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Related Concept Videos

Infertility in Males01:23

Infertility in Males

262
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...
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Infertility in Females01:28

Infertility in Females

292
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...
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In Vitro Fertilization01:24

In Vitro Fertilization

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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...
259

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Evaluating prognosis in unexplained infertility.

Ling Shan Au1, Qian Feng1, Laxmi Shingshetty2

  • 1Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.

Fertility and Sterility
|February 29, 2024
PubMed
Summary
This summary is machine-generated.

Prediction models help guide treatment for unexplained infertility. For good prognosis cases, delaying treatment is advised; for poor prognosis, immediate intervention like intrauterine insemination (IUI) is recommended.

Keywords:
Prognosisnatural conceptionprediction modelunexplained infertility

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Area of Science:

  • Reproductive Medicine
  • Clinical Epidemiology
  • Biostatistics

Background:

  • Unexplained infertility diagnosis poses a dilemma, balancing uncertainty with natural conception potential.
  • Overtreatment is a risk if all cases receive immediate intervention.
  • Prediction models can estimate natural conception likelihood, aiding treatment decisions.

Purpose of the Study:

  • To assess the effectiveness of prediction models in guiding treatment decisions for couples with unexplained infertility.
  • To determine if prediction models optimize fertility outcomes and limit unnecessary interventions.

Main Methods:

  • A systematic review of 25 studies evaluating prediction models for natural conception in unexplained infertility.
  • Analysis focused on model derivation, validation, and impact assessment.
  • Inclusion of randomized clinical trials to evaluate model impact on treatment outcomes.

Main Results:

  • The Hunault model, incorporating female age, infertility duration, prior pregnancy, and sperm motility, shows excellent calibration despite limited discrimination.
  • For unexplained infertility with >30% 12-month natural conception chance, immediate intrauterine insemination (IUI) and controlled ovarian hyperstimulation are not superior to expectant management.
  • Below the 30% threshold, IUI is superior to expectant management, but immediate in vitro fertilization (IVF) offers no advantage over IUI.

Conclusions:

  • Delayed treatment is appropriate for unexplained infertility cases with a good prognosis for natural conception.
  • Immediate treatment, including IUI with controlled ovarian hyperstimulation, is warranted for poor prognosis cases.
  • Integrating prediction models into clinical practice optimizes treatment selection, maximizes fertility outcomes, and minimizes overtreatment.