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Infertility HELP
Based on 18,760 articles published since 2008

These are the 18760 published articles about Infertility that originated from Worldwide during 2008-2018.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline [Fertility preservation, contraception and menopause hormone therapy in women treated for rare ovarian tumors: Guidelines from the French national network dedicated to rare gynaecological cancer]. 2018

Rousset-Jablonski, Christine / Selle, Fréderic / Adda-Herzog, Elodie / Planchamp, François / Selleret, Lise / Pomel, Christophe / Chabbert-Buffet, Nathalie / Daraï, Emile / Pautier, Patricia / Trémollières, Florence / Guyon, Frederic / Rouzier, Roman / Laurence, Valérie / Chopin, Nicolas / Faure-Conter, Cécile / Bentivegna, Enrica / Vacher-Lavenu, Marie-Cécile / Lhomme, Catherine / Floquet, Anne / Treilleux, Isabelle / Lecuru, Fabrice / Gouy, Sébastien / Kalbacher, Elsa / Genestie, Catherine / de la Motte Rouge, Thibault / Ferron, Gwenael / Devouassoux-Shisheboran, Mojgan / Kurtz, Jean-Emmanuel / Namer, Moise / Joly, Florence / Pujade-Lauraine, Eric / Grynberg, Michael / Querleu, Denis / Morice, Philippe / Gompel, Anne / Ray-Coquard, Isabelle. ·Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France; Hospices civils de Lyon, centre hospitalier Lyon-Sud, 165, chemin du grand-Revoyet, 69495 Pierre-Bénite cedex, France. Electronic address: christine.rousset-jablonski@lyon.unicancer.fr. · Groupe hospitalier Diaconesses Croix-Saint-Simon, 12-18, rue du Sergent-Bauchat, 75012 Paris, France. · Hôpital Foch, service de gynécologie-obstétrique, 40, rue Worth, 92151 Suresnes, France. · Institut Bergonié, 229, Cours-de-l'Argonne, 33000 Bordeaux, France. · Hôpital Tenon, service de gynécologie-obstétrique et médecine de la reproduction, 4, rue de la Chine, 75020 Paris, France. · Centre Jean-Perrin, 58, rue Montalembert BP, 392, 63011 Clermont-Ferrand cedex 1, France. · Institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France. · Hôpital Paule-de-Viguier, centre de ménopause et de dépistage de l'ostéoporose, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France. · Institut Curie, 26, rue d'Ulm, 75005 Paris, France. · Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France. · Hôpital Cochin-Port Royal, 53, avenue de l'Observatoire, 75014 Paris, France. · Hôpital Européen Geroges-Pompidou, 20, rue Leblanc, 75015 Paris, France. · CHU Besançon-Jean-Minjoz, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France. · Centre Eugène-Marquis, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France. · CLCC, institut Claudius-Regaud, IUCT Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France. · Hospices civils de Lyon, centre hospitalier Lyon-Sud, 165, chemin du grand-Revoyet, 69495 Pierre-Bénite cedex, France. · CHU de Strasbourg, hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France. · Recommandations pour la pratique clinique, Nice-Saint-Paul, 06000 Nice, France. · Centre François-Baclesse, 3, avenue du Général-Harris, 14076 Caen cedex 5, France. · CHU Paris Centre, hôpital Hôtel-Dieu, 1, place du Parvis-Notre-Dame, 75004 Paris, France. · Hôpital Jean-Verdier, avenue du 14 juillet, 93140 Bondy, France. ·Bull Cancer · Pubmed #29397916.

