Ernesto Bosch1, Carlo Bulletti2, Alan B Copperman3, Renato Fanchin4, Hakan Yarali5, Carlos A Petta6, Nikolaos P Polyzos7, Daniel Shapiro8, Filippo Maria Ubaldi9, Juan A Garcia Velasco10, Salvatore Longobardi11, Thomas D'Hooghe12, Peter Humaidan13. 1. Instituto Valenciano de Infertilidad, Valencia, Spain. Electronic address: Ernesto.Bosch@ivi.es. 2. Extra Omnes Medicina e Salute Riproduttiva, Cattolica, Italy. 3. Icahn School of Medicine at Mount Sinai and Reproductive Medicine Associates of New York, New York NY, USA; Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York NY, USA. 4. Centre of Reproductive Medicine, Hôpital Foch, University Paris-Ouest, Suresnes, France. 5. Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey; Anatolia IVF and Women's Health Centre, Ankara, Turkey. 6. Departamento de Ginecologia, Clinica Fertilidade e Vida, Campinas and Hospital Sirio Libanês, Sao Paulo, Brazil. 7. Department of Reproductive Medicine, Dexeus University Hospital, Barcelona Spain; Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Faculty of Health, Aarhus University, Aarhus, Denmark. 8. Reproductive Biology Associates, Atlanta GA, USA. 9. G.EN.E.R.A. Centres for Reproductive Medicine Rome, Italy. 10. IVI Madrid, Rey Juan Carlos University, IdIPAZ, Madrid, Spain. 11. Merck KGaA, Darmstadt, Germany. 12. Department of Development and Regeneration, University of Leuven (KU Leuven), Leuven, Belgium; The Fertility Clinic, Skive Regional Hospital, and Faculty of Health, Aarhus University, Aarhus, Denmark. 13. Faculty of Health, Aarhus University, Aarhus, Denmark; The Fertility Clinic, Skive Regional Hospital, and Faculty of Health, Aarhus University, Aarhus, Denmark.
Abstract
RESEARCH QUESTION: How might time to healthy singleton delivery affect decision-making during infertility treatment? DESIGN: This was a Delphi consensus investigating expert opinion that comprised three steps. In Step 1, 12 experts developed statements. In Step 2, 27 experts (including 12 from Step 1) voted (online survey) on their agreement/disagreement with each statement (providing reasons). Consensus was reached if ≥66% of participants agreed/disagreed. Statements not reaching consensus were revised and the process repeated until consensus was achieved. In Step 3 details of the final agreed statements were communicated. RESULTS: Twelve statements were developed, and consensus (agreement) was reached on all after one round of voting. CONCLUSIONS: Time to healthy singleton delivery should be taken into consideration when making decisions related to infertility treatment, and it is important that fertility treatment is provided in a timely manner, avoiding over- or under-treatment. In all subfertile women <40 years old, IVF outcomes could be optimized by performing up to six single-embryo transfers and certain procedures might reduce time to healthy singleton delivery. These procedures include preimplantation genetic testing for aneuploidies, frozen replacement cycles immediately after failed fresh cycles and use of gonadotrophin-releasing hormone antagonists. Finally, the number of oocytes retrieved should be maximized to increase cumulative live birth rate.
RESEARCH QUESTION: How might time to healthy singleton delivery affect decision-making during infertility treatment? DESIGN: This was a Delphi consensus investigating expert opinion that comprised three steps. In Step 1, 12 experts developed statements. In Step 2, 27 experts (including 12 from Step 1) voted (online survey) on their agreement/disagreement with each statement (providing reasons). Consensus was reached if ≥66% of participants agreed/disagreed. Statements not reaching consensus were revised and the process repeated until consensus was achieved. In Step 3 details of the final agreed statements were communicated. RESULTS: Twelve statements were developed, and consensus (agreement) was reached on all after one round of voting. CONCLUSIONS: Time to healthy singleton delivery should be taken into consideration when making decisions related to infertility treatment, and it is important that fertility treatment is provided in a timely manner, avoiding over- or under-treatment. In all subfertile women <40 years old, IVF outcomes could be optimized by performing up to six single-embryo transfers and certain procedures might reduce time to healthy singleton delivery. These procedures include preimplantation genetic testing for aneuploidies, frozen replacement cycles immediately after failed fresh cycles and use of gonadotrophin-releasing hormone antagonists. Finally, the number of oocytes retrieved should be maximized to increase cumulative live birth rate.
Authors: Mary C Mahony; Brooke Hayward; Gilbert L Mottla; Kevin S Richter; Stephanie Beall; G David Ball; Thomas D'Hooghe Journal: Front Endocrinol (Lausanne) Date: 2021-12-09 Impact factor: 5.555