Attitudes towards posthumous reproduction in patients undergoing embryo or gamete cryopreservation

In a recent Ethics Committee Opinion, the ASRM addresses the importance of consenting patients on disposition of gametes or embryos prior to undergoing retrieval [1]. Despite the potential legal and ethical dilemmas that can arise if disposition is not expressly stated, this is not a requirement at all fertility centers. Previous studies have evaluated the attitudes of both the general population and couples seeking fertility counseling, however these were mostly focused on posthumous gamete retrieval, not the use of previously cryopreserved gametes or embryos after death of an intimate partner [2,3]. To assess attitudes of patients undergoing fertility treatment regarding posthumous use of cryopreserved gametes or embryos. Patients and partners who are currently undergoing or plan to undergo in-vitro fertilization or gamete cryopreservation were invited to complete an anonymous online survey using REDCap software. Patients were recruited using flyers posted in patient rooms and waiting areas. The questionnaire consisted of a brief introduction and definitions of posthumous reproduction. Eleven questions were used to identify attitudes regarding posthumous disposition of genetic material and posthumous reproduction. The remaining seven questions pertained to demographics. A series of descriptive statistics was performed to analyze relationships between respondents. Recruitment is ongoing, with a desired sample size of 150-200 participants. In the four weeks of recruitment, there were twenty-six respondents. Of those, twenty identified as female (77%), six identified as male (23%). Twenty-five indicated they were in a heterosexual relationship, while one was in a same-sex relationship. Fifteen of the twenty-six (57.6%) indicated they would choose their intimate partner to receive their frozen gametes or embryos in the case of their death. Of these fifteen, all fifteen (100%) indicated they would strongly agree or agree to their partner using their gametes or embryos to conceive a child. Of these fifteen, eleven (73.3%) stated they strongly agreed or agreed their partner could use their genetic material to conceive a child even without explicit consent prior to death. Two of the fifteen were neutral on the topic and two disagreed with their intimate partner using their genetic material to conceive in the setting of no prior explicit consent. Our preliminary findings indicate strong support for posthumous reproduction among infertility patients and partners undergoing gamete or embryo cryopreservation. There was unanimous support for usage of gametes or embryos if they intended for their intimate partner to be the recipient of their genetic material. Surprisingly, a majority of patients (73.3%) who support posthumous reproduction would agree with their intimate partner using their genetic material to conceive even without explicit consent. Subgroup analyses of gender, political affiliation, religion and type of cryopreservation are planned as study recruitment continues.