ABSTRACT: INTRODUCTION: Rare ovarian tumors include complex borderline ovarian tumors, sex-cord tumors, germ cell tumors, and rare epithelial tumors. Indications and modalities of fertility preservation, infertility management and contraindications for hormonal contraception or menopause hormone therapy are frequent issues in clinical practice. A panel of experts from the French national network dedicated to rare gynaecological cancers, and of experts in reproductive medicine and gynaecology have worked on guidelines about fertility preservation, contraception and menopause hormone therapy in women treated for ovarian rare tumors. METHODS: A panel of 39 experts from different specialties contributed to the preparation of the guidelines, following the DELPHI method (formal consensus method). Statements were drafted after a systematic literature review, and then rated through two successive rounds. RESULTS: Thirty-five recommendations were selected, and concerned indications for fertility preservation, contraindications for ovarian stimulation (in the context of fertility preservation or for infertility management), contraceptive options (especially hormonal ones), and menopause hormone therapy for each tumor type. Overall, prudence has been recommended in the case of potentially hormone-sensitive tumors such as sex cord tumors, serous and endometrioid low-grade adenocarcinomas, as well as for high-risk serous borderline ovarian tumors. DISCUSSION: In the context of a scarce literature, a formal consensus method allowed the elaboration of guidelines, which will help clinicians in the management of these patients.

2 Guideline Child-rearing ability and the provision of fertility services: an Ethics Committee opinion. 2017

Anonymous3581073 / Anonymous3591073. ·The American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #29202968.

ABSTRACT: Fertility programs may withhold services from prospective patients on the basis of well-grounded reasons that those patients will be unable to provide minimally adequate or safe care for offspring. This document was reviewed and updated; this version replaces the previous version of this document, last published July 2013 (Fertil Steril 2013;100:50-53).

3 Guideline Performing the embryo transfer: a guideline. 2017

Anonymous1890993 / Anonymous1900993. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #28366416.

ABSTRACT: A systematic review of the literature was conducted which examined each of the major steps of embryo transfer. Recommendations made for improving pregnancy rates are based on interventions demonstrated to be either beneficial or not beneficial.

4 Guideline Guidance on the limits to the number of embryos to transfer: a committee opinion. 2017

Anonymous1820993 / Anonymous1830993. ·American Society for Reproductive Medicine; and Society for Assisted Reproductive Technology, Birmingham, Alabama. ·Fertil Steril · Pubmed #28292618.

ABSTRACT: Based on American Society for Reproductive Medicine (ASRM) and Society for Assisted Reproductive Technology data available through 2014, ASRM's guidelines for the limits on the number of embryos to be transferred in in vitro fertilization (IVF) cycles have been further refined in continuing efforts to promote singleton gestation and reduce the number of multiple pregnancies. This version replaces the document titled Criteria for number of embryos to transfer: a committee opinion that was published most recently in August of 2013 (Fertil Steril 2013;99:44-6).

5 Guideline Recommendations for practices utilizing gestational carriers: a committee opinion. 2017

Anonymous120972 / Anonymous130972. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #28069181.

ABSTRACT: This document provides the latest recommendations for evaluation of gestational carriers and intended parents. It incorporates recent information from the US Centers for Disease Control and Prevention, the US Food and Drug Administration, and the American Association of Tissue Banks, with which all programs offering gestational carrier services must be thoroughly familiar. This document replaces the previous document of the same name, last published in 2015 (Fertil Steril

6 Guideline Financial compensation of oocyte donors: an Ethics Committee opinion. 2016

Anonymous7460901 / Anonymous7470901. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #28340933.

ABSTRACT: Financial compensation of women donating oocytes for infertility therapy or for research is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, and oocyte retrieval, and not vary according to the planned use of the oocytes, the number or quality of oocytes retrieved, the number or outcome of prior donation cycles, or the donor's ethnic or other personal characteristics. This document replaces the document of the same name, last published in 2007 (Fertil Steril 2007;88:305-9).

7 Guideline Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline. 2016

Anonymous230883 / Anonymous240883. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #27678032.

ABSTRACT: Ovarian hyperstimulation syndrome (OHSS) is an uncommon but serious complication associated with assisted reproductive technology (ART). This systematic review aims to identify who is at high risk, how to prevent OHSS, and the treatment for existing OHSS.

8 Guideline Cross-border reproductive care: an Ethics Committee opinion. 2016

Anonymous210883 / Anonymous220883. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #27678029.

