Information and counselling on post-mortem reproduction: a Delphi study with ART specialists

Area of Science:

• Reproductive Medicine
• Bioethics
• Psychology

Background:

• Post-mortem assisted reproductive technology (ART) and intrauterine insemination (IUI) present complex ethical and psychosocial challenges.
• Existing literature and clinical guidelines inadequately address the multifaceted needs of individuals undergoing these procedures.

Purpose of the Study:

• To identify critical issues concerning information provision, psychosocial counselling, and future guidelines for post-mortem ART/IUI.
• To establish expert consensus on best practices for managing post-mortem reproductive technologies.

Main Methods:

• A three-round international Delphi study involving 39 ART specialists (embryologists, physicians, nurses, psychologists).
• Qualitative thematic analysis of initial expert perspectives followed by Likert scale agreement ratings and item prioritization.
• Consensus defined as ≥70% agreement/disagreement on statements.

Main Results:

• Essential considerations include safeguarding legal/procedural aspects and obtaining prior written consent from the deceased partner.
• Integration of psychological counselling throughout the post-mortem ART/IUI process is crucial.
• Areas of divergence identified regarding bereavement periods, family involvement, and long-term support; gaps in legal clarity and child-centeredness noted.

Conclusions:

• Multidisciplinary, consensus-informed guidance is essential for clinical practice in post-mortem ART/IUI.
• Critical gaps exist in legal frameworks, psychological support, and family/child-centered considerations.
• Further research and policy development are needed to address emerging themes like healthcare professional impact and socio-cultural factors.