What is the most appropriate course of action if a patient's relative dies after semen collection during an In Vitro Fertilization (IVF) procedure, but the patient wants to continue with the IVF?

Posthumous Use of Gametes in IVF: Ethical and Legal Considerations

The IVF procedure should be stopped and refused (Option B) following the death of the sperm donor, as both genetic contributors must provide current, ongoing consent for embryo creation and transfer, and this consent cannot be presumed to continue after death without explicit prior written authorization for posthumous use. 1

Legal and Ethical Framework

The fundamental principle governing assisted reproductive technology is that both genetic contributors retain dispositional authority that cannot be unilaterally overridden 1. This applies equally to gamete use and embryo disposition throughout the entire IVF process.

Consent Requirements

• Current consent from both parties is mandatory for any reproductive procedure, including gamete use, fertilization, and embryo transfer 1
• The deceased relative's consent was given for the IVF procedure while alive, but death fundamentally changes the consent landscape as ongoing participation is no longer possible 1
• Consent cannot be assumed to transfer or continue posthumously without explicit documentation authorizing posthumous use of gametes 1

Critical Distinction from Embryo Disposition

While this scenario involves collected gametes rather than created embryos, the same ethical principles apply:

• Dispositional authority remains with both genetic contributors regardless of the stage of the reproductive process 1
• Neither party can proceed unilaterally with reproductive decisions that require mutual consent 1
• The surviving partner cannot make decisions about gamete use without the deceased's explicit prior authorization 1

Why Continuing Would Be Inappropriate

Proceeding with IVF using the deceased relative's sperm would violate reproductive autonomy for several critical reasons:

• The deceased cannot provide ongoing consent for fertilization and potential parenthood 1
• Death terminates the ability to participate in shared decision-making about reproduction 1
• Using gametes posthumously without explicit prior written consent violates the deceased's reproductive rights 1

Required Documentation for Posthumous Use

If the couple had wanted to preserve the option of posthumous reproduction, they should have:

• Documented explicit written consent for posthumous gamete use at the outset of the IVF process 1
• Specified terms of disposition in case of death, separation, or disagreement 1
• Included provisions addressing what should happen to collected gametes if one party dies during the IVF cycle 1

Common Pitfalls to Avoid

• Never proceed with gamete use or embryo creation without documented consent from both parties, even if one party has died 1
• Do not assume that initial consent for IVF automatically includes posthumous use of gametes or embryos 1
• Ensure original IVF consent forms are reviewed for any specific provisions regarding death during treatment 1
• Never allow emotional circumstances to override the requirement for explicit consent from both genetic contributors 1

Appropriate Course of Action

The clinic must stop the IVF procedure and take the following steps:

• Review the original consent documents to determine if posthumous use was explicitly authorized 1
• If no such authorization exists, the gametes should be disposed of according to clinic policy and applicable law 1
• Provide counseling and support to the surviving partner regarding grief and alternative family-building options 1
• Do not proceed with fertilization or transfer under any circumstances without documented posthumous use authorization 1

The answer is Option B: Stop and refuse to continue with IVF.