ABSTRACT: Cross-border reproductive care (CBRC) is a growing worldwide phenomenon, raising questions about why assisted reproductive technology (ART) patients travel abroad, what harms and benefits may result, and what duties health-care providers may have in advising and treating patients who travel for reproductive services. Cross-border care offers benefits and poses harms to ART stakeholders, including patients, offspring, providers, gamete donors, gestational carriers, and local populations in destination countries. This document replaces the previous document of the same name, last published in 2013 (Fertil Steril 2013;100:645-50).

9 Guideline Fertility drugs and cancer: a guideline. 2016

Anonymous330880 / Anonymous340880. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #27573989.

ABSTRACT: Methodological limitations in studying the association between the use of fertility drugs and cancer include the inherent increased risk of cancer in women who never conceive, the low incidence of most of these cancers, and that the age of diagnosis of cancer typically is many years after fertility drug use. Based on available data, there does not appear to be a meaningful increased risk of invasive ovarian cancer, breast cancer, or endometrial cancer following the use of fertility drugs. Several studies have shown a small increased risk of borderline ovarian tumors; however, there is insufficient consistent evidence that a particular fertility drug increases the risk of borderline ovarian tumors, and any absolute risk is small. Given the available literature, patients should be counseled that infertile women may be at an increased risk of invasive ovarian, endometrial, and breast cancer; however, use of fertility drugs does not appear to increase this risk.

10 Guideline Provision of fertility services for women at increased risk of complications during fertility treatment or pregnancy: an Ethics Committee opinion. 2016

Anonymous13540878 / Anonymous13550878. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #27530060.

ABSTRACT: This opinion addresses the ethics of providing fertility treatment to women at elevated risk from fertility treatment or pregnancy. Providers ethically may treat women at elevated risk provided that they are carefully assessed; that specialists in their medical condition are consulted as appropriate; and that patients are fully informed about risks, benefits, and alternatives, including oocyte and embryo donation, use of a gestational surrogate, not undergoing fertility care, and adoption. Providers also may conclude that the risks are too high for them to treat particular patients ethically; such determinations must be made in a medically objective and unbiased manner and patients must be fully informed of the decision. Counseling of women who wish to initiate fertility treatment with underlying medical conditions that confer increased risk during treatment or pregnancy should incorporate the most current knowledge available, being cognizant of the woman's personal determinants in relation to her reproductive desires. In such a way, both physician and patient will optimize decision making in an ethically sound, patient-supportive context.

11 Guideline Financial "risk-sharing" or refund programs in assisted reproduction: an Ethics Committee opinion. 2016

Anonymous1800876 / Anonymous1810876. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #27450188.

ABSTRACT: Financial "risk-sharing" fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. This opinion of the ASRM Ethics Committee analyzes the ethical issues raised by these fee structures, including patient selection criteria, conflicts of interest, success rate transparency, and patient informed consent. This document replaces the document of the same name, last published in 2013 (Fertil Steril 2013;100:334-6).

12 Guideline Oocyte or embryo donation to women of advanced reproductive age: an Ethics Committee opinion. 2016

Anonymous1780876 / Anonymous1790876. ·American Society for Reproductive Medicine, Birmingham, Alabama. ·Fertil Steril · Pubmed #27450186.

ABSTRACT: Advanced reproductive age (ARA) is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. Oocyte donation reverses the age-related decline in implantation and birth rates of women in their 40s and 50s and restores pregnancy potential beyond menopause. However, obstetrical complications in older patients remain high, particularly related to operative delivery and hypertensive and cardiovascular risks. Physicians should perform a thorough medical evaluation designed to assess the physical fitness of a patient for pregnancy before deciding to attempt transfer of embryos to any woman of advanced reproductive age (>45 years). Embryo transfer should be strongly discouraged or denied to women of ARA with underlying conditions that increase or exacerbate obstetrical risks. Because of concerns related to the high-risk nature of pregnancy, as well as longevity, treatment of women over the age of 55 should generally be discouraged. This statement replaces the earlier ASRM Ethics Committee document of the same name, last published in 2013 (Fertil Steril 2013;100:337-40).

