Discussing the death of a loved one is never easy, and doing it in the midst of fertility treatment can be even harder. We attended a talk about the importance of discussing posthumous use of sperm, eggs or embryos with a trained infertility counsellor.
Two recent court cases have brought posthumous use of sperm back into the news. The high court in France has allowed a woman to take her deceased husband’s frozen sperm to Spain for assisted reproductive treatment.
In Australia a court ordered that the testes of a dead man be removed and stored in case his partner https://www.theguardian.com/science/2016/jun/01/parents-likely-to-block-girlfriends-attempt-to-access-sperm-from-dead-sonwants to use it for IVF in the future – although there is a possible legal challenge pending.
What is often missed in the news stories surrounding the issue is the emotional aspects of discussing posthumous use. I recently attended a stimulating talk on Posthumous Use Implications Counselling (PUIC) by Dr. Chris Bulmer, Head of Counselling at Leeds Centre for Reproductive Medicine.
What is Posthumous Use Implications Counselling
PUIC is focussed on helping patients to deal with the idea that they either might need to use the sperm of a partner after they have passed away. This means freezing the sperm of the male partner whilst they are still alive so that it can be used after they have died.
What is the law in the UK?
In the UK explicit consent is required in order for sperm, or embryos created with a man’s sperm, to be used after his death. The Beth Warren case in 2014 resulted in further clarification to the consent forms to ensure that patients are aware of all their options. The HFEA has issued clear guidance on the issue as well.
Why should you consider discussing this?
For many patients the thought of freezing sperm for posthumous use may not be something that immediately springs to mind. However, there are 3 main groups of patients who may typically consider it:
- Cancer patients
- Serving military personnel
- Patients who do it just in case
By far the largest group of patients are those whose partner is dealing cancer.
How does grief affect decision making?
Dr. Bulmer commented that counselling patients with these needs can be a challenge. It can be complicated by the sense of grief and loss that anybody would experience with the loss of a partner.
‘grief is an elongated social process with a beginning, middle and end that can mean that decisions made today might not be right 6 months down the line’
According to Dr. Bulmer grief peaks at 3-4 months after the passing of a partner. However, overall symptom reduction typically taking place between 17-24 months which means decisions made before then may not be considered in the right frame of mind.
If a patient does have a change of heart months down the line (maybe they don’t want to use the sperm any more) there can be feelings of guilt which can make decision making harder.
What about the children?
Dr. Bulmer was keen to emphasise that patients take an holistic view and consider all of those affected by the decision to use the gametes of a deceased partner. It may surprise you to hear that the majority of patients in this position don’t consider what impact not having a present-father can have on the child.
In recent survey, run by Dr. Bulmer over 90% of patients requiring PUIC had not considered what impact not having a present-father would have on the child. Dr. Bulmer went on to say that:
‘whatever relationship a child may have with their absent father it’s not going to be a normal attachment as there is no one there’
That said, it is possible to create a connection using photos and stories but this will require commitment.
Making a decision to start a family is hard enough without having to consider the fact that one of you won’t be there. If you find yourself in this situation it’s incredibly important that you take your time and speak to a counsellor, with your partner, and understand the implication of posthumous use.
It’s also worth taking the time to learn how your grief and loss can impact on your decision making and to understand that how you feel, will change. There’s also the knock-on effects to your children that need to be considered.
The good news is that professionals are there to help you and experts like Dr. Bulmer will make sure you get the support you need.