RESUMO
Encounters for infertility care are opportunities to assess and update immunization status. Individuals of reproductive age are often unaware of their need for immunization, their immunization status, and the potentially severe consequences of preventable disease on pregnancy outcome. The purpose of this American Society for Reproductive Medicine (ASRM) Practice Committee document is to summarize current recommendations regarding vaccinations for individuals of reproductive age. This document replaces the ASRM Practice Committee document titled "Vaccination guidelines for female infertility patients," last published in 2018 (Fertil Steril 2018;110:838-41).
Assuntos
Vacinação , Humanos , Feminino , Gravidez , Vacinação/normas , Vacinas , Medicina Reprodutiva/normas , Infertilidade Feminina/imunologia , Infertilidade Feminina/terapia , Guias de Prática Clínica como Assunto/normasRESUMO
Linear mixed models are regularly used within the field of reproductive medicine. This manuscript explains the basics of mixed models, when they could be used, and how they could be applied.
Assuntos
Medicina Reprodutiva , Humanos , Medicina Reprodutiva/normas , Medicina Reprodutiva/métodos , Modelos Lineares , Interpretação Estatística de Dados , Reprodutibilidade dos Testes , FemininoAssuntos
Infertilidade , Medicina Reprodutiva , Humanos , Medicina Reprodutiva/normas , Infertilidade/terapia , Infertilidade/diagnóstico , Infertilidade/fisiopatologia , Feminino , Estados Unidos/epidemiologia , Sociedades Médicas/normas , Masculino , Religião e Medicina , Características Culturais , Terminologia como AssuntoRESUMO
The purpose of this American Society for Reproductive Medicine Practice Committee Opinion is to provide clinicians with principles and strategies for the diagnostic evaluation of patients presenting with primary or secondary amenorrhea. This revised document replaces the Practice Committee Document titled "Current evaluation of amenorrhea," last published in 2008 (Fertil Steril 2008;90:S219-25).
Assuntos
Amenorreia , Humanos , Feminino , Amenorreia/diagnóstico , Amenorreia/terapia , Amenorreia/fisiopatologia , Medicina Reprodutiva/normas , Medicina Reprodutiva/métodosRESUMO
This introduction is to a Views and Reviews series of articles outlining best practices in the design and analysis of reproductive medicine articles. The investigators are experienced researchers and biostatisticians who highlight key points with illustrative examples from both published and theoretical clinical studies. This series is meant not only to educate readers in the interpretation of clinical research studies but also to inspire better-designed studies in the future.
Assuntos
Ensaios Clínicos como Assunto , Medicina Reprodutiva , Projetos de Pesquisa , Humanos , Medicina Reprodutiva/normas , Medicina Reprodutiva/métodos , Ensaios Clínicos como Assunto/métodos , Projetos de Pesquisa/normasRESUMO
Financial "risk-sharing" fee structures in assisted reproduction programs charge patients a higher initial fee that includes multiple cycles but offers a partial or complete refund if treatment fails. This opinion of the American Society for Reproductive Medicine Ethics Committee analyzes the ethical issues raised by these fee structures, including patient selection criteria, conflicts of interest, success rate transparency, and patient-informed consent. This document replaces the document of the same name, last published in 2016.
Assuntos
Comissão de Ética , Técnicas de Reprodução Assistida , Participação no Risco Financeiro , Humanos , Técnicas de Reprodução Assistida/ética , Técnicas de Reprodução Assistida/economia , Comissão de Ética/economia , Participação no Risco Financeiro/ética , Participação no Risco Financeiro/economia , Feminino , Consentimento Livre e Esclarecido/ética , Medicina Reprodutiva/ética , Medicina Reprodutiva/economia , Medicina Reprodutiva/normas , Seleção de Pacientes/ética , Gravidez , Infertilidade/terapia , Infertilidade/economia , Infertilidade/fisiopatologia , Infertilidade/diagnósticoRESUMO
This Committee Opinion provides practitioners with suggestions to reduce the likelihood of iatrogenic multiple gestation resulting from infertility treatment. This document replaces the document of the same name previously published in 2012 (Fertil Steril 2012;97:825-34 by the American Society for Reproductive Medicine).