13 Guideline Uterine septum: a guideline. 2016

Anonymous13510869 / Anonymous13520869. · ·Fertil Steril · Pubmed #27235766.

ABSTRACT: The purpose of this guideline is to review the literature regarding septate uterus and determine optimal indications and methods of treatment for it. Septate uterus has been associated with an increase in the risk of miscarriage, premature delivery, and malpresentation; however, there is insufficient evidence that a uterine septum is associated with infertility. Several studies indicate that treating a uterine septum is associated with an improvement in live-birth rates in women with a history of prior pregnancy loss, recurrent pregnancy loss, or infertility. In a patient without infertility or prior pregnancy loss, it may be reasonable to consider septum incision following counseling regarding potential risks and benefits of the procedure. Many techniques are available to surgically treat a uterine septum, but there is insufficient evidence to recommend one specific method over another.

14 Guideline Committee Opinion No. 663 Summary: Aromatase Inhibitors in Gynecologic Practice. 2016

Anonymous1930869. · ·Obstet Gynecol · Pubmed #27214185.

ABSTRACT: Aromatase inhibitors have been used for the treatment of breast cancer, ovulation induction, endometriosis, and other estrogen-modulated conditions. For women with breast cancer, bone mineral density screening is recommended with long-term aromatase inhibitor use because of risk of osteoporosis due to estrogen deficiency. Based on long-term adverse effects and complication safety data, when compared with tamoxifen, aromatase inhibitors are associated with a reduced incidence of thrombosis, endometrial cancer, and vaginal bleeding. For women with polycystic ovary syndrome and a body mass index greater than 30, letrozole should be considered as first-line therapy for ovulation induction because of the increased live birth rate compared with clomiphene citrate. Lifestyle changes that result in weight loss should be strongly encouraged. Aromatase inhibitors are a promising therapeutic option that may be helpful for the management of endometriosis-associated pain in combination therapy with progestins.


Goodman, Neil F / Cobin, Rhoda H / Futterweit, Walter / Glueck, Jennifer S / Legro, Richard S / Carmina, Enrico / Anonymous4410851 / Anonymous4420851 / Anonymous4430851. · ·Endocr Pract · Pubmed #26642102.

