Posthumous assisted reproduction
- Shane T Lipskind, MD
Shane T Lipskind, MD
- Clinical Assistant Professor
- Department of Obstetrics and Gynecology
- University of Arizona College of Medicine
- Elizabeth S Ginsburg, MD
Elizabeth S Ginsburg, MD
- Associate Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
Assisted reproductive technologies (ART), including in vitro fertilization (IVF) and cryopreservation of gametes (eggs and sperm) and embryos, are intended to address an innate human drive - the desire to reproduce. These procedures, which enable human reproduction across a myriad of medical and social situations, also make it possible to create life using gametes or embryos from a genetic parent who is no longer living.
Posthumous assisted reproduction (PAR) is the process by which ART is used to establish pregnancy and produce genetic offspring after the death of the parent. This distinctly modern phenomenon raises numerous challenges for patients, their families and clinicians, as well as society at large.
Postmortem conception by artificial insemination using cryopreserved sperm has been available since the 1950s [1,2]. One of its first uses was to offer men in high risk professions (eg, astronauts, soldiers) an option for fathering children in the event of injury or death. Postmortem sperm retrieval was first reported in 1980. Development of now routine techniques, such as oocyte retrieval, in vitro fertilization (IVF), and cryopreserved embryo transfer, expanded the possibilities of parenting after death for both men and women.
Few studies have assessed the utilization of posthumous assisted reproduction (PAR), and an accurate number of births that have resulted from PAR is not known. Several factors likely contribute to the lack of information. First, PAR probably accounts for a relatively small proportion of all assisted reproductive technology (ART) procedures. In addition, individuals who request gamete or embryo banking for PAR may never actually use them [3,4]. Lastly, both patients and clinicians may be reluctant to report these pregnancies and births in the medical literature to avoid drawing media attention to this controversial practice. Nevertheless, it seems inevitable that PAR will gain more public awareness and acceptance as utilization of ART and fertility preservation services increase .
USE OF POSTHUMOUS REPRODUCTION
Posthumous reproduction is intended to fulfill a couple’s desire to reproduce. Since it is considered within the context of the untimely death or imminent demise of at least one genetic parent, it is assumed that at least one invested party, including the intended social parent(s), desires children through posthumous reproduction and that the requisite gametes or embryos are available.
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- USE OF POSTHUMOUS REPRODUCTION
- PROCEDURES FOR OBTAINING GAMETES AND EMBRYOS
- Ovarian tissue and testicular tissue
- Premeditated posthumous reproduction
- Unplanned posthumous reproduction
- ETHICAL ISSUES
- Respect for autonomy
- Social justice
- LEGAL ISSUES
- Ownership of gametes and embryos
- Inheritance rights of children
- Third parties
- SUMMARY AND RECOMMENDATIONS