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

PURPOSE: To explore what issues should be addressed in terms of information, psychosocial counselling, and future guidelines for individuals considering post-mortem ART/IUI. METHODS: A three-round Delphi study was conducted (December 2024 to August 2025) among international ART specialists (embryologists, physicians, nurses, and clinical psychologists). The study was disseminated via the mailing lists of the European Society of Human Reproduction and Embryology (ESHRE) and the Portuguese Society of Reproductive Medicine (SPMR), with the participation of 39 members. In round one, an open-ended question elicited expert perspectives on key issues in information provision, psychosocial counselling, and future guidance for post-mortem ART/IUI. Responses were subjected to qualitative thematic analysis. In round two, participants rated their agreement with each item using a five-point Likert scale. Consensus was reached if ≥ 70% of participants agreed/disagreed with a statement. In round three, prioritisation of items was performed. RESULTS: The most important points identified were the need to safeguard legal and procedural aspects, the need to ensure prior written consent from the deceased partner, and the need to integrate psychological counselling throughout the post-mortem ART/IUI process. Areas of divergence were also identified, in relation to bereavement periods, family involvement, and long-term psychosocial support. Emerging themes underrepresented in the literature were also identified, including the psychological impact on healthcare professionals and broader social and cultural considerations. CONCLUSIONS: These findings underscore the need for multidisciplinary, consensus-informed guidance to support clinical practice in post-mortem ART/IUI. In the same way, this study highlights critical gaps in legal clarity, psychological support, and family-centred and child-centred considerations.