ABSTRACT: Polycystic ovary syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world. This document, produced by the collaboration of the American Association of Clinical Endocrinologists and the Androgen Excess Society aims to highlight the most important clinical issues confronting physicians and their patients with PCOS. It is a summary of current best practices in 2014. Insulin resistance is believed to play an intrinsic role in the pathogenesis of PCOS. The mechanism by which insulin resistance or insulin give rise to oligomenorrhea and hyperandrogenemia, however, is unclear. Hyperinsulinemic-euglycemic clamp studies have shown that both obese and lean women with PCOS have some degree of insulin resistance. Insulin resistance is implicated in the ovulatory dysfunction of PCOS by disrupting the hypothalamic-pituitary-ovarian axis. Given the association with insulin resistance, all women with PCOS require evaluation for the risk of metabolic syndrome (MetS) and its components, including type 2 diabetes, hypertension, hyperlipidemia, and the possible risk of clinical events, including acute myocardial infarction and stroke. Obese women with PCOS are at increased risk for MetS with impaired glucose tolerance (IGT; 31 to 35%) and type 2 diabetes mellitus (T2DM; 7.5 to 10%). Rates of progression from normal glucose tolerance to IGT, and in turn to T2DM, may be as high as 5 to 15% within 3 years. Data suggest the need for baseline oral glucose tolerance test every 1 to 2 years based on family history of T2DM as well as body mass index (BMI) and yearly in women with IGT. Compared with BMI- and age-matched controls, young, lean PCOS women have lower high-density lipoprotein (HDL) size, higher very-low-density lipoprotein particle number, higher low-density lipoprotein (LDL) particle number, and borderline lower LDL size. Statins have been shown to lower testosterone levels either alone or in combination with oral contraceptives (OCPs) but have not shown improvement in menses, spontaneous ovulation, hirsutism, or acne. Statins reduce total and LDL cholesterol but have no effect on HDL, C-reactive protein, fasting insulin, or homeostasis model assessment of insulin resistance in PCOS women, in contrast to the general population. There have been no long-term studies of statins on clinical cardiac outcomes in women with PCOS. Coronary calcification is more prevalent and more severe in PCOS than in controls. In women under 60 years of age undergoing coronary angiography, the presence of polycystic ovaries on sonography has been associated with more arterial segments with >50% stenosis, but the relationship between PCOS and actual cardiovascular events remains unclear. Therapies for PCOS are varied in their effects and targets and include both nonpharmacologic as well as pharmacologic approaches. Weight loss is the primary therapy in PCOS--reduction in weight of as little as 5% can restore regular menses and improve response to ovulation- inducing and fertility medications. Metformin in premenopausal PCOS women has been associated with a reduction in features of MetS. Clamp studies using ethinyl estradiol/drosperinone combination failed to reveal evidence of an increase in either peripheral or hepatic insulin resistance. Subjects with PCOS have a 1.5-times higher baseline risk of venous thromboembolic disease and a 3.7-fold greater effect with OCP use compared with non-PCOS subjects. There is currently no genetic test to screen for or diagnose PCOS, and there is no test to assist in the choice of treatment strategies. Persistent bleeding should always be investigated for pregnancy and/or uterine pathology--including transvaginal ultrasound exam and endometrial biopsy--in women with PCOS. PCOS women can have difficulty conceiving. Those who become pregnant are at risk for gestational diabetes (which should be evaluated and managed appropriately) and the microvascular complications of diabetes. Assessment of a woman with PCOS for infertility involves evaluating for preconceptional issues that may affect response to therapy or lead to adverse pregnancy outcomes and evaluating the couple for other common infertility issues that may affect the choice of therapy, such as a semen analysis. Women with PCOS have multiple factors that may lead to an elevated risk of pregnancy, including a high prevalence of IGT--a clear risk factor for gestational diabetes--and MetS with hypertension, which increases the risk for pre-eclampsia and placental abruption. Women should be screened and treated for hypertension and diabetes prior to attempting conception. Women should be counseled about weight loss prior to attempting conception, although there are limited clinical trial data demonstrating a benefit to this recommendation. Treatment for women with PCOS and anovulatory infertility should begin with an oral agent such as clomiphene citrate or letrozole, an aromatase inhibitor.

16 Guideline Obesity and reproduction: a committee opinion. 2015

Anonymous7140844. · ·Fertil Steril · Pubmed #26434804.

ABSTRACT: The purpose of this ASRM Practice Committee report is to provide clinicians with principles and strategies for the evaluation and treatment of couples with infertility associated with obesity. This revised document replaces the Practice Committee document titled, "Obesity and reproduction: an educational bulletin," last published in 2008 (Fertil Steril 2008;90:S21-9).

17 Guideline Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion. 2015

Anonymous4810842. · ·Fertil Steril · Pubmed #26364838.

ABSTRACT: In the United States, economic, racial, ethnic, geographic, and other disparities exist in access to fertility treatment and in treatment outcomes. This opinion examines the factors that contribute to these disparities and proposes actions to address them.

18 Guideline Access to fertility services by transgender persons: an Ethics Committee opinion. 2015

Anonymous4480842. · ·Fertil Steril · Pubmed #26363388.

ABSTRACT: This statement explores the ethical considerations surrounding the provision of fertility services to transgender individuals and concludes that denial of access to fertility services is not justified.

19 Guideline Subclinical hypothyroidism in the infertile female population: a guideline. 2015

Anonymous4630838. ·ASRM@asrm.org ·Fertil Steril · Pubmed #26239023.

ABSTRACT: There is controversy regarding whether to treat subtle abnormalities of thyroid dysfunction in the infertile female patient. This guideline document reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage, as well as obstetrical and neonatal outcomes in this population.

