Recommendations from the 2024 Australian evidence‐based guideline for unexplained infertility: <scp>ADAPTE</scp> process from the <scp>ESHRE</scp> evidence‐based guideline on unexplained infertility

The guideline includes 40 evidence-based recommendations, 21 practice points and three research recommendations addressing: definition - defining infertility and frequency of intercourse, infertility and age, female and male factor infertility; diagnosis - ovulation, ovarian reserve, tubal factor, uterine factor, laparoscopy, cervical/vaginal factor, male factor, additional testing for systemic conditions; and treatment - expectant management, active treatment, mechanical-surgical procedures, alternative therapeutic approaches, quality of life. CHANGES IN ASSESSMENT AND MANAGEMENT RESULTING FROM THE GUIDELINE: This guideline refines the definition of unexplained infertility and addresses basic diagnostic procedures for infertility assessment not considered in previous guidelines on unexplained infertility. For therapeutic approaches, consideration of evidence quality, efficacy, safety and, in the Australian setting, feasibility, acceptability, cost, implementation and ultimately recommendation strength were integrated across multidisciplinary expertise and consumer perspectives in adapting recommendations to the Australian context by using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework, which had not been used in past guidelines on unexplained infertility to formulate recommendations. The Australian process also included an established data integrity check to ensure evidence could be trusted to guide practice. Practice points were added and expanded to consider the Australian setting. No evidence-based recommendations were underpinned by high quality evidence, with most having low or very low quality evidence. In this context, research recommendations were made including those for the Australian context. The full guideline and technical report are publicly available online and can be accessed at https://www.monash.edu/medicine/mchri/infertility and are supported by extensive translation resources, including the free patient ASKFertility mobile application (https://www.askfertility.org/).

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Publication Details

Journal
The Medical Journal of Australia
Published
2024-09-15
DOI
https://doi.org/10.5694/mja2.52437
Citations
2
Primary Topic
Reproductive Health and Technologies
Type
article
Field-Weighted Citation Impact
1.07

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article

Recommendations from the 2024 Australian evidence‐based guideline for unexplained infertility: ADAPTE process from the ESHRE evidence‐based guideline on unexplained infertility

Daniela Romualdi, Ksenija Geršak, Harold R Verhoeve, Ernesto Bosch et al.
2 citations
The Medical Journal of Australia
Reproductive Health and Technologies
1.07
article

Recommendations from the 2024 Australian evidence‐based guideline for unexplained infertility: ADAPTE process from the ESHRE evidence‐based guideline on unexplained infertility

Daniela Romualdi, Ksenija Geršak, Harold R Verhoeve, Ernesto Bosch, Helena Jane Teede, Cindy Farquhar, Luk J. F. Rombauts, Barış Ata, Nathalie Le Clef, Sesh Kamal Sunkara, Robert J. Norman, Aya Mousa, Rhonda Garad, M Mincheva, Roy Homburg, Michael Costello, Samuel Santos‐Ribeiro, Sara Somers, Clare Boothroyd, Terhi Piltonen, Lisa Bedson, Marlene Kong, Ben Willem Mol, Trudy Loos, M. Flanagan, Rebecca Kerner
article en
2 citations

Abstract

The guideline includes 40 evidence-based recommendations, 21 practice points and three research recommendations addressing: definition - defining infertility and frequency of intercourse, infertility and age, female and male factor infertility; diagnosis - ovulation, ovarian reserve, tubal factor, uterine factor, laparoscopy, cervical/vaginal factor, male factor, additional testing for systemic conditions; and treatment - expectant management, active treatment, mechanical-surgical procedures, alternative therapeutic approaches, quality of life. CHANGES IN ASSESSMENT AND MANAGEMENT RESULTING FROM THE GUIDELINE: This guideline refines the definition of unexplained infertility and addresses basic diagnostic procedures for infertility assessment not considered in previous guidelines on unexplained infertility. For therapeutic approaches, consideration of evidence quality, efficacy, safety and, in the Australian setting, feasibility, acceptability, cost, implementation and ultimately recommendation strength were integrated across multidisciplinary expertise and consumer perspectives in adapting recommendations to the Australian context by using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework, which had not been used in past guidelines on unexplained infertility to formulate recommendations. The Australian process also included an established data integrity check to ensure evidence could be trusted to guide practice. Practice points were added and expanded to consider the Australian setting. No evidence-based recommendations were underpinned by high quality evidence, with most having low or very low quality evidence. In this context, research recommendations were made including those for the Australian context. The full guideline and technical report are publicly available online and can be accessed at https://www.monash.edu/medicine/mchri/infertility and are supported by extensive translation resources, including the free patient ASKFertility mobile application (https://www.askfertility.org/).

The Medical Journal of AustraliaVol. 221(8)
South Australia Pathology (AU), Koç University (TR), University of Liverpool (GB), University of Ljubljana (SI), University of Auckland (NZ), King's College London (GB), Oulu University Hospital (FI), Ghent University Hospital (BE), Ljubljana University Medical Centre (SI), Agostino Gemelli University Polyclinic (IT), UNSW Sydney (AU), Liverpool Women's Hospital (GB), CARE Fertility (US), Valencian Infertility Institute (ES), OLVG (NL), National Statistical Institute of Portugal (PT), European Society of Human Reproduction and Embryology (BE), Monash Health (AU), National Health and Medical Research Council (AU), Monash University (AU), The University of Adelaide (AU), University of Oulu (FI)
Monash University, European Society of Human Reproduction and Embryology, Medical Research Council, National Health and Medical Research Council
Openalex Percentile: Top 20%
Reproductive Health and Technologies
1.07
DOIOpen Access PDFOpenAlex
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