Assuntos
Infertilidade Feminina/terapia , Gravidez Múltipla/fisiologia , Medicina Reprodutiva/normas , Técnicas de Reprodução Assistida/normas , Sociedades Médicas/normas , Técnicas de Cultura Embrionária/métodos , Técnicas de Cultura Embrionária/normas , Feminino , Humanos , Infertilidade Feminina/diagnóstico , Indução da Ovulação/efeitos adversos , Indução da Ovulação/métodos , Indução da Ovulação/normas , Gravidez , Medicina Reprodutiva/métodos , Técnicas de Reprodução Assistida/efeitos adversosRESUMO
This committee opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples or individuals attempting conception who have no evidence of infertility. This document replaces the document of the same name previously published in 2013 (Fertil Steril 2013;100:631-7).
Assuntos
Aconselhamento Diretivo/normas , Fertilidade/fisiologia , Infertilidade/terapia , Técnicas de Reprodução Assistida , Adulto , Aconselhamento Diretivo/métodos , Endocrinologistas/organização & administração , Endocrinologistas/normas , Comportamento Alimentar/fisiologia , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Medicina Reprodutiva/organização & administração , Medicina Reprodutiva/normas , Técnicas de Reprodução Assistida/normas , Técnicas de Reprodução Assistida/tendências , Comportamento de Redução do Risco , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Estados UnidosRESUMO
To succeed in the conduct of clinical trials in reproductive medicine, teams must be trained and cultivated to collaborate and achieve a common goal. Here I share my personal experiences and lessons learned in teaming in the research setting by covering topics in time management, resource allocation, collaboration, publishing, and communication.
Assuntos
Comportamento Cooperativo , Medicina Reprodutiva/organização & administração , Pesquisa Translacional Biomédica/organização & administração , Pesquisa Biomédica/organização & administração , Pesquisa Biomédica/normas , Feminino , Humanos , Comunicação Interdisciplinar , Masculino , Gravidez , Medicina Reprodutiva/normas , Pesquisa Translacional Biomédica/normasAssuntos
Assistência ao Paciente/tendências , Médicos/tendências , Medicina Reprodutiva/tendências , Equilíbrio Trabalho-Vida/tendências , Humanos , Satisfação no Emprego , Assistência ao Paciente/normas , Médicos/normas , Medicina Reprodutiva/normas , Equilíbrio Trabalho-Vida/normas , Carga de Trabalho/normasRESUMO
On the basis of American Society for Reproductive Medicine and Society for Assisted Reproductive Technology data, the American Society for Reproductive Medicine's guidelines for the limits on the number of embryos to be transferred during in vitro fertilization cycles have been further refined in continuing efforts to promote singleton gestation and reduce the number of multiple pregnancies. This version replaces the document titled "Criteria for number of embryos to transfer: a committee opinion" that was published most recently in August of 2017 (Fertil Steril 2017;107:901-3).
