Andrea Garolla1, Damiano Pizzol1,2, Andrea Roberto Carosso3, Andrea Borini4, Filippo Maria Ubaldi5, Aldo Eugenio Calogero6, Alberto Ferlin7, Antonio Lanzone8,9, Francesco Tomei10, Bruno Engl11, Laura Rienzi5, Lucia De Santis12,13, Giovanni Coticchio4, Lee Smith14, Rossella Cannarella6, Attilio Anastasi15, Massimo Menegazzo1, Liborio Stuppia16,17, Christian Corsini1, Carlo Foresta1. 1. Section of Andrology and Reproductive Medicine & Centre for Male Gamete Cryopreservation, Department of Medicine, University of Padova, Padova, Italy. 2. Italian Agency for Development Cooperation, Public Health, Jerusalem, Israel. 3. Department of Surgical Sciences, Gynecology and Obstetrics 1, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, University of Torino, Torino, Italy. 4. 9.baby, Family and Fertility Center, Tecnobios Procreazione, Bologna, Italy. 5. GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy. 6. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. 7. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. 8. Department of Woman's Health Sciences of the Child and Public Health, Unit of Obstetrics Pathology, University Clinic Foundation "A Gemelli" IRCCS, Rome, Italy. 9. Clinic of Obstetrics and Gynecology, Catholic University Sacro Cuore, Rome, Italy. 10. Assisted Reproductive Unit, Santa Maria degli Angeli Hospital, Pordenone, Italy. 11. Donna Salus, Center for Women's Health and Fertility, Bolzano, Italy. 12. IVF Unit, Gynaecological-Obstetric Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy. 13. Italian Society of Embryology, Reproduction and Research (SIERR), Giarre, Italy. 14. The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom. 15. Center for Physiopathology of Human Reproduction, Delta Hospital, Lagosanto, Italy. 16. Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G. d'Annunzio" University, Chieti, Italy. 17. Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Abstract
Capsule: This expert opinion summarizes current knowledge on risk factors for infertility and identifies a practical clinical and diagnostic approach for the male and female partners of an infertile couple aimed to improve the investigation and management of fertility problems. Background: Infertility represents an important and growing health problem affecting up to 16% of couples worldwide. In most cases, male, female, or combined factor can be identified, and different causes or risk factors have been related to this condition. However, there are no standardized guidelines on the clinical-diagnostic approach of infertile couples and the recommendations concerning infertility are sometimes lacking, incomplete, or problematic to apply. Objective: The aim of this work is to provide an appropriate clinical and diagnostic pathway for infertile couples designed by a multidisciplinary-team of experts. The rationale is based on the history and physical examination and then oriented on the basis of initial investigations. This approach could be applied in order to reduce variation in practice and to improve the investigation and management of fertility problems. Methods: Prominent Italian experts of the main specialties committed in the ART procedures, including gynecologists, andrologists, embryologists, biologists, geneticists, oncologists, and microbiologists, called "InfertilItaly group", used available evidence to develop this expert position. Outcomes: Starting from the individuation of the principal risk factors that may influence the fertility of females and males and both genders, the work group identified most appropriate procedures using a gradual approach to both partners aimed to obtain a precise diagnosis and the most effective therapeutic option, reducing invasive and occasionally redundant procedures. Conclusions: This expert position provides current knowledge on risk factors and suggests a diagnostic workflow of infertile couples. By using this step-by-step approach, health care workers involved in ART, may individuate a practical clinical management of infertile couples shared by experts.
Capsule: This expert opinion summarizes current knowledge on risk factors for infertility and identifies a practical clinical and diagnostic approach for the male and female partners of an infertile couple aimed to improve the investigation and management of fertility problems. Background: Infertility represents an important and growing health problem affecting up to 16% of couples worldwide. In most cases, male, female, or combined factor can be identified, and different causes or risk factors have been related to this condition. However, there are no standardized guidelines on the clinical-diagnostic approach of infertile couples and the recommendations concerning infertility are sometimes lacking, incomplete, or problematic to apply. Objective: The aim of this work is to provide an appropriate clinical and diagnostic pathway for infertile couples designed by a multidisciplinary-team of experts. The rationale is based on the history and physical examination and then oriented on the basis of initial investigations. This approach could be applied in order to reduce variation in practice and to improve the investigation and management of fertility problems. Methods: Prominent Italian experts of the main specialties committed in the ART procedures, including gynecologists, andrologists, embryologists, biologists, geneticists, oncologists, and microbiologists, called "InfertilItaly group", used available evidence to develop this expert position. Outcomes: Starting from the individuation of the principal risk factors that may influence the fertility of females and males and both genders, the work group identified most appropriate procedures using a gradual approach to both partners aimed to obtain a precise diagnosis and the most effective therapeutic option, reducing invasive and occasionally redundant procedures. Conclusions: This expert position provides current knowledge on risk factors and suggests a diagnostic workflow of infertile couples. By using this step-by-step approach, health care workers involved in ART, may individuate a practical clinical management of infertile couples shared by experts.
Authors: Lauren A Wise; Kenneth J Rothman; Ellen M Mikkelsen; Henrik Toft Sørensen; Anders H Riis; Elizabeth E Hatch Journal: Fertil Steril Date: 2012-03-15 Impact factor: 7.329
Authors: N Pitteloud; P A Boepple; S DeCruz; S B Valkenburgh; W F Crowley; F J Hayes Journal: J Clin Endocrinol Metab Date: 2001-06 Impact factor: 5.958
Authors: Rui Wang; Nora A Danhof; Raissa I Tjon-Kon-Fat; Marinus Jc Eijkemans; Patrick Mm Bossuyt; Monique H Mochtar; Fulco van der Veen; Siladitya Bhattacharya; Ben Willem J Mol; Madelon van Wely Journal: Cochrane Database Syst Rev Date: 2019-09-05
Authors: Damiano Pizzol; Alberto Ferlin; Andrea Garolla; Andrea Lenzi; Alessandro Bertoldo; Carlo Foresta Journal: Front Biosci (Landmark Ed) Date: 2014-01-01
Authors: C De Geyter; C Calhaz-Jorge; M S Kupka; C Wyns; E Mocanu; T Motrenko; G Scaravelli; J Smeenk; S Vidakovic; V Goossens Journal: Hum Reprod Open Date: 2020-02-24