Developing guidelines for posthumous assisted reproduction in adolescent and young adult patients

Celine Akande – NYU Grossman School of Medicine; Michelle Bayefsky – Reproductive Medicine Associates of New York; Arthur Caplan – NYU Grossman School of Medicine; Gwendolyn Quinn – NYU Grossman School of Medicine

Abstract: Posthumous assisted reproduction (PAR) can involve: (1) retrieving eggs or sperm to create a child after the death of a patient; (2) using stored eggs or sperm after the death of a patient who produced the eggs or sperm before death; or (3) using stored embryos after the death of a patient who contributed to creation of the embryos. While counseling regarding PAR is crucial for any individual undergoing fertility treatment, cases of adolescent/young adult (AYA) patients undergoing fertility preservation for medical reasons, such as cancer, raise particularly complex ethical, religious, legal, emotional, and logistical considerations. Current practice is driven by varying, sometimes discordant, and at times absent policies among hospitals, fertility clinics, and storage facilities. Our study sought to develop recommendations for uniform, equitable, and evidence-based guidelines for PAR education and practice, with particular attention to the AYA population. We will present results and analysis of 40 in-depth qualitative interviews with interested/affected groups including oncology and reproductive medicine clinicians, reproductive attorneys, members of hospital ethics committees, religious leaders, and individuals who considered or pursued PAR. We will then describe the project’s second phase involving a Delphi method, in which statements generated from review of the literature and honed from interview data were used to develop expert-driven consensus guideline recommendations.

Keywords: Posthumous assisted reproduction, Reproductive ethics, Assisted reproductive technologies (ART)