Our bodies, it seems, die not all at once, but in parts. Early scientific literature advises doctors to extract and freeze a sperm sample within 24–36 hours of death but case studies show that under the right conditions, viable sperm can survive well beyond this deadline. Rothman tells of a man who died kayaking in cold water whose sperm were in good shape a full two days later. And in April 2015, doctors in Australia announced a “happy, healthy baby” born from sperm removed 48 hours after the death of the father.

The sperm don’t have to be zippy and perfect, just alive. Though swimmers freeze and thaw much better, sluggish sperm can still create a pregnancy. All it takes is a single sperm injected into an egg.

1) Urethra. 2) Penis. 3) Urinary bladder. 4) Seminal vesicle. 5) Ejaculatory duct. 6) Prostate gland. 7) Vas deferens. 8) Epididymis. 9) Testis. 10) Scrotum. © Kyle Bean and Mitch Payne

But first someone must retrieve it. To understand the procedure, it is useful know a little about the male reproductive system. However you know them – balls, nads, nuts, marbles, cherries, cojones – the testes are the spherical organs that hang down behind the penis. Connected to each testis, cupping it from above, is the epididymis, the tube in which sperm mature and are transported from the testes to the vas deferens. The vas deferens carries mature sperm to the urethra, which runs down the middle of the penis to the outside world.

There are several main ways that sperm are harvested, including needle extraction. As the name suggests, this method involves inserting a needle into the testis and drawing out some sperm. It’s often used in live patients but, because minimising invasiveness does not matter the same in dead people, doctors tend to use other methods post-mortem.

One of these approaches is to extract the testis or epididymis surgically. As the epididymis is where sperm go to mature, this tissue is a popular target. The doctor surgically removes the epididymis and milks it or otherwise separates the sperm from the tissue. Alternatively, the epididymis or a piece of testicular tissue can be frozen whole.

As the sperm in the vas deferens are fully mature, it is also possible to extract them from there. The surgeon may make a slit in this long, flexible tube and draw out fluid with a needle (aspiration) or flush the tube with a solution (irrigation). Mature sperm are better able to move, find an egg and penetrate it to complete fertilisation.

This technique is still widely used for bulls, ferrets, leopards, elephants and hippopotamuses

A fourth option is rectal probe ejaculation, also known as electroejaculation. The doctor inserts a conductive probe into the man’s anus until it is next to the prostate. A jolt of electricity causes a muscle contraction that stimulates ejaculation of sperm through the usual channels.

Interestingly, this technique was developed for and is still widely used in animal husbandry (for bulls, ferrets, leopards, elephants and hippopotamuses, among others). Because it does not require intact reflexes, it is also used for men who have spinal injuries.

But just because we know how to extract sperm after death, there is no assurance that someone will be given access to the procedure should they request it. Martin Bastuba, founder and medical director of Male Fertility & Sexual Medicine Specialists in San Diego, is the doctor who retrieved Mike Clark’s sperm after his motorcycle accident. “There are no specific rules,” Bastuba says. “Most of the laws on the books were written before this technology really existed.”

The US legal position is a tangle of confusing and sometimes conflicting regulations. The laws that govern tissue and organ donation are federal (the Uniform Anatomical Gift Act and the National Organ Transplant Act), but they don’t necessarily apply to sperm, classed as renewable tissue. Arthur Caplan, head of bioethics at the New York University Langone Medical Center, says that federal law “should be emended to include sperm, eggs, uterus, ovaries and testes”. Meanwhile, artificial reproduction is regulated by individual states.

If a man has made no prior directives, such as enrolling as an organ donor, the next of kin can decide when to stop life support, whether to donate a man’s organs, how his body will be used or disposed of, and his funeral rites. But his sperm are often treated differently.

Sperm, it is said, are special. Several recent court rulings have given sperm a legal status higher than that of blood, bone marrow or organs. While those substances and body parts may be used to save life, sperm – like eggs – are often singled out for their potential to create life. In line with this view are positions such as that of the American Society for Reproductive Medicine, which argued 2013 that, “in the absence of a written directive, it is reasonable to conclude that physicians are not obligated to comply with either request [for sperm extraction or use of extracted sperm] from a surviving spouse or partner”.

Other opinions and legal rulings vary, though. In 2006, a judge who was interpreting organ donation policy ruled that organs, sperm included, can be gifted by a man’s parents after his death, provided the man didn’t previously refuse to make such a gift.

Because we still can’t decide on what sperm are or are not, policies on post-mortem sperm extraction differ between hospitals, and are spotty and inconsistent. Many hospitals have no policy at all. In one review published in 2013 in the journal Fertility and Sterility, biomedical ethicists contacted 40 US hospitals about their post-mortem sperm collection protocols. Only six produced complete protocols, and 24 of them (60 per cent) reported that either they either had no protocol or were unaware of one. This lack of policy may be because post-mortem sperm requests are rare. Unfortunately, when a request is made, the countdown has already begun and the hospital needs to be able to decide quickly.

This variability means that two hospitals across the street from each other might make opposite decisions. The 2013 Fertility and Sterility review concludes: “Many institutions do not yet have protocols in place, and those that are in place differ in important ways, including the standard of evidence regarding consent, wait time mandates before use of the sperm, method of sperm retrieval, and logistics of sperm storage and payment for the procedure.”

Doctors seeking direction may find help in published guidelines, a kind of urology “pirate code”. The guidelines from the urology department of Cornell University have been adopted by New York Hospital and others formally and informally across the US. The guidelines include that the person requesting must be the wife of the deceased, that the couple must have been committed to having children together, and that the widow must wait at least a year to gain access to the extracted sperm.

The American Society for Reproductive Medicine’s position is that post-mortem sperm requests should be granted only to surviving spouses or life partners, and that there must be a grief period prior to the sperm’s use. Notably, it counsels that medical centres “are not obligated to participate in such activities, but in any case should develop written policies”.

If a doctor or hospital does not feel comfortable performing the procedure, often they can release the body to someone else. Bastuba has harvested sperm in the intensive care unit of a hospital, in a morgue, in a medical examiner’s office, and even in a funeral home. But there has to be enough time so that the sperm will still be viable. Every decision made along the way must comply with individual hospital policy or the decision of its medical ethics board.