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Infertility in Males

Infertility in Males

Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...

Infertility in Females

Infertility in Females

Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
Endometriosis, a condition characterized by abnormal growth of...

In Vitro Fertilization

In Vitro Fertilization

In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...

Actuarial Approach

Actuarial Approach

The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...

Kaplan-Meier Approach

Kaplan-Meier Approach

The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...

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Should we adopt a prognosis-based approach to unexplained infertility?

Laxmi Shingshetty¹, Abha Maheshwari¹, David J McLernon²

¹Aberdeen Centre for Reproductive Medicine, NHS Grampian, Aberdeen, UK.

Human Reproduction Open

|November 16, 2022

Summary

Unexplained infertility treatment is complex. A prognosis-based approach, estimating natural and treatment conception chances, guides decisions, personalizing care and minimizing unnecessary interventions for better outcomes.

Keywords:

assisted conception expectant management live birth prediction models spontaneous pregnancy treatment unexplained infertility

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Area of Science:

Reproductive Medicine
Clinical Decision-Making
Infertility Research

Background:

Unexplained infertility (UI) lacks identifiable pathology, complicating treatment strategies.
Existing prognostic models for UI are underutilized in clinical practice.
Couples with UI have a chance of spontaneous conception, requiring interventions to improve pregnancy rates.

Discussion:

Proposes a prognosis-based approach for UI treatment decisions.
Emphasizes individualized conception probability assessment over time.
Aims to optimize treatment timing and resource allocation.

Key Insights:

Treatment decisions should be based on dynamic, couple-specific conception probabilities.
This approach personalizes care, avoiding a one-size-fits-all strategy.
Minimizes unnecessary treatments while ensuring timely access for those needing it.

Outlook:

Potential for improved patient counseling and shared decision-making in UI.
Encourages wider adoption of evidence-based prognostic tools.
Future research could refine dynamic prediction models for UI management.