Management of the infertile couple: an evidence-based protocol

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.

[1]  A. Chandra,et al.  A public health focus on infertility prevention, detection, and management. , 2010, Fertility and sterility.

[2]  P. Crosignani,et al.  Optimal use of infertility diagnostic tests and treatments. The ESHRE Capri Workshop Group. , 2000, Human reproduction.

[3]  S. Irvine.  Guidelines in the treatment of male infertility , 2004 .

[4]  Y. Gillerot,et al.  Pathogenesis of Human Malformations , 1992 .

[5]  P. Crosignani.  Diagnosis and management of the infertile couple: missing information ESHRE Capri Workshop Group 1 , 2004 .

[6]  G. Forti,et al.  Evaluation and Treatment of the Infertile Couple , 1998 .

[7]  P. Rowe,et al.  Clinical patterns and major causes of infertility in Mongolia , 2004, The journal of obstetrics and gynaecology research.

[8]  L. Schmidt.  Psychosocial burden of infertility and assisted reproduction , 2006, The Lancet.

[9]  T. Hargreave,et al.  Investigating and managing infertility in general practice , 1998, BMJ.

[10]  A. Olatunji,et al.  The pattern of infertility cases at a university hospital. , 2004, West African journal of medicine.

[11]  P. Braude,et al.  Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial , 2001, The Lancet.

[12]  M. Osler,et al.  Alcohol use as predictor for infertility in a representative population of Danish women , 2003, Acta obstetricia et gynecologica Scandinavica.

[13]  J. Grimshaw,et al.  Pragmatic randomised controlled trial to evaluate guidelines for the management of infertility across the primary care-secondary care interface , 2001, BMJ : British Medical Journal.

[14]  D. Cahill,et al.  Management of infertility , 2002, BMJ : British Medical Journal.

[15]  J. Adinma,et al.  High prevalence of male infertility in southeastern Nigeria , 2003, Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.

[16]  A. L. Rutledge.  PSYCHOMARITAL EVALUATION AND TREATMENT OF THE INFERTILE COUPLE , 1979, Clinical obstetrics and gynecology.

[17]  L. Gianaroli,et al.  Guidelines for the appropriate use of genetic tests in infertile couples , 2002, European Journal of Human Genetics.

[18]  Orji Eo,et al.  Male contribution to infertility in Ile-Ife, Nigeria. , 2002 .

[19]  A. Agarwal,et al.  Effect of cigarette smoking on levels of seminal oxidative stress in infertile men: a prospective study. , 2002, Fertility and sterility.

[20]  M. O. Araoye.  Epidemiology of infertility: social problems of the infertile couples. , 2004, West African journal of medicine.

[21]  B. Velkeniers,et al.  Thyroid and infertility. , 2002, Verhandelingen - Koninklijke Academie voor Geneeskunde van Belgie.

[22]  Leon Speroff,et al.  Clinical gynecologic endocrinology and infertility , 1983 .

[23]  O. Arulogun,et al.  Acceptability of child adoption as management option for infertility in Nigeria: evidence from focus group discussions. , 2009, African journal of reproductive health.

[24]  Alison Taylor.  Making a diagnosis , 2003, BMJ : British Medical Journal.

[25]  E. Vayena,et al.  Assisted reproductive technologies in developing countries: are we caring yet? , 2009, Fertility and sterility.

[26]  C. Niederberger.  WHO manual for the standardized investigation, diagnosis and management of the infertile male , 2001 .

[27]  J. Balasch,et al.  Investigation of the infertile couple: investigation of the infertile couple in the era of assisted reproductive technology: a time for reappraisal. , 2000, Human reproduction.

[28]  A. Razzak,et al.  The infertile couple: a cohort study in Duhok, Iraq. , 2002, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[29]  W. Cates,et al.  WORLDWIDE PATTERNS OF INFERTILITY: IS AFRICA DIFFERENT? , 1985, The Lancet.

[30]  Allison M. Case.  Infertility evaluation and management. Strategies for family physicians. , 2003, Canadian family physician Medecin de famille canadien.

[31]  C. Lombard,et al.  Psychological distress among women suffering from couple infertility in South Africa: a quantitative assessment. , 2005, Human reproduction.

[32]  S. Masoodi,et al.  Epidemiologic and etiologic aspects of primary infertility in the Kashmir region of India. , 1997, Fertility and sterility.

[33]  T. Adachi.  [Female infertility]. , 2002, Nihon rinsho. Japanese journal of clinical medicine.

[34]  A. Shahin.  The problem of IVF cost in developing countries: has natural cycle IVF a place? , 2007, Reproductive biomedicine online.

[35]  A. Mcwhinnie,et al.  Guidelines for counselling in infertility: outline version. , 2001, Human reproduction.

[36]  E. Diczfalusy,et al.  Diagnosis and management of the infertile couple: missing information. , 2004, Human reproduction update.

[37]  J. Collins,et al.  Age of the female partner is a prognostic factor in prolonged unexplained infertility: a multicenter study. , 1989, Fertility and sterility.

[38]  B. S. Verkauf.  The incidence and outcome of single-factor, multifactorial, and unexplained infertility. , 1983, American journal of obstetrics and gynecology.

[39]  A. Birmingham,et al.  The Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Assisted Reproductive Technology , 2006 .

[40]  J. Hustin,et al.  The First Twelve Weeks of Gestation , 1992, Springer Berlin Heidelberg.

[41]  Razzak Ah,et al.  The infertile couple: a cohort study in Duhok, Iraq. , 2002 .

[42]  D. Lamb,et al.  World Health Organization Laboratory Manual for the Examination of Human Semen and Sperm‐Cervical Mucus Interaction, 4th ed. , 2000, Journal of Andrology.

[43]  W. Cates,et al.  WORLDWIDE PATTERNS OF INFERTILITY: IS AFRICA DIFFERENT? , 1985, The Lancet.

[44]  The Eshre Capri.  Optimal use of infertility diagnostic tests and treatments , 2000 .

[45]  N. Laufer,et al.  Investigation of the infertile couple: should diagnostic laparoscopy be performed after normal hysterosalpingography in treating infertility suspected to be of unknown origin? , 2002, Human reproduction.

[46]  P. Brinsden,et al.  Reproductive medicine : from A to Z , 1998 .

[47]  E G Baxley,et al.  A primary care approach to the infertile couple. , 2001, The Journal of the American Board of Family Practice.