Assuntos
Transferência Embrionária/normas , Fertilização in vitro/normas , Infertilidade/terapia , Medicina Reprodutiva/normas , Adulto , Tomada de Decisão Clínica , Consenso , Transferência Embrionária/efeitos adversos , Feminino , Fertilização in vitro/efeitos adversos , Humanos , Infertilidade/diagnóstico , Infertilidade/fisiopatologia , Idade Materna , Gravidez , Redução de Gravidez Multifetal/normas , Medição de Risco , Fatores de Risco , Transferência de Embrião Único/normas , Resultado do TratamentoRESUMO
OBJECTIVE: To provide evidence-based recommendations to practicing physicians and others regarding the efficacy of oocyte cryopreservation (OC) for donor oocyte in vitro fertilization and planned OC. METHODS: The American Society for Reproductive Medicine conducted a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1986 to 2018. The American Society for Reproductive Medicine Practice Committee and a task force of experts used available evidence and through consensus developed evidence-based guideline recommendations. MAIN OUTCOME MEASURE(S): Outcomes of interest included live birth rate, clinical pregnancy rate, obstetrical and neonatal outcomes, and factors predicting reproductive outcomes. RESULT(S): The literature search identified 30 relevant studies to inform the evidence base for this guideline. RECOMMENDATION(S): Evidence-based recommendations were developed for predicting the likelihood of live births after planned OC, autologous OC in infertile women, and donor OC, as well as factors that may impact live birth rates. Recommendations were developed regarding neonatal outcomes after using fresh vs. cryopreserved oocytes in cases of autologous or donor oocytes. CONCLUSION(S): There is insufficient evidence to predict live birth rates after planned OC. On the basis of limited data, ongoing and live birth rates appear to be improved for women who undergo planned OC at a younger vs. older age. Although there are no significant differences in per transfer pregnancy rates with cryopreserved vs. fresh donor oocytes, there is insufficient evidence that the live birth rate is the same with vitrified vs. fresh donor oocytes. Neonatal outcomes appear similar with cryopreserved oocytes compared with fresh oocytes. Future studies that compare cumulative live birth rates are needed.
Assuntos
Criopreservação/normas , Preservação da Fertilidade/normas , Fertilização in vitro/normas , Infertilidade Feminina/terapia , Recuperação de Oócitos/normas , Oócitos , Medicina Reprodutiva/normas , Adulto , Consenso , Medicina Baseada em Evidências/normas , Feminino , Fertilidade , Preservação da Fertilidade/efeitos adversos , Fertilização in vitro/efeitos adversos , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/fisiopatologia , Nascido Vivo , Recuperação de Oócitos/efeitos adversos , Gravidez , Complicações na Gravidez/etiologia , Taxa de Gravidez , Fatores de Risco , Resultado do TratamentoRESUMO
Basic and translational research in reproductive medicine can provide new insights with the application of scanning probe microscopies, such as atomic force microscopy (AFM) and scanning near-field optical microscopy (SNOM). These microscopies, which provide images with spatial resolution well beyond the optical resolution limit, enable users to achieve detailed descriptions of cell topography, inner cellular structure organization, and arrangements of single or cluster membrane proteins. A peculiar characteristic of AFM operating in force spectroscopy mode is its inherent ability to measure the interaction forces between single proteins or cells, and to quantify the mechanical properties (i.e., elasticity, viscoelasticity, and viscosity) of cells and tissues. The knowledge of the cell ultrastructure, the macromolecule organization, the protein dynamics, the investigation of biological interaction forces, and the quantification of biomechanical features can be essential clues for identifying the molecular mechanisms that govern responses in living cells. This review highlights the main findings achieved by the use of AFM and SNOM in assisted reproductive research, such as the description of gamete morphology; the quantification of mechanical properties of gametes; the role of forces in embryo development; the significance of investigating single-molecule interaction forces; the characterization of disorders of the reproductive system; and the visualization of molecular organization. New perspectives of analysis opened up by applying these techniques and the translational impacts on reproductive medicine are discussed.
