Fertility treatment when the prognosis is very poor or futile: a committee opinion

doi:10.1016/j.fertnstert.2012.03.045

Cited by 43 publications

(6 citation statements)

References 13 publications

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“…A much better approach would be to define sterility quantitatively and as part of a hierarchy ranging from fertility to sterility. Indeed, the Ethics Committee of the American Society of Reproductive Medicine (ASRM) coined the term "futility" to describe fertility treatments that have 1% or less chance of achieving a live birth [50]. (ii) Prospectively diagnosing clinical sterility is challenging, while natural sterility can be determined prospectively by routine diagnostic tests and includes a lack of sperm cells or oocytes.…”

Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

“…According to the World Health Organization, a fertile couple conceives naturally within one year of trying, and an infertile couple fails to conceive naturally within one year of trying. The two extensions are elaborations of the "futility" concept proposed by the Ethics Committee of the American Society of Reproductive Medicine (ASRM) [50]. The first extension adds the definition of a prospectively clinically sterile couple, who has 1% or less chance of achieving a live birth with reproductive medicine assistance.…”

Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

“…Women 2020, 1, FOR PEER REVIEW 4 elaborations of the "futility" concept proposed by the Ethics Committee of the American Society of Reproductive Medicine (ASRM) [50]. The first extension adds the definition of a prospectively clinically sterile couple, who has 1% or less chance of achieving a live birth with reproductive medicine assistance.…”

Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

“…An attempt to determine futility conditions was made by the Ethics Committee of the ASRM. Their suggestions for treatment of futility highlighted challenges associated with determining futility and sterility prospectively [50]. For example, they suggested that it is futile to treat couples with IVF if a female has an ovarian failure.…”

Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

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Sterility, an Overlooked Health Condition

Royfman

Shah

Sindhwani

et al. 2020

Women

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Clinically, infertility is defined as the inability to conceive after a certain period. In contrast, sterility is defined as the inability to produce a biological child; however, this is not a practical definition that can be applied in a clinical setting to a patient’s diagnosis. Unlike infertility, sterility is rarely discussed in biomedical and clinical literature and is often used synonymously with infertility. Infertility affects about 10% of couples globally, but the prevalence of sterility remains unknown. We divide sterility into three subtypes natural, clinical, and hardship. To estimate sterility prevalence, we analyzed primary literature and meta-analysis papers on the rates of live births and pregnancies throughout several treatments of infertile couples (e.g., untreated patients, in vitro fertilization-treated, and patients administered other treatments). This analysis indicates that all treatments fail in delivering a biological child to most couples, suggesting that most infertile couples may fail to conceive. More comprehensive primary studies are needed to provide a precise estimate of sterility. Furthermore, research is needed to study the causes of sterility, as well as develop methods for diagnosis and treatment that are financially affordable and emotionally tolerable. Altogether, sterility is an under-discussed condition that is more common than expected, as many infertile couples are unable to conceive and are, in effect, sterile.

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Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

Section: There Is a Need To Diagnose Sterility Prospectivelymentioning

confidence: 99%

See 2 more Smart Citations

Sterility, an Overlooked Health Condition

Royfman

Shah

Sindhwani

et al. 2020

Women

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“…This is the main reason why the American Society for Reproductive Medicine (ASRM) has not recommended upper-age limits for women using their own eggs but has issued guidelines concerning treatment that has a poor prognosis or is futile. They define ‘‘futility’’ as interventions with less than a 1% likelihood of live birth, and ‘‘very poor prognosis’’ as odds of >1% but <5% (16). It is therefore very important to identify all predictive factors that discern between women who could really benefit from this procedure and women who are candidates for other treatment options, like oocyte donation.…”

Section: Introductionmentioning

confidence: 99%

Predictive factors for live birth in autologous in vitro fertilization cycles in women aged 40 years and older

Reljič

Lovrec

2019

Slovenian Journal of Public Health

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Background The aim of the study was to determine predictive factors for live birth after in vitro fertilization with autologous oocytes in women ≥40 years of age. Methods Authors conducted a retrospective analysis of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles performed at the Department of Reproductive Medicine and Gynecologic Endocrinology, University Medical Centre Maribor, Slovenia between January 2006 and December 2015 in women aged 40 or more. The characteristics of patients and cycles were compared regarding live birth as the final outcome. Results A total of 1920 IVF/ICSI cycles with egg retrieval in women ≥40 years of age were performed leading to 1591 embryo transfers. The live birth rate per embryo transfer was 17.3% at 40, 11.6% at 41, 8.2% at 42, 7.9% at 43, 1.9% at 44 and 0.0% at ≥45 years of age. The multivariate logistic regression model showed that besides women’s age (OR 0.66, 95% CI: 0.55–0.78), the number of previous cycles (OR 0.88, 95% CI: 0.82–0.95), number of good quality embryos on day 2 (OR 1.19, 95% CI: 1.05-1.36), number of embryos transferred (OR 1.57, 95% CI: 1.19–2.07) and day 5 embryo transfer (OR 2.21, 95% CI: 1.37–3.55) were also independent prognostic factors for live birth. Conclusions The chance of in vitro fertilization success in women ≥40 years of age should not be estimated only on the woman’s age, but also on other predictive factors: number of previous cycles, number of good quality embryos on day 2, number of transferred embryos and blastocyst embry transfer.

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Infertility

Ragab

2021

Encyclopedia of Global Bioethics

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Fertility treatment when the prognosis is very poor or futile: a committee opinion

Cited by 43 publications

References 13 publications

Sterility, an Overlooked Health Condition

Sterility, an Overlooked Health Condition

Predictive factors for live birth in autologous in vitro fertilization cycles in women aged 40 years and older

Infertility

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