The International Glossary on Infertility and Fertility Care, 2017†‡§

Abstract

STUDY QUESTIONCan a consensus and evidence-driven set of terms and definitions be generated to be used globally in order to ensure consistency when reporting on infertility issues and fertility care interventions, as well as to harmonize communication among the medical and scientific communities, policy-makers, and lay public including individuals and couples experiencing fertility problems?SUMMARY ANSWERA set of 283 consensus-based and evidence-driven terminologies used in infertility and fertility care has been generated through an inclusive consensus-based process with multiple stakeholders.WHAT IS KNOWN ALREADYIn 2006 the International Committee for Monitoring Assisted Reproductive Technologies (ICMART) published a first glossary of 53 terms and definitions. In 2009 ICMART together with WHO published a revised version expanded to 87 terms, which defined infertility as a disease of the reproductive system, and increased standardization of fertility treatment terminology. Since 2009, limitations were identified in several areas and enhancements were suggested for the glossary, especially concerning male factor, demography, epidemiology and public health issues.STUDY DESIGN, SIZE, DURATIONTwenty-five professionals, from all parts of the world and representing their expertise in a variety of sub-specialties, were organized into five working groups: clinical definitions; outcome measurements; embryology laboratory; clinical and laboratory andrology; and epidemiology and public health. Assessment for revisions, as well as expansion on topics not covered by the previous glossary, were undertaken. A larger group of independent experts and representatives from collaborating organizations further discussed and assisted in refining all terms and definitions.PARTICIPANTS/MATERIALS, SETTING, METHODSMembers of the working groups and glossary co-ordinators interacted through electronic mail and face-to-face in international/regional conferences. Two formal meetings were held in Geneva, Switzerland, with a final consensus meeting including independent experts as well as observers and representatives of international/regional scientific and patient organizations.MAIN RESULTS AND THE ROLE OF CHANCEA consensus-based and evidence-driven set of 283 terminologies used in infertility and fertility care was generated to harmonize communication among health professionals and scientists as well as the lay public, patients and policy makers. Definitions such as ‘fertility care’ and ‘fertility awareness’ together with terminologies used in embryology and andrology have been introduced in the glossary for the first time. Furthermore, the definition of ‘infertility’ has been expanded in order to cover a wider spectrum of conditions affecting the capacity of individuals and couples to reproduce. The definition of infertility remains as a disease characterized by the failure to establish a clinical pregnancy; however, it also acknowledges that the failure to become pregnant does not always result from a disease, and therefore introd...

Analysis of PGT‐M and PGT‐SR outcomes at a Canadian fertility clinic

“…All PGT‐M and PGT‐SR cases over 49 months, concluding in March 2018, were included in this study. All patients pursing PGT‐M and PGT‐SR had biopsied blastocyst samples tested in a commercial reference laboratory for preimplantation genetic screening for aneuploidy (PGT‐A) by means of next generation sequencing (NGS) or array comparative genomic hybridization (aCGH). For patients undergoing PGT‐M, euploid samples were subsequently tested by karyomapping .…”

“…Preimplantation genetic testing can be performed to screen embryos for monogenic/single gene disorders (PGT‐M) and structural chromosomal rearrangements (PGT‐SR) . The process of PGT‐M and PGT‐SR requires the following: (a) an IVF cycle to obtain embryos, (b) trophectoderm biopsy at the blastocyst stage, and (c) testing the biopsied cells to evaluate if the heritable genetic finding is present .…”

Challenges of infertility genetic counseling: Impact on counselors' personal and professional lives

“…Infertility genetic counselors (GCs) work with patients who are struggling to become pregnant, are pursuing assisted reproductive technologies (ART), and desire preconception carrier screening or genetic testing of embryos. They have a variety of roles as members of reproductive medicine health care teams including: counseling around preimplantation genetic testing, recently termed preimplantation genetic testing for Mendelian disorders (PGT‐M), structural rearrangements (PGT‐SR), and aneuploidy (PGT‐A; Zegers‐Hochschild et al, ); assisting in preconception carrier screening; participating in family history evaluation and gamete donor screening; and coordinating tests to investigate a genetic cause for infertility (“National Society of Genetic Counselors: Assisted Reproductive Technologies/Infertility SIG,” ). Infertility genetic counseling is a relatively new specialty, with special interest groups (SIGs) established in 1996 in the National Society of Genetics Counselors (NSGC; J. Fischer, pers.…”

Chlamydia trachomatis‐induced cell‐mediated and humoral immune response in women with unexplained infertility

“…Unexplained infertility is diagnosed in approximately 30% subfertile couples, when standard investigations in infertility workup yield normal results 4 . As these couples usually have good prognosis for natural conception, expectant management is often recommended.…”