Management of the infertile couple: an evidence-based protocol

Abstract

BackgroundInfertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. Evaluation usually starts after 12 months; however it may be indicated earlier. The most common causes of infertility are: male factor such as sperm abnormalities, female factor such as ovulation dysfunction and tubal pathology, combined male and female factors and unexplained infertility.ObjectivesThe aim of this study is to provide the healthcare professionals an evidence-based management protocol for infertile couples away from medical information overload.MethodsA comprehensive review where the literature was searched for "Management of infertility and/or infertile couples" at library website of University of Bristol (MetaLib) by using a cross-search of different medical databases besides the relevant printed medical journals and periodicals. Guidelines and recommendations were retrieved from the best evidence reviews such as that from the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), and Royal College of Obstetricians and Gynaecologists (RCOG).ResultsA simple guide for the clinicians to manage the infertile couples.ConclusionsThe study deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. It is an approach to disseminate the recommended medical care for infertile couple to the practicing clinicians.

Effects of assisted reproductive technologies on human sex ratio at birth

“…The number of babies born from assisted conception, assisted reproductive technologies (ART), is increasing rapidly: their numbers have quadrupled in the last twenty years, and, to date, approximately 5 million babies worldwide have been born following ART (2,3). In the UK, the prevalence of infertility is still higher with one in six couples reported to experience infertility problems (4), and ART births constitute 2-2.5% of all births in the country (5,6). Despite these numbers, the impact of ART treatments on the general human population is poorly understood.…”

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“…As técnicas hoje envolvem tratamento médico para induzir ovulação, cirúrgico como laparoscopia, histeroscopia, reprodução assistida dentre outros que apresentam alto custo fazendo com que os casais busquem as terapias complementares 14 .…”

Introductory Chapter: One-Stop Infertility Evaluation Unit

“…Their cumulative probabilities of conception are 60% within the first six months, 84% within the first year, and 92% within the second year of regular fertility-focused sexual activity [4]. There is no definite cutoff point to say when a couple is infertile.…”