Scenario | Gamete provider(s) | Requester(s) | Techniques | Considerations |
Possibility of death is anticipated | Military personnel in combat zones or other high risk occupations[2] Patients with potentially fatal illness (eg, cancer)[2] | The gamete provider and a surviving partner or family member | Gamete/embryo cryopreservation | Satisfies issues of informed consent from gamete provider prior to their death and respect for autonomy of the deceased |
Fertility preservation | Patients are expected to survive a potentially gonadotoxic event, such as chemotherapy or radiation for cancer | Usually a surviving partner or family member | Cryopreservation of gametes, embryos, or reproductive tissues (eg, ovarian tissue) | Tissues are stored for future use in anticipation of probable cure Disposition of reproductive tissues should be decided at the time of their collection[1] Legal minors may not be able to give informed consent |
General infertility | Individuals/couples previously or currently using assisted reproductive technologies for routine indications | Usually a surviving partner or family member Possibly an unknown recipient (in the case of gamete or embryo donation)[3] | Gamete/embryo cryopreservation | Cryopreserved gametes or embryos already stored for use by the intended parents while living[3] Desire to reproduce while alive is explicit, but wishes concerning posthumous reproduction are not always considered Disposition of gametes/embryos in case of death should be determined prior to freezing[1] Full disclosure and 3rd party consent required in cases of anonymous gamete/embryo donation[1] |
Sudden unexpected death or incapacitated state | Patients suffering recent death, coma, or irrecoverable illness rendering them unable to provide consent for PAR[4] | Surviving partner or family member | Posthumous or perimortem gamete retrieval and cryopreservation | Often no opportunity to obtain consent from the prospective gamete donor Gamete retrieval can be invasive and is usually time-sensitive The act may be of emotionally therapeutic value for survivors even if the gametes are rarely if ever used |
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