Guideline 5 – Screening, diagnostic assessment and management of infertility

||Guideline 5 – Screening, diagnostic assessment and management of infertility
Guideline 5 – Screening, diagnostic assessment and management of infertility2017-11-20T08:34:04+00:00

Guideline 5 – Screening, diagnostic assessment, and management of infertility

The clinical questions being addressed:

  • NARRATIVE REVIEW Should women with PCOS and infertility undergo pre-conception (pre-pregnancy) evaluation (assessment) for (and where possible correction of) risk factors that may adversely affect fertility and response to infertility therapy?
  • NARRATIVE REVIEW Should women with PCOS undergo pre-conception (pre-pregnancy) evaluation (assessment) for (and where possible correction of) risk factors that may lead to adverse (early or late) pregnancy outcomes?
  • NARRATIVE REVIEW Should women with PCOS undergo close (early or late) pregnancy monitoring for adverse pregnancy outcomes?
  • NARRATIVE REVIEW Should women with PCOS and infertility due to anovulation alone with normal semen analysis have tubal patency testing prior to starting ovulation induction with timed intercourse or IUI treatment or delayed tubal patency testing?
  • In women with PCOS, is clomiphene citrate effective for improving fertility outcomes?
  • In women with PCOS, is metformin effective for improving fertility outcomes?
  • In women with PCOS and a BMI<30-32, what is the effectiveness of metformin compared to clomiphene citrate for improving fertility outcomes?
  • In women with PCOS, are aromatase inhibitors effective for improving fertility outcomes?
  • In women with PCOS, are gonadotrophins effective for improving fertility outcomes?
  • In women with PCOS undergoing (controlled) ovarian (hyper) stimulation for IVF/ICSI, does the choice of FSH effect fertility outcomes?
  • In women with PCOS undergoing (controlled) ovarian (hyper) stimulation for IVF/ICSI, is exogenous LH treatment during IVF/ICSI effective for improving fertility outcomes?
  • In women with PCOS, is stimulated IVF/ICSI effective for improving fertility outcomes?
  • In women with PCOS undergoing IVF/ICSI treatment, is the GnRH antagonist protocol or GnRH agonist long protocol the most effective for improving fertility outcomes?
  • In women with PCOS undergoing (controlled) ovarian (hyper) stimulation for IVF/ICSI, is adjuvant metformin effective for improving fertility outcomes?
  • In women with PCOS undergoing GnRH antagonist IVF/ICSI treatment, is the use of hCG trigger or GnRH agonist trigger the most effective for improving fertility outcomes?
  • In women with PCOS, is In Vitro Maturation (IVM) effective for improving fertility outcomes?
  • In women with PCOS, are anti-obesity pharmacological agents effective for improving fertility outcomes?
  • In women with PCOS, is ovarian surgery effective for improving fertility outcomes?
  • In women with PCOS, what is the effectiveness of lifestyle interventions compared to bariatric surgery for improving fertility and adverse outcomes?

Members of GDG 5


Dr Michael Costello
Obstetrician-Gynaecologist/ Reproductive Endocrinologist
IVF Australia, University of NSW, The Royal Hospital for Women


Professor Robert Norman
Obstetrician-Gynaecologist/ Reproductive Endocrinologist
University of Adelaide


Professor Luigi Devoto
Obstetrician-Gynaecologist/ Reproductive Endocrinologist
University of Chile


Professor Rick Legro
Obstetrician-Gynaecologist
PennState Health


Professor Roger Hart
Obstetrician-Gynaecologist/ Reproductive Endocrinologist
Fertility Specialists of WA, University of Western Australia


Professor Jie Qiao
Obstetrician-Gynaecologist
Third Hospital University of Peking


Associate Professor Luk Rombauts
Gynaecologist/ Reproductive Endocrinologist
Monash IVF, Monash University, Monash Health


Professor Adam Balen
Obstetrician-Gynaecologist
Leeds Teaching Hospitals NHS Trust


Dr Edgar Mocanu
Obstetrician-Gynaecologist
Rotunda Hospital Dublin


Dr Cailin Jordan
Psychologist/Fertility Counsellor
Hollywood Fertility Centre


Professor Ray Rodgers
Academic
University of Adelaide


Professor Eszter Vanky
Obstetrician-Gynaecologist
St. Olav’s Hospital