As a medical social worker at Israel’s Kaplan Hospital, Prof. Shir Daphna-Tekoah is no stranger to trauma.
But when she was drafted in to work on October 7, the day Hamas attacked Israeli farms, villages and a music festival, the scale of the disaster quickly became apparent.
“I’ve seen dozens of people killed in accidents or shootings, but this was the hardest thing I’ve done in my life,” Daphna-Tekoah told CNN by telephone.
As head of the hospital’s rape crisis center, she was called in as reports surfaced of sexual assaults. But it was soon all hands on deck as the emergency room filled up with the injured.
“I saw the horror on their faces,” Daphna-Tekoah said. “I saw in their eyes that they’d seen something unbelievable.”
Worse followed. “Then came the dead bodies of youngsters in their party clothes,” she said. “They were no more than 23, 24, my own children’s age.”
It was Daphna-Tekoah’s responsibility to support the families saying goodbye to their murdered loved ones. Of one family, she said: “I asked if they would like to thank their child or ask for forgiveness for anything.
“The mother said: ‘I’m so sorry I let you go to the party and that I didn’t protect you.’”
Then, Daphna-Tekoah posed another question. “I asked ‘Would you like me to find out about sperm preservation?’”
“I can’t even explain what I saw,” said Daphna-Tekoah, who knew little about the process other than the need to act fast.
“Before, there was only agony and darkness in the mother’s eyes and suddenly there was a flicker of light and hope.”
Daphna-Tekoah immediately approached hospital management, and just a few hours later they had the legal sign-off needed. By the following morning, the sperm of several victims from the Nova festival had been retrieved.
Now, more than seven weeks later, Israeli hospitals have been inundated with requests to cryogenically freeze the sperm of those killed in the conflict, hospital officials say.
Posthumous sperm retrieval (PSR) was previously open to partners - provided other relatives did not object - but parents of the deceased had to apply for legal permission.
But the Ministry of Health has recently slashed the red tape. In a statement on its website, it says hospitals have been instructed, during the war, to approve requests for PSR “from the deceased’s parents, without referring them to a family court.”
Sperm lives on briefly after death, which is why it’s possible for doctors - usually a fertility or urology specialist - to retrieve it from testicular tissue. Any live sperm cells found are transferred and frozen in liquid nitrogen.
Dr. Noga Fuchs Weizman, medical director of the sperm bank and male infertility unit at Tel Aviv’s Ichilov Hospital, said there have been many requests from bereaved families.
“The demand has been very high,” she told CNN in a video call, adding that dozens of families have accessed the service since October 7.
According to Dr. Shimi Barda, laboratory director of the unit, the Israel Defense Forces (IDF) offer families the option when informing them of their loss. “They proactively suggest it,” he said.
Soon after the October 7 attacks, the case of Israeli singer Shaylee Atary, whose husband was killed trying to protect their baby in Kibbutz Kfar Aza, made headlines.
According to Israel’s Ministry of Foreign Affairs, Atary “did everything in her power to retrieve his sperm,” in the hope of expanding their family in the future. She was unsuccessful, but her experience raised awareness.
The retrieval initiative is overseen by the Ministry of Health, which then splits cases between four hospitals.
Detecting live sperm is most likely in the first 24 hours after death, so timing is crucial, said Barda.
“We’ve limited the timeframe to 72 hours; however, the literature and our own experience suggests 44 to 45 hours is the maximum.”
The manner of death is also important.
“It depends on the state of the body, how it was kept and how severe the injuries were,” said Barda.
The hospital speaks directly to families, said Fuchs Weizman. “We tell them what we managed to freeze… and briefly about the process later, if they choose to use it.”
Barda added: “It’s very emotional, very hard, but we give them some hope.”
‘It’s a long process’
Irit Oren Gunders is the founder of Or Lamishpachot (Light to the Families), a non-profit organization supporting families of fallen soldiers. She has long campaigned for parents to have access to PSR.
“We need to give them hope and open their hearts again and only grandchildren will do it. It isn’t that they want a baby instead of their son - it’s the grandchild,” she told CNN by telephone.
Irit Rosenblum, a pioneering lawyer and founder of New Family, which advocates for family rights, is also working with bereaved parents.
Rosenblum made legal history in 2007 with the case of a woman whose son was killed in Gaza. This client became the first parent in Israel and one of the first in the world to win the right to have her son’s sperm extracted, she said. But it took over a decade for her to become a grandmother.
PSR can be the easy part, Rosenblum told CNN. “It’s a long process,” she said in a telephone interview. “We’ve had approximately 40 requests for extraction recently and it was easy to allow them but the next step will be finding women to use the sperm.”
Rosenblum says she has been instrumental in the birth of more than 100 children. She has long campaigned for biological wills, which provide unequivocal guidance after death. Since the Hamas attacks, she has made it quick and easy to complete a biological will online.
“I’m not a religious person but Israeli society is very family oriented and continuity is a must,” she said.
“The mourner has lost the will to live - the only way to restore meaning to their lives is through the continuity of the person they lost. Not allowing it, even though we have the technology, is not moral.”
Yulia and Vlad Poznianski, whose son Baruch died of cancer aged 25, are among those helped by Rosenblum.
Fifteen years on, Yulia still finds it difficult to talk about Baruch’s death. Instead, she focuses on the future and her granddaughter, Shira, who’s just turned 8.
“We made new life,” said Yulia, of their collaboration with Liat Malka, a single woman who had Shira using their son’s sperm.
“We’re very grateful to her but she’s also grateful to us,” said Yulia of Malka, explaining that they are very active grandparents.
Yulia describes Shira as a “brilliant” child whose resemblance to her father is “unbelievable.”
“She’s a big girl and she understands. She’s not the first and won’t be the last child whose father isn’t alive - especially now,” said Yulia.
Soldiers sent into conflict must be told about their options, said Yulia. “They have to know that they can leave their parents or wife their biological will.”
Israel ‘pushing the envelope’
Gil Siegal, head of the Center for Health Law and Bioethics at Kiryat Ono College in Israel and faculty at the University of Virginia Law School, told CNN by telephone: “It’s not by accident that Israel is a pioneer in reproductive medicine.
“The combination of high-tech medicine and a strong cultural, religious and existentialist bent for reproduction results in the highest number of IVF clinics per capita and the highest number of IVF cycles for women in the world.”
He said traditional ethical perspectives have been upended by the loss of life - especially among the young - since October 7.
“This is a new twist and Israel is pushing the envelope here,” he said. “We have the science and know-how on the one hand and on the second hand we have the impetus, which is religion, culture and history.”
Nevertheless, ethical questions must be considered, he said.
“When you face such a horrendous loss you do anything that is some sort of panacea for your endless grief and pain - but this is not the way we make policy.”
He believes bereaved parents should be allowed to access PSR, “but then you halt.”
With “zero urgency,” he said, “we have time to sit and debate and think about the implications of planned orphanhood, motivated by the request of the deceased’s parents.”
He added: “Planned orphanhood in the sense that this child was born out of a tragedy as a living memorial of the deceased soldier.”
But for Daphna-Tekoah, the answer is clear in the wake of the Hamas attack.
“If, as a country, we encourage people to donate organs after death, why aren’t we giving people the right to donate sperm? We’re not living in the Middle Ages and the technology is here. It’s their human right,” she said.
“It was a catastrophe and we owe it to them.”
This story has been updated.
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