Posthumous Assisted Reproduction

ABSTRACT

Cryopreservation of gametes and embryos allows for children to be conceived after the death of their genetic parents through the process of posthumous assisted reproduction (PAR). Although the techniques are routine, the moral and ethical details are controversial and remain unsettled. Furthermore, there are numerous medicolegal implications that complicate matters. The principal parties to be considered are the decedent, the child who will be born of PAR, the significant other requesting the procedure, other living children, and even society at large. Numerous case studies exist and expert opinions have been published recognizing PAR as a vexing ethical issue. Most experts agree that explicit written consent forms signed at the time of cryopreservation are the best method to minimize some of the controversy involved with PAR.

Posthumous assisted reproduction - posthumous conception - gamete cryopreservation - embryo cryopreservation.

REFERENCES

• 1 Bahadur G. Ethical challenges in reproductive medicine: posthumous reproduction. International Congress Series—Advances in Fertility and Reproductive Medicine. Proceedings of the 18th World Congress on Fertility and Sterility Montreal; Canada 2004 1266: 295-302
• 2 Shefi S, Raviv G, Eisenberg M L et al. Posthumous sperm retrieval: analysis of time interval to harvest sperm.  Hum Reprod. 2006;  21(11) 2890-2893
• 3 Michelmann H W, Nayudu P. Cryopreservation of human embryos.  Cell Tissue Bank. 2006;  7(2) 135-141
• 4 Hoffman D I, Zellman G L, Fair C C Society for Assisted Reproduction Technology (SART) and RAND et al. Cryopreserved embryos in the United States and their availability for research.  Fertil Steril. 2003;  79(5) 1063-1069
• 5 Practice Committee of American Society for Reproductive Medicine . Ovarian tissue and oocyte cryopreservation.  Fertil Steril. 2008;  90(5 Suppl) S241-S246
• 6 Fadini R, Brambillasca F, Renzini M M et al. Human oocyte cryopreservation: comparison between slow and ultrarapid methods.  Reprod Biomed Online. 2009;  19(2) 171-180
• 7 Nachtigall R D, Dougall K M, Harrington J, Duff J, Lee M, Becker G. How couples who have undergone in vitro fertilization decide what to do with surplus frozen embryos.  Fertil Steril. 2009;  92(6) 2094-2096
• 8 Dohrenwend A. Perspective: a grand challenge to academic medicine: speak out on gay rights.  Acad Med. 2009;  84(6) 788-792
• 9 Tasker F. Lesbian mothers, gay fathers, and their children: a review.  J Dev Behav Pediatr. 2005;  26(3) 224-240
• 10 Ethics Committee of the American Society of Reproductive Medicine . Access to fertility treatment by gays, lesbians, and unmarried persons.  Fertil Steril. 2009;  92(4) 1190-1193
• 11 Weiss R. Babies in limbo: laws outpaced by fertility advances. Washington Post; February 8, 1998: A1
• 12 Fischbach R L, Loike J D. Postmortem fatherhood: life after life.  Lancet. 2008;  371(9631) 2166-2167
• 13 Wilder B. Assisted reproduction technology: trends and suggestions for the developing law.  Journal of the American Academy of Matrimonial Lawyers. 2002;  18 34
• 14 Aziza-Shuster E. A child at all costs: posthumous reproduction and the meaning of parenthood.  Hum Reprod. 1994;  9(11) 2182-2185
• 15 Lynch C UN. Backs human cloning ban. Washington Post; March 9, 2005: A15
• 16 Keefer C L. Lessons learned from nuclear transfer (cloning).  Theriogenology. 2008;  69(1) 48-54
• 17 Kindregan Jr C P, McBrien M. Posthumous reproduction.  Fam Law Q. 2005;  39(3) 579-597
• 18 Bahadur G. Death and conception.  Hum Reprod. 2002;  17(10) 2769-2775
• 19 White G B. Commentary: legal and ethical aspects of sperm retrieval.  J Law Med Ethics. 1999;  27(4) 359-361
• 20 Das K K, Lerner B H. Opportunities not taken: successes and shortcomings in the Institute of Medicine's report on organ donation.  Kidney Int. 2007;  71(8) 726-729
• 21 Siegel-Itzkovich J. Israel allows removal of sperm from dead men at wives' request.  BMJ. 2003;  327(7425) 1187
• 22 Maccallum F, Golombok S. Children raised in fatherless families from infancy: a follow-up of children of lesbian and single heterosexual mothers at early adolescence.  J Child Psychol Psychiatry. 2004;  45(8) 1407-1419
• 23 Pennings G, de Wert G, Shenfield F, Cohen J, Devroey P, Tarlatzis B. ESHRE Task Force on Ethics and Law . ESHRE Task Force on Ethics and Law 11: Posthumous assisted reproduction.  Hum Reprod. 2006;  21(12) 3050-3053
• 24 MacCallum F, Keeley S. Embryo donation families: a follow-up in middle childhood.  J Fam Psychol. 2008;  22(6) 799-808
• 25 Ethics Committee of the American Society for Reproductive Medicine . Posthumous reproduction.  Fertil Steril. 2004;  82(Suppl 1) S260-S262
• 26 Assisted Reproductive Technologies Analysis and Recommendations for Public Policy New York State Task Force . 1998; 
• 27 BBC News .Diane Blood registers sons. 2003. Available at http://news.bbc.co.uk/2/hi/uk_news/england/nottinghamshire/3252436.stm Accessed May 25, 2010
• 28 Planchon S. Comment: the application of the dead man's statutes in family law.  Journal of the American Academy of Matrimonial Lawyers. 2001;  13 561-577
• 29 KTLA News .Girl conceived with dead man's sperm denied benefits. 2009. Available at: http://www.ktla.com/news/landing/ktla-pasadena-girl-frozen-sperm,0,2986422.story Accessed May 25, 2010
• 30 Batzer F R, Hurwitz J M, Caplan A. Postmortem parenthood and the need for a protocol with posthumous sperm procurement.  Fertil Steril. 2003;  79(6) 1263-1269