20 Guideline Management of secondary infertility following cesarean section: Report from the Subcommittee of the Reproductive Endocrinology Committee of the Japan Society of Obstetrics and Gynecology. 2015

Tsuji, Shunichiro / Murakami, Takashi / Kimura, Fuminori / Tanimura, Satoshi / Kudo, Masataka / Shozu, Makio / Narahara, Hisashi / Sugino, Norihiro. ·Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga, Japan. · Department of Obstetrics and Gynecology, Toyama Prefectural Central Hospital, Toyama, Japan. · Department of Obstetrics and Gynecology, Hokkaido University, Hokkaido, Japan. · Department of Obstetrics and Gynecology, Chiba University, Chiba, Japan. · Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Oita, Japan. · Department of Obstetrics and Gynecology, Yamaguchi University Hospital, Yamaguchi, Japan. ·J Obstet Gynaecol Res · Pubmed #26096819.

ABSTRACT: AIM: The aim of this study was to examine the current status and management of secondary infertility following cesarean section in Japan. MATERIAL AND METHODS: A two-step questionnaire survey was performed in 1092 facilities, including teaching hospitals and artificial reproductive technology clinics, registered with the Japan Society of Obstetrics and Gynecology. In our questionnaires, we obtained data about symptoms, clinical findings, diagnostic methods, and pregnancy outcomes. Treatments were sorted into three groups, namely typical infertility treatment (group A), conservative treatment (group B), and operative treatment (group C). RESULTS: Of the 1092 facilities, 616 (56%) sent back reply forms to the first questionnaire; 56 (32%) of 176 facilities answered the second questionnaire, and 189 cases were able to be analyzed after completion of the two questionnaires. The commonest symptom was abnormal uterine bleeding during the follicular phase (91 cases; 48% of the 189 eligible cases), and the commonest clinical finding was fluid pooling in the area of cesarean scar dehiscence during the ovulatory phase (142 cases; 75%). The most commonly used diagnostic method was transvaginal ultrasound (153 cases, 81%). The pregnancy rate was 33% in group A, 50% in group B, and 60% in group C. In patients with abnormal uterine bleeding, painful symptoms and fluid pooling at the cesarean scar dehiscence, the pregnancy rate was significantly higher in group C (64%) than in group A (16%; P = 0.0063). CONCLUSIONS: We recommend operative treatment for secondary infertility following cesarean section with painful symptoms and fluid pooling at the site of cesarean scar dehiscence.

21 Guideline The management of uterine fibroids in women with otherwise unexplained infertility. 2015

Carranza-Mamane, Belina / Havelock, Jon / Hemmings, Robert / Anonymous1650831 / Anonymous1660831. ·Sherbrooke QC. · Vancouver BC. · Montreal QC. ·J Obstet Gynaecol Can · Pubmed #26001875.

