Andrology and Sperm Bank, Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Infertility and IVF Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Hospital, Petach-Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Andrology. 2024 Feb;12(2):380-384. doi: 10.1111/andr.13483. Epub 2023 Jun 27.
Banking of frozen spermatozoa by single men opens the possibility of procreation long after their death. Requests for posthumous reproduction by the families of the deceased are growing, raising an ethical debate, especially when written instructions were not left by the patients and in cases of unplanned perimortem collection. The issue of the progenitors' intention to procreate after death is the key to ethically based decision-making in these cases.
To evaluate the attitude of single men cryopreserving spermatozoa before life-threatening medical situations towards post-mortem usage of their cryopreserved spermatozoa.
MATERIALS & METHODS: Adult single men prior to sperm cryopreservation before cytotoxic therapy were asked to sign a structured form declaring their will and instructions for the usage of their cryopreserved spermatozoa in case of their demise.
Four hundred fifty-two men of diverse ethnicity, religious and cultural backgrounds signed the form providing instructions for the use of their cryopreserved spermatozoa in case of mortality. Their age was 27.4 ± 8.06 years. Seven (1.5%) patients willed their spermatozoa for posthumous reproduction to a sibling, 22 (4.9%) to parents, and 26 (5.7%) to their informal female partners. The significant majority (n = 397; 87.8 %) of the single men were ordered to destroy their cryopreserved spermatozoa in case of their expiry. Note that, 26-39 years old men were less likely (81.8% vs. >90% in other ages) to order sperm destruction, as well as men with a poorer prognosis (83% vs. 90%).
In this study group, most single men cryopreserving spermatozoa in the face of future life-threatening morbidity do so for their own future live parenthood, and are not interested in posthumous reproduction.
Our results doubt the claim that single men who had an unplanned perimortem sperm collection can be universally presumed to have wished to father a child posthumously. Any claimed assumed consent in these cases should be considered for each case individually based on its specific circumstances.
单身男性冷冻精子库的建立使得他们在去世后仍有生育的可能。越来越多的死者家属要求进行死后生育，这引发了一场伦理辩论，尤其是当患者没有留下书面指示，并且在计划外的临终前采集精子的情况下。在这些情况下，判断死者的生育意愿是基于伦理决策的关键。
评估在危及生命的医疗状况之前冷冻精子的单身男性对死后使用其冷冻精子的态度。
在接受细胞毒性治疗之前，要求成年单身男性在冷冻精子前签署一份结构化表格，声明他们对死后使用其冷冻精子的意愿和指示。
共有 452 名来自不同种族、宗教和文化背景的单身男性签署了该表格，他们对死后使用自己的冷冻精子做出了指示。他们的年龄为 27.4±8.06 岁。有 7 名（1.5%）患者希望将其精子用于死后生育给兄弟姐妹，22 名（4.9%）希望用于生育给父母，26 名（5.7%）希望用于生育给非正式的女性伴侣。绝大多数（n=397；87.8%）单身男性在去世时要求销毁其冷冻精子。值得注意的是，26-39 岁的男性更有可能（81.8%比其他年龄段的>90%）要求销毁精子，而预后较差的男性（83%比 90%）也是如此。
在本研究组中，大多数在面临未来危及生命的疾病时冷冻精子的单身男性都是为了自己未来的亲生父母而这样做的，他们对死后生育不感兴趣。
我们的研究结果对那些认为意外在临终前采集精子的单身男性可以普遍被假定为希望死后生育子女的说法表示怀疑。在这些情况下，任何声称的默认同意都应该根据具体情况单独考虑每个病例。
