Sperm donation for IVF: should it be allowed after death?

Photo: Tero Vesalainen - Getty Images/iStockphoto
Photo: Tero Vesalainen - Getty Images/iStockphoto 

Men should be able to voluntarily donate sperm to strangers after death argue UK ethicists, who claim it could help with sperm shortages in the country.

In an article published in British Medical Journal, Dr Nathan Hodson and Dr Joshua Parker suggest that not only is it "technically feasible" for dead men to donate their sperm, it's also "ethically permissable." "The inability to access donor sperm and the suffering this causes, we argue, justifies allowing access to sperm donated after death," they write.

According to the authors, "voluntary non-directed postmortem sperm donation," would involve being able to register the desire to donate sperm after death, to be used by strangers. 

But does a sperm shortage justify harvesting sperm after death?"

The authors believe it does.

"If it is morally acceptable that individuals can donate their tissues to relieve the suffering of others in 'life-enhancing transplants' for diseases, we see no reason this cannot be extended to other forms of suffering like infertility, which may or may not also be considered a disease."

Dr Hodson and Dr Parker argue that like organ donation, men would indicate whether they'd like to donate their sperm after death. "Following death, sperm is extracted, stored in fertility clinics and made available to those requiring donor sperm."

According to the authors, while men donate their sperm for a number of reasons, living sperm donation remains uncommon among British men. "There are barriers to donating sperm in life that may prevent some men acting on their desire to help others or see their genes continue into future generations through donation," they write adding that posthumous sperm donation "avoids most of these problems, allowing men to access the positives of sperm donation without the drawbacks."

But what about the parent or parents who use the sperm? How do they factor in?

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Well, Dr Hodson and Dr Parker note that some may prefer using sperm from a dead rather than a living donor. "The knowledge that the man who produced the donor sperm has died could provide a degree of simplicity when thinking about that child's future in terms of potential future interactions with their donor," they write.

While the discussion centred on the practice in the UK, is post-mortem sperm donation something we could - or should - see here in Australia?

 Dr Ben Kroon, fertility specialist, reproductive endocrinologist and obstetrician and gynaecologist tells Essential Baby that the idea of post-mortem sperm donation is "very interesting". 

"There certainly is a shortage of Australian men willing to altruistically donate sperm, so much so that many women and IVF units look to overseas sperm banks to fill in the gap in supply," he says. Despite that, however, Dr Kroon says he doesn't think post-mortem sperm donation is really the answer to the deficiency in sperm donors faced by Australia and other countries. 

And there are a number of key reasons why.

"Assessment of a live donor requires health checks where genetic conditions and infectious diseases are excluded and past reproductive performance is evaluated," Dr Kroon says. "A semen analysis is always performed, and men with a poor sample may not be included in the donor pool." But when it comes to a deceased donor, however, Dr Kroon says the only estimate of the reproductive potential of the sample is their history of prior reproductive performance.

"It is impossible to meaningfully evaluate the quality of sperm retrieved from the testis as it has yet to develop the capacity to swim," Dr Kroon explains adding that in very rare circumstances sperm may be retrieved from a 'brain dead' patient on life support through the use of vibro-ejaculation.

Dr Kroon says he suspects the vast majority of sperm retrieved from patients after their death in Australia is by either testicular sperm aspiration, (using a needle) open testicular biopsy or en block resection of the whole testis (removing the entire testicle). "Using these techniques, there is no way to sufficiently grade the quality of the retrieved sperm," he says. According to Dr Kroon, "grading the sperm" would be very helpful in the case of sperm retrieved post mortem, because sperm deteriorates depending on the length of time since the man has been deceased and the conditions in which the body was kept.

"Additionally, the process that has led to his death may well have meant the man was unwell prior to death," he continues. "In the face of significant illness, sperm production often slows and sperm quality may be affected. This is frequently seen in men diagnosed with cancer who choose to have sperm frozen prior to chemotherapy / radiotherapy. "

 Dr Kroon notes that women put considerable time, emotional energy and money into procuring sperm and being unable to give them any reassurance about the quality of the sperm they have purchased is "sub-optimal."

"My personal view is that this is likely to be a very expensive, ethically challenging and inefficient way to bolster the donor pool," Dr Kroon says, adding that it would be better to debate the merits of allowing payment for both sperm and egg donation. " Australian women flock overseas to access donor eggs and I think we do them a disservice in not providing such a service here. I have no doubt that donor payment would entice both men and women to donate in higher numbers and in doing so allow us to provide the greatest possible level of treatment for Australian singles and couples struggling with their fertility."

Adam Hooper who manages the Facebook group Sperm Donation Australia, which matches potential donors to those seeking sperm, tells Essential Baby that while their organisation "doesn't like to discriminate and believes people have the right to make their own choices," all their current donors donate while still alive. Hooper believes post-mortem sperm donation "just opens up a whole new can of worms and is probably based on business sense rather than ethical sense.

"The system needs to be looked at," he says. "But taking from the dead isn't the solution."