Life after death: Should dead men become sperm donors?

You can still have children after you die.

You’ll never meet them, of course, but your genetic code can live on in another person, through advancements in reproductive technology.

In some cases, people have their sperm or eggs harvested or frozen, perhaps before a cancer treatment, or as part of fertility treatments. In the event of their death — with prior consent — their partner might use the frozen samples to create a child.

In other, rarer cases, the sperm — for medical reasons — is taken from a man after he’s dead.

This week, the Journal of Medical Ethics published a paper arguing that a man should also be able to indicate that he wishes his sperm to be harvested after his death, and put into a sperm bank for use by anyone, just like he might consent to his organs being donated.

“Not every man who dies has a partner who wants to use their sperm,” said paper author Nathan Hodson, a fellow at Harvard University’s School of Public Health.

“There are lots of people out there who are looking for sperm donors. What we’re proposing is to put the two together.”

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Such a practice brings up some tricky ethical questions, experts say.

But medically, it’s possible.

Sperm can be harvested and used to successfully produce a healthy child for around 48 hours after a man’s death, according to small case studies.

While it might be medically possible to remove eggs after a woman’s death, it would be tricky given women’s menstrual cycles, said Simon Phillips, scientific director of the Clinique Ovo in Montreal and a board member of the Canadian Fertility and Andrology Society. He’s not aware of any cases of this happening.

Canadian law currently requires written consent for someone’s reproductive material to be extracted after they die for the purposes of creating an embryo.

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In December 2019, a B.C. judge ruled on a case involving a woman who wished to extract and use her husband’s sperm after he died suddenly. The sperm sat frozen for more than a year while she waited for judicial approval to use it.

She and various people who knew the couple testified that he would have wanted more children — something the judge said was never in doubt.

In the end, the judge ruled against her, and said she couldn’t use her husband’s sperm. The reason he gave was that there was no clear written consent from the man before he died.

Sperm donation in Canada is covered under a separate set of regulations, Phillips said, which also wouldn’t permit posthumous donation in the manner proposed by the paper. But regulations can be changed.

An unmet need

Far more people want donated sperm than donate it in the U.K., Hodson noted. This is also true in Canada, where most donated sperm is imported from the U.S., according to Phillips.

Allowing posthumous sperm donation may not solve the whole problem of the shortage of sperm, Hodson said. “But having said that, if it was possible to meet some people’s needs through this, that’s not a bad thing at all either.”

In the paper, Hodson suggests that quality and safety standards would have to be at least the same as for live sperm donation.

This is an important point, according to Vardit Ravitsky, a professor of bioethics at the Université de Montréal’s school of public health.

“If a man dies young, why did he die?” she asked. “If it was an accident, that’s one thing. But if it’s a genetic issue, then that’s probably sperm you do not want to use for reproduction.”

Even deaths from certain illnesses might be related to genetics, she said.

There are other potential problems too, she thinks. For one, some family members might consider the extraction procedure, which can involve surgery, to be an invasion or violation of their loved one’s remains.

There’s also the question of the eventual child. Canada currently allows men to choose whether they want to donate their sperm anonymously, or in an “Open ID” donation where the child can learn the name of and possibly even contact their biological father someday.

“We do know that what has been dubbed the ‘donated generation’ — many of the hundreds of thousands of kids born from sperm and egg donation — voiced strong interest in knowing genetically where they came from,” Ravitsky said.

“Which means if it becomes more common to use sperm from deceased men, for those who would like to reach out and meet their donor, that’s not a possibility.”

There’s an ongoing debate about the ethics of creating a child who is an orphan at conception, she said.

Families might also disagree about what to do with a sperm sample, even when there is a designated recipient, she said. There have been cases in Israel of a man’s widow and his parents ending up in court over his sperm, she said.

In one recent case, she said, “The widow didn’t want to use the sperm that her husband left. So his parents said, ‘OK, we’ll take it and we’ll use it with another woman.’ And she went to court to stop them.”

Sperm might be considered differently than an organ donation, she said, because it would be used to create new life, not just save one.

“It’s not just the use of the organ. It’s an entire human being that’s going to exist that genetically is part of your family.”

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“Just imagine discovering that your husband agreed to this and now the sperm goes to some random woman and his genetic child is now in this world. … Maybe the child looks like him.”

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Balancing everyone’s wishes is a tricky thing to do, she said.

As technology opens up more and more possibilities, these are questions that may have to be wrestled with down the road.

“When IVF (in-vitro fertilization) started 42 years ago, it was really about helping a married heterosexual couple get their sperm and eggs to connect,” Ravitsky said.

But once we were able to preserve eggs, sperm and embryos outside the body, Ravitsky added, “Everything became possible: making an embryo and putting it in another woman. Taking the sperm or the egg not from the couple. Taking it post-death.

“We just opened the door to all these other practices and I don’t think we realized the avalanche of possibilities that will emerge.”