Assuntos
Microscopia de Varredura por Sonda/métodos , Medicina Reprodutiva/métodos , Animais , Fenômenos Biomecânicos , Embrião de Mamíferos/citologia , Embrião de Mamíferos/metabolismo , Embrião de Mamíferos/ultraestrutura , Células Germinativas/citologia , Células Germinativas/metabolismo , Células Germinativas/ultraestrutura , Humanos , Microscopia de Força Atômica/métodos , Microscopia de Varredura por Sonda/normas , Imagem Molecular/métodos , Imagem Molecular/normas , Medicina Reprodutiva/normas , Imagem Individual de Molécula/métodosRESUMO
PURPOSE: To study how SART-member fertility clinics communicated via clinic websites during the first wave of the COVID-19 pandemic following publication of ASRM COVID-19 Task Force recommendations. METHODS: SART-member fertility clinic websites were systematically surveyed for the presence of an REI-specific COVID-19 message (REI-CM) and analyzed for their adherence to ASRM guidance. RESULTS: Of the 381 active clinic websites, 249 (65.3%) had REI-specific COVID messaging. The presence of REI-CM was more common in private than in academic practices (73% vs 38%, p < 0.001) and with increasing practice volume: 38% of clinics with < 200 annual cycles vs 91% of clinics with > 1000 cycles (p < 0.001). Adherence to ASRM guidance was more common in academic than in private practices (54% vs 31%, p = 0.02). Additionally, 9% of REI-CM (n = 23) announced continued treatment regardless of a patient's clinical urgency. This messaging was more common in groups doing > 1000 cycles a year (18%, p = 0.009). Clinics treating all-comers were less likely to cite ASRM than other clinics (41% vs 62%, p = 0.045). However, 75% (n = 14) cited COVID-19 guidance from WHO, CDC, and state and local governments. CONCLUSIONS: Clinic response to ASRM recommendations during the first wave of COVID-19 pandemic was heterogeneous. Although academic practices were more likely to follow ASRM guidance, there was a lower extent of patient-facing messaging among academic practices than private clinics. In event of further escalations of this and future pandemics, clinics can learn from experiences to provide clear messaging to patients.
Assuntos
COVID-19/prevenção & controle , Comunicação , Clínicas de Fertilização/normas , Infertilidade/terapia , Medicina Reprodutiva/normas , SARS-CoV-2/fisiologia , Telemedicina/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/virologia , HumanosRESUMO
This document provides the latest recommendations for the evaluation of potential sperm, oocyte, and embryo donors as well as their recipients, incorporating recent information about optimal screening and testing for sexually transmitted infections, genetic diseases, and psychological assessments. This revised document incorporates recent information from the US Centers for Disease Control and Prevention, US Food and Drug Administration, and American Association of Tissue Banks, which all programs offering gamete and embryo donation services must be thoroughly familiar with, and replaces the document titled "Recommendations for gamete and embryo donation: a committee opinion," last published in 2013.
Assuntos
Seleção do Doador/normas , Destinação do Embrião/normas , Doação de Oócitos/normas , Medicina Reprodutiva/normas , Sêmen , Doadores de Tecidos/psicologia , Consenso , Aconselhamento/normas , Destinação do Embrião/efeitos adversos , Feminino , Testes Genéticos/normas , Nível de Saúde , Humanos , Masculino , Saúde Mental , Doação de Oócitos/efeitos adversos , Cuidado Pré-Concepcional/normas , Gravidez , Medição de Risco , Fatores de RiscoRESUMO
This guidance document was developed by the Mental Health Professional Group (MHPG) in partnership with the Practice Committee of the American Society for Reproductive Medicine (ASRM) to help determine the qualifications and training of mental health professionals working in reproductive medicine. This document replaces the document titled "ASRM Qualification Guidelines for Infertility," last published in March 2015 and originally developed in 1995.
Assuntos
Aconselhamento/normas , Conselheiros/normas , Credenciamento/normas , Fertilidade , Infertilidade/terapia , Medicina Reprodutiva/normas , Competência Clínica/normas , Consenso , Escolaridade , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Infertilidade/diagnóstico , Infertilidade/fisiopatologiaRESUMO
The prevalence and ease of electronic communication, specifically email through patient portals associated with electronic medical records or via traditional enterprise email clients (e.g., Outlook) and video, have resulted in increased use for rapid communication between practitioners and their patients. Concerns regarding patient privacy and compliance with the regulations of the Health Insurance Portability and Accountability Act (HIPAA) remain a barrier to routine incorporation of electronic communication into practice. Furthermore, capital investment, implementation, and maintenance costs may provide additional barriers. These long-standing concerns have been heightened and tested by the COVID-19 pandemic. Best-practice guidelines for the secure and safe use of electronic communication with reproductive care patients are provided.