ABSTRACT: OBJECTIVE: To provide recommendations regarding the best management of fibroids in couples who present with infertility. Usual and novel treatment options for fibroids will be reviewed with emphasis on their applicability in women who wish to conceive. OPTIONS: Management of fibroids in women wishing to conceive first involves documentation of the presence of the fibroid and determination of likelihood of the fibroid impacting on the ability to conceive. Treatment of fibroids in this instance is primarily surgical, but must be weighed against the evidence of surgical management improving clinical outcomes, and risks specific to surgical management and approach. OUTCOMES: The outcomes of primary concern are the improvement in pregnancy rates and outcomes with management of fibroids in women with infertility. EVIDENCE: Published literature was retrieved through searches of PubMed, MEDLINE, the Cochrane Library in November 2013 using appropriate controlled vocabulary (e.g., leiomyoma, infertility, uterine artery embolization, fertilization in vitro) and key words (e.g., fibroid, myomectomy). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English and French. There were no date restrictions. Searches were updated on a regular basis and incorporated in the guideline to November 2013. Grey (unpublished literature) was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. VALUES: The quality of evidence in this document was rated using the criteria described by the Canadian Task Force on Preventive Health Care (Table). BENEFITS, HARMS, AND COSTS: These recommendations are expected to allow adequate management of women with fibroids and infertility, maximizing their chances of pregnancy by minimizing risks introduced by unnecessary myomectomies. Reducing complications and eliminating unnecessary interventions are also expected to decrease costs to the health care system. Summary Statements 1. Subserosal fibroids do not appear to have an impact on fertility; the effect of intramural fibroids remains unclear. If intramural fibroids do have an impact on fertility, it appears to be small and to be even less significant when the endometrium is not involved. (II-3) 2. Because current medical therapy for fibroids is associated with suppression of ovulation, reduction of estrogen production, or disruption of the target action of estrogen or progesterone at the receptor level, and it has the potential to interfere in endometrial development and implantation, there is no role for medical therapy as a stand-alone treatment for fibroids in the infertile population. (III) 3. Preoperative assessment of submucosal fibroids is essential to the decision on the best approach for treatment. (III) 4. There is little evidence on the use of Foley catheters, estrogen, or intrauterine devices for the prevention of intrauterine adhesions following hysteroscopic myomectomy. (II-3) 5. In the infertile population, cumulative pregnancy rates by the laparoscopic and the minilaparotomy approaches are similar, but the laparoscopic approach is associated with a quicker recovery, less postoperative pain, and less febrile morbidity. (II-2) 6. There are lower pregnancy rates, higher miscarriage rates, and more adverse pregnancy outcomes following uterine artery embolization than after myomectomy. (II-3) Studies also suggest that uterine artery embolization is associated with loss of ovarian reserve, especially in older patients. (III) Recommendations 1. In women with infertility, an effort should be made to adequately evaluate and classify fibroids, particularly those impinging on the endometrial cavity, using transvaginal ultrasound, hysteroscopy, hysterosonography, or magnetic resonance imaging. (III-A) 2. Preoperative assessment of submucosal fibroids should include, in addition to an assessment of fibroid size and location within the uterine cavity, evaluation of the degree of invasion of the cavity and thickness of residual myometrium to the serosa. A combination of hysteroscopy and transvaginal ultrasound or hysterosonography are the modalities of choice. (III-B) 3. Submucosal fibroids are managed hysteroscopically. The fibroid size should be < 5 cm, although larger fibroids have been managed hysteroscopically, but repeat procedures are often necessary. (III-B) 4. A hysterosalpingogram is not an appropriate exam to evaluate and classify fibroids. (III-D)  5. In women with otherwise unexplained infertility, submucosal fibroids should be removed in order to improve conception and pregnancy rates. (II-2A) 6. Removal of subserosal fibroids is not recommended. (III-D) 7. There is fair evidence to recommend against myomectomy in women with intramural fibroids (hysteroscopically confirmed intact endometrium) and otherwise unexplained infertility, regardless of their size. (II-2D) If the patient has no other options, the benefits of myomectomy should be weighed against the risks, and management of intramural fibroids should be individualized. (III-C) 8. If fibroids are removed abdominally, efforts should be made to use an anterior uterine incision to minimize the formation of postoperative adhesions. (II-2A) 9. Widespread use of the laparoscopic approach to myomectomy may be limited by the technical difficulty of this procedure. Patient selection should be individualized based on the number, size, and location of uterine fibroids and the skill of the surgeon. (III-A) 10. Women, fertile or infertile, seeking future pregnancy should not generally be offered uterine artery embolization as a treatment option for uterine fibroids. (II-3E).

22 Guideline Diagnostic evaluation of the infertile male: a committee opinion. 2015

Anonymous2160818. · ·Fertil Steril · Pubmed #25597249.

ABSTRACT: The purpose of this ASRM Practice Committee report is to provide clinicians with principles and strategies for the evaluation of couples with male infertility problems. This revised document replaces the document of the same name, last published in 2012 (Fertil Steril 2012;98:294-301).

