024 at a tertiary academic medical center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n                    <jats:p>Twenty-eight deceased men aged 19\u201337\u2009years whose families requested PHSR. Unilateral testicular biopsy was performed, followed by sperm viability assessment and cryopreservation. Fresh and post-thaw sperm viability were analyzed as functions of PMI, body refrigeration, and mechanism of death using linear regression and multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n                    <jats:p>Viable sperm were successfully retrieved in 25 of 28 cases (89%) up to 37\u2009h post-mortem under optimal conditions. Median fresh sperm viability was 42.0% (quartile 1\u2013quartile 3 [Q1\u2013Q3] 38.0\u201352.0%), declining to 27.0% (Q1\u2013Q3: 20.0\u201332.0%) following cryopreservation, representing a median reduction of 39% (Q1\u2013Q3: 32\u201348%). Linear regression showed a time-dependent viability decline of \u223c2% per hour post-mortem. Refrigeration was associated with preserved viability at extended PMIs, with all successful retrievals beyond 14\u2009h occurring in refrigerated bodies. Blast injuries showed higher initial viability than gunshot wounds but a more rapid decline over time. A multivariate model incorporating PMI, refrigeration, and mechanism of death explained 59.2% of the variance in sperm viability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n                    <jats:p>Limited sample size (n\u2009=\u200928) and unique wartime circumstances may limit generalizability. Documentation of intermediate storage conditions was challenging under combat conditions. Long-term outcomes and fertilization success require further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n                    <jats:p>These findings provide evidence-based benchmarks for PHSR protocols and practical guidance for clinical decision-making and family counseling. The quantitative relationships identified can inform timing decisions and optimize retrieval success rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n                    <jats:p>This study received no external funding. All authors declare no competing interests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION NUMBER<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/humrep\/deaf172","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T11:51:13Z","timestamp":1755777073000},"page":"2056-2065","source":"Crossref","is-referenced-by-count":4,"title":["Posthumous sperm retrieval in the context of armed conflict"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6553-0350","authenticated-orcid":false,"given":"Shimi","family":"Barda","sequence":"first","affiliation":[{"name":"Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Israel Academic College , Ramat Gan,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snir","family":"Dekalo","sequence":"additional","affiliation":[{"name":"Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Department of Urology, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Mendelson","sequence":"additional","affiliation":[{"name":"Department of Urology, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Marom","sequence":"additional","affiliation":[{"name":"Department of Urology, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yotam","family":"Veredgorn","sequence":"additional","affiliation":[{"name":"Department of Urology, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Bashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foad","family":"Azem","sequence":"additional","affiliation":[{"name":"Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noga Fuchs","family":"Weizman","sequence":"additional","affiliation":[{"name":"Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv,","place":["Israel"]},{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"2025110412230590500_deaf172-B1","first-page":"474","article-title":"Prediction of post-thaw sperm motility and sperm cryosurvival rate using the pre-freeze sperm parameters","volume":"78","author":"Aribarg","year":"1995","journal-title":"J Med Assoc Thai"},{"key":"2025110412230590500_deaf172-B2","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1093\/humrep\/17.10.2769","article-title":"Death and conception","volume":"17","author":"Bahadur","year":"2002","journal-title":"Hum Reprod"},{"key":"2025110412230590500_deaf172-B3","volume-title":"Principles of Biomedical Ethics","author":"Beauchamp","year":"2001"},{"key":"2025110412230590500_deaf172-B4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.fertnstert.2018.04.002","article-title":"Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion","volume":"110","author":"Daar","year":"2018","journal-title":"Fertil Steril"},{"key":"2025110412230590500_deaf172-B5","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1016\/j.fertnstert.2013.08.005","article-title":"Semen cryopreservation for men banking for oligospermia, cancers, and other pathologies: prediction of post-thaw outcome using basal semen quality","volume":"100","author":"Degl\u2019Innocenti","year":"2013","journal-title":"Fertil Steril"},{"key":"2025110412230590500_deaf172-B6","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1007\/s10815-022-02535-8","article-title":"What can we learn about posthumous sperm retrieval after extra long-term follow-up?","volume":"39","author":"Gat","year":"2022","journal-title":"J Assist Reprod Genet"},{"key":"2025110412230590500_deaf172-B7","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.rbms.2017.03.003","article-title":"A cross-cultural analysis of posthumous reproduction: the significance of the gender and margins-of-life perspectives","volume":"4","author":"Hashiloni-Dolev","year":"2017","journal-title":"Reprod Biomed Soc Online"},{"key":"2025110412230590500_deaf172-B8","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1097\/01.ogx.0000145929.69990.d6","article-title":"A guest editorial: posthumous sperm procurement: demand and concerns","volume":"59","author":"Hurwitz","year":"2004","journal-title":"Obstet Gynecol Surv"},{"key":"2025110412230590500_deaf172-B9","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1016\/S0022-5347(01)64700-1","article-title":"Postmortem sperm procurement","volume":"157","author":"Kerr","year":"1997","journal-title":"J