Assuntos
Confidencialidade/normas , Correio Eletrônico/normas , Medicina Reprodutiva/normas , Telemedicina/normas , Envio de Mensagens de Texto/normas , Gravação em Vídeo/normas , COVID-19/epidemiologia , Registros Eletrônicos de Saúde/normas , Fidelidade a Diretrizes/normas , Humanos , Medicina Reprodutiva/métodos , Telemedicina/métodos , Gravação em Vídeo/métodosRESUMO
Luteal phase deficiency (LPD) is a clinical diagnosis associated with an abnormal luteal phase length of ≤10 days. Potential etiologies of LPD include inadequate progesterone duration, inadequate progesterone levels, or endometrial progesterone resistance. LPD has not only been described in association with medical conditions but also in fertile, normally menstruating women. Although progesterone is important for the process of implantation and early embryonic development, LPD has not been proven to be an independent entity causing infertility or recurrent pregnancy loss. Controversy exists regarding the multiple proposed measures for diagnosing LPD and, assuming it can be diagnosed accurately, whether treatment improves outcomes. This document replaces the document entitled "Current clinical irrelevance of luteal phase deficiency: a committee opinion," last published in 2015 (Fertil Steril 2015;103:e27-e32).
Assuntos
Aborto Espontâneo/prevenção & controle , Fertilidade , Infertilidade Feminina/terapia , Fase Luteal/sangue , Progesterona/sangue , Medicina Reprodutiva/normas , Técnicas de Reprodução Assistida/normas , Aborto Espontâneo/sangue , Aborto Espontâneo/diagnóstico , Aborto Espontâneo/fisiopatologia , Biomarcadores/sangue , Consenso , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/fisiopatologia , Valor Preditivo dos Testes , Gravidez , Progesterona/deficiência , Fatores de Risco , Resultado do TratamentoRESUMO
The term "social media" refers to computer-mediated technologies that enable individuals and communities to gather, communicate, network, and share information. These technologies represent useful tools for enabling individual providers and their clinics to broadcast content that educates, informs, advertises, and narrates content to a larger audience. There are multiple benefits to maintaining a presence on social media, either as an individual physician or as a clinic, but several pitfalls deserve consideration as well. This guidance document does not endorse any specific cloud-based platform or service, though some are mentioned for the purposes of illustration.
Assuntos
Padrões de Prática Médica/normas , Medicina Reprodutiva/normas , Mídias Sociais/normas , Publicidade/ética , Publicidade/métodos , Publicidade/normas , Relações Comunidade-Instituição/normas , Tomada de Decisões/fisiologia , Revelação/ética , Revelação/normas , Humanos , Disseminação de Informação/ética , Disseminação de Informação/métodos , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/normas , Relações Médico-Paciente , Padrões de Prática Médica/ética , Medicina Reprodutiva/ética , Medicina Reprodutiva/métodos , Medicina Reprodutiva/tendências , Mídias Sociais/ética , Mídias Sociais/tendênciasRESUMO
PURPOSE: The summary presented herein represents Part I of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part I outlines the appropriate evaluation of the male in an infertile couple. Recommendations proceed from obtaining an appropriate history and physical exam (Appendix I), as well as diagnostic testing, where indicated. MATERIALS/METHODS: The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January, 2000 through May, 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table 1[Table: see text]). This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology. RESULTS: This Guideline provides updated, evidence-based recommendations regarding evaluation of male infertility as well as the association of male infertility with other important health conditions. The detection of male infertility increases the risk of subsequent development of health problems for men. In addition, specific medical conditions are associated with some causes for male infertility. Evaluation and treatment recommendations are summarized in the associated algorithm (figure[Figure: see text]). CONCLUSION: The presence of male infertility is crucial to the health of patients and its effects must be considered for the welfare of society. This document will undergo updating as the knowledge regarding current treatments and future treatment options continues to expand.