23 Guideline Testing and interpreting measures of ovarian reserve: a committee opinion. 2015

Anonymous5530817. · ·Fertil Steril · Pubmed #25585505.

ABSTRACT: Currently there is no uniformly accepted definition of decreased ovarian reserve (DOR), as the term may refer to three related but distinctly different outcomes: oocyte quality, oocyte quantity, or reproductive potential. Available evidence concerning the performance of ovarian reserve tests is limited by small sample sizes, heterogeneity among study design, analyses and outcomes, and the lack of validated outcome measures.

24 Guideline British Fertility Society Policy and Practice Committee: adjuvants in IVF: evidence for good clinical practice. 2015

Nardo, Luciano G / El-Toukhy, Tarek / Stewart, Jane / Balen, Adam H / Potdar, Neelam. ·Reproductive Health Group, Centre for Reproductive Health, Daresbury Park , Daresbury, Cheshire , UK. ·Hum Fertil (Camb) · Pubmed #25531921.

ABSTRACT: Optimisation of the environment favourable for satisfactory ovarian response to stimulation and successful embryo implantation remains at the core of assisted conception programmes. The evidence base for the routine use of different adjuvants, alone or in combination, for women undergoing their first in vitro fertilisation (IVF) treatment cycle and for those with poor prognosis is inadequate. The aim of this document is to update the last review of the available literature carried out by the British Fertility Society Policy and Practice Committee (BFS P&P) published in 2009 and to provide fertility professionals with evidence-based guidance and recommendations regarding the use of immunotherapy, vasodilators, uterine relaxants, aspirin, heparin, growth hormone, dehydroepiandrosterone, oestrogen and metformin as adjuvants in IVF. Unfortunately despite the lapse of 5 years since the last publication, there is still a lack of robust evidence for most of the adjuvants searched and large well-designed randomised controlled trials are still needed. One possible exception is metformin, which seems to have a positive effect in women with polycystic ovary syndrome undergoing IVF. Patients who are given other adjuvants on an empirical basis should always be informed of the lack of evidence and the potential side effects.

25 Guideline Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee. 2015

Richenberg, Jonathan / Belfield, Jane / Ramchandani, Parvati / Rocher, Laurence / Freeman, Simon / Tsili, Athina C / Cuthbert, Faye / Studniarek, Michal / Bertolotto, Michele / Turgut, Ahmet Tuncay / Dogra, Vikram / Derchi, Lorenzo E. ·Royal Sussex County Hospital Brighton and Brighton and Sussex Medical School, Brighton, Sussex, UK, Jonathan.richenberg@bsuh.nhs.uk. ·Eur Radiol · Pubmed #25316054.

ABSTRACT: OBJECTIVES: The subcommittee on scrotal imaging, appointed by the board of the European Society of Urogenital Radiology (ESUR), have produced guidelines on imaging and follow-up in testicular microlithiasis (TML). METHODS: The authors and a superintendent university librarian independently performed a computer-assisted literature search of medical databases: MEDLINE and EMBASE. A further parallel literature search was made for the genetic conditions Klinefelter's syndrome and McCune-Albright syndrome. RESULTS: Proposed guidelines are: follow-up is not advised in patients with isolated TML in the absence of risk factors (see Key Points below); annual ultrasound (US) is advised for patients with risk factors, up to the age of 55; if TML is found with a testicular mass, urgent referral to a specialist centre is advised. CONCLUSION: Consensus opinion of the scrotal subcommittee of the ESUR is that the presence of TML alone in the absence of other risk factors is not an indication for regular scrotal US, further US screening or biopsy. US is recommended in the follow-up of patients at risk, where risk factors other than microlithiasis are present. Risk factors are discussed and the literature and recommended guidelines are presented in this article. KEY POINTS: • Follow up advised only in patients with TML and additional risk factors. • Annual US advised for patients with risk factors up to age 55. • If TML is found with testicular mass, urgent specialist referral advised. • Risk factors - personal/ family history of GCT, maldescent, orchidopexy, testicular atrophy.