Urol"},{"key":"2025110412230590500_deaf172-B10","first-page":"775","article-title":"Any man can be a father, but should a dead man be a dad: an approach to the formal legalization of posthumous sperm retrieval and posthumous reproduction in the United States","volume":"47","author":"Krebs","year":"2018","journal-title":"Hofstra L Rev"},{"key":"2025110412230590500_deaf172-B11","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1093\/humrep\/deh360","article-title":"Posthumous sperm retrieval for the purpose of later insemination or IVF in Israel: an ethical and psychosocial critique","volume":"19","author":"Landau","year":"2004","journal-title":"Hum Reprod"},{"key":"2025110412230590500_deaf172-B12","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/1477750918820648","article-title":"Expanding the use of posthumous assisted reproduction technique: should the deceased\u2019s parents be allowed to use his sperm?","volume":"14","author":"Ram-Tiktin","year":"2019","journal-title":"Clinical Ethics"},{"key":"2025110412230590500_deaf172-B13","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s10561-019-09775-6","article-title":"Correlation between sperm motility and sperm chromatin\/DNA damage before and after cryopreservation and the effect of folic acid and nicotinic acid on post-thaw sperm quality in normozoospermic men","volume":"20","author":"Rarani","year":"2019","journal-title":"Cell Tissue Bank"},{"key":"2025110412230590500_deaf172-B14","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1093\/humrep\/dev191","article-title":"Pregnancy and childhood health and developmental outcomes with the use of posthumous human sperm","volume":"30","author":"Robson","year":"2015","journal-title":"Hum Reprod"},{"key":"2025110412230590500_deaf172-B15","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/S1474-4422(13)70161-3","article-title":"Blast-related traumatic brain injury","volume":"12","author":"Rosenfeld","year":"2013","journal-title":"Lancet Neurol"},{"key":"2025110412230590500_deaf172-B16","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/S0015-0282(16)45147-2","article-title":"A method for obtaining viable sperm in the postmortem state","volume":"34","author":"Rothman","year":"1980","journal-title":"Fertil Steril"},{"key":"2025110412230590500_deaf172-B17","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/00005373-199502000-00006","article-title":"Epidemiology of trauma deaths: a reassessment","volume":"38","author":"Sauaia","year":"1995","journal-title":"J Trauma"},{"key":"2025110412230590500_deaf172-B18","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1111\/andr.13757","article-title":"Israeli men\u2019s attitudes toward posthumous reproduction and prior consent amid ongoing armed conflict","volume":"13","author":"Savitsky","year":"2025","journal-title":"Andrology"},{"key":"2025110412230590500_deaf172-B19","doi-asserted-by":"crossref","first-page":"2890","DOI":"10.1093\/humrep\/del232","article-title":"Posthumous sperm retrieval: analysis of time interval to harvest sperm","volume":"21","author":"Shefi","year":"2006","journal-title":"Hum Reprod"},{"key":"2025110412230590500_deaf172-B20","volume-title":"Gunshot Wounds Forensic Pathology. StatPearls [Internet]","author":"Shrestha","year":"2025"},{"key":"2025110412230590500_deaf172-B21","doi-asserted-by":"crossref","first-page":"16813","DOI":"10.1038\/s41598-020-73630-y","article-title":"Reduced spermatozoa functionality during stress is the consequence of adrenergic-mediated disturbance of mitochondrial dynamics markers","volume":"10","author":"Starovlah","year":"2020","journal-title":"Sci Rep"},{"key":"2025110412230590500_deaf172-B22","first-page":"663","article-title":"Posthumous reproduction and the law: tissue transplantation, property rights and the reproductive relational autonomy","volume":"28","author":"Stewart","year":"2021","journal-title":"J Law Med"},{"key":"2025110412230590500_deaf172-B23","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1093\/humrep\/15.4.739","article-title":"Ethics of postmortem sperm retrieval: ethics of sperm retrieval after death or persistent vegetative state","volume":"15","author":"Strong","year":"2000","journal-title":"Hum Reprod"},{"key":"2025110412230590500_deaf172-B24","first-page":"235","article-title":"A case report on the prolonged viability of postmortem human testicular sperm","volume":"4","author":"Thomas","year":"2023","journal-title":"F S Rep"},{"key":"2025110412230590500_deaf172-B25","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.rbmo.2014.10.001","article-title":"A discussion supporting presumed consent for posthumous sperm procurement and conception","volume":"30","author":"Tremellen","year":"2015","journal-title":"Reprod Biomed Online"},{"key":"2025110412230590500_deaf172-B26","first-page":"349","article-title":"Ethical considerations in post-mortem sperm retrieval: a comprehensive review","volume":"28","author":"Vidua","year":"2024","journal-title":"JBRA Assist Reprod"},{"key":"2025110412230590500_deaf172-B27","doi-asserted-by":"crossref","first-page":"963689721999617","DOI":"10.1177\/0963689721999617","article-title":"Cryopreservation: an overview of principles and cell-specific considerations","volume":"30","author":"Whaley","year":"2021","journal-title":"Cell Transplant"},{"key":"2025110412230590500_deaf172-B28","doi-asserted-by":"crossref","first-page":"4470","DOI":"10.3390\/ijms20184470","article-title":"Mechanisms of stress-induced spermatogenesis impairment in male rats following unpredictable chronic mild stress (uCMS)","volume":"20","author":"Zou","year":"2019","journal-title":"Int J Mol Sci"}],"container-title":["Human Reproduction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/40\/11\/2056\/64196163\/deaf172.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/40\/11\/2056\/64196163\/deaf172.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T17:23:15Z","timestamp":1762276995000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/humrep\/article\/40\/11\/2056\/8246297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":28,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,9,2]]},"published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/humrep\/deaf172","relation":{},"ISSN":["0268-1161","1460-2350"],"issn-type":[{"value":"0268-1161","type":"print"},{"value":"1460-2350","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,9,2]]}}}