Procreation after death or mental incompetence: Medical advance or technology gone awry?

Objective: To review our experience with semen retrieval in men who are incompetent or dead and to formulate general medical, legal, and ethical guidelines for practitioners. Design: Case series and literature review. Setting: Academic. Patient(s): Seven incompetent or neurologically dead individuals in whom sperm retrieval was requested. Intervention(s): Electroejaculation. Result(s): Seminal emission was induced in the two men who underwent electroejaculation. Sperm suitable for cryopreservation was obtained in one of these men. Review of the legal and ethical implications of such procedures led to development of general guidelines for determining whether gamete retrieval should be performed when requested. Issues of procreational autonomy, consideration of the decedent's wishes, and assurance of the well-being of any new life created were considered most strongly in the formation of these guidelines. Conclusion(s): Although the retrieval of sperm from deceased or incompetent individuals may be achieved readily, it is incumbent upon the practitioner to consider the legal and moral implications of these procedures before proceeding.