TY - JOUR
T1 - How time to healthy singleton delivery could affect decision-making during infertility treatment
T2 - a Delphi consensus
AU - Bosch, Ernesto
AU - Bulletti, Carlo
AU - Copperman, Alan B
AU - Fanchin, Renato
AU - Yarali, Hakan
AU - Petta, Carlos A
AU - Polyzos, Nikolaos P
AU - Shapiro, Daniel
AU - Ubaldi, Filippo Maria
AU - Garcia Velasco, Juan A
AU - Longobardi, Salvatore
AU - D'Hooghe, Thomas
AU - Humaidan, Peter
AU - Pinborg, Anja Bisgaard
AU - Delphi TTP Consensus Group
N1 - Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2019/1
Y1 - 2019/1
N2 - 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.
AB - 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.
KW - Adult
KW - Birth Rate
KW - Consensus
KW - Decision Making
KW - Female
KW - Fertilization in Vitro
KW - Humans
KW - Infertility, Female/therapy
KW - Pregnancy
KW - Pregnancy Rate
KW - Preimplantation Diagnosis
KW - Single Embryo Transfer
KW - Time Factors
U2 - 10.1016/j.rbmo.2018.09.019
DO - 10.1016/j.rbmo.2018.09.019
M3 - Journal article
C2 - 30477755
SN - 1472-6483
VL - 38
SP - 118
EP - 130
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
IS - 1
ER -