Priority Setting Partnership for Infertility What should infertility research focus on next? Our partnership has brought together healthcare professionals, people with fertility problems, and others to set future priorities for infertility research.
2 Priority Setting Partnership for Infertility Chairs Dr James M. N. Duffy Prof. Cindy Farquhar Balliol College, University of Oxford, Cochrane Gynaecology and Fertility, United Kingdom University of Auckland, New Zealand Steering Group Funders G. David Adamson Sebastian Franik Dean Morbeck Helen L. Torrance ARC Fertility, United States Münster University Hospital, Germany Fertility Associates, New Zealand University Medical Centre Utrecht, The Netherlands Siladitya Bhattacharya Linda C. Giudice Helen Nagels University of Aberdeen, United Kingdom International Federation of Fertility Societies University of Auckland, New Zealand Andy Vail Human Reproduction Open University of Manchester, Elizabeth Glanville Ernst H.Y. Ng United Kingdom Sohinee Bhattacharya Auckland District Health Board, University of Hong Kong, Hong Kong University of Aberdeen, United Kingdom New Zealand Melissa Vercoe Craig Niederberger University of Auckland, New Zealand Magdalena Bofjll Martha Hickey University of Illinois at Chicago, Th ị Ng ọ c Lan V ươ ng University of Auckland, New Zealand University of Melbourne, Australia United States Fertility and Sterility University of Medicine and Pharmacy at Kate Brian Andrew Horne Ho Chi Minh City, Vietnam Women’s Voices, Royal College of University of Edinburgh, United Kingdom Anne-Sophie Otter Obstetricians and Gynaecologists, Osakidetza OSI, Spain Alex Y. Wang M. Louise Hull United Kingdom University of Technology Sydney, Australia University of Adelaide, Australia Lucian Puscasiu Barbara Collura University of Medicine, Pharmacy, Science Rui Wang Neil P . Johnson RESOLVE: The National Infertility and Technology Targu Mures, Romania University of Adelaide, Australia University of Adelaide, Australia Association, Untied States Satu Rautakallio-Hokkanen Madelon van Wely Vanessa Jordan Cate Curtis Fertility Europe, Finland Amsterdam University Medical Centers, University of Auckland, New Zealand Fertility NZ, New Zealand The Netherlands Sjoerd Repping Yakoub Khalaf University of Waikato, New Zealand Amsterdam University Medical Centers, Jack Wilkinson Kings College London, United Kingdom Leona Dann The Netherlands University of Manchester, United Kingdom José Knijnenburg Health Quality and Safety Commission, Lynn Sadler Karina Wong Freya, The Netherlands New Zealand University of Auckland, New Zealand Fertility NZ, New Zealand Richard S. Legro Johannes L.H. Evers Marian Showell Tze Yoong Wong Penn State College of Medicine, University Medical Centre Maastricht, University of Auckland, New Zealand Auckland District Health Board, United States The Netherlands New Zealand Jane Stewart Sarah Lensen Human Reproduction British Fertility Society, United Kingdom Mohamed A. Youssef University of Auckland, New Zealand Roy G. Farquharson Cairo University, Egypt Annika Strandell Liverpool Women’s NHS Foundation Trust, Jeanette MacKenzie Sahlgrenska University Hospital, Sweden United Kingdom Fertility Plus, New Zealand Catherine Strawbridge Anita Fincham Ben W. Mol Fertility Network UK, United Kingdom Fertility Europe, Poland Monash University, Australia
3 Priority Setting Partnership for Infertility What should infertility research focus on next? Reproductive medicine helps to assist people with fertility problems to become parents. Unfortunately, despite the escalation in research activity and an exponential rise in published research, many of the fundamental questions about the treatment of infertility remain. This is a barrier to improving the care people with fertility problems receive. Our Priority Setting Partnership has brought healthcare professionals, people with fertility problems, and others together to set future priorities for infertility research. We have engaged in an open and transparent process, using robust consensus development methods advocated by the James Lind Alliance. Over 700 people from 53 countries participated in our partnership. With their help we have prioritised the top ten research uncertainties for male infertility, female and unexplained infertility, medically assisted reproduction, and ethics, access, and organisation of care. We anticipate that this prioritised list of research uncertainties, developed to specifjcally highlight the most pressing clinical needs as perceived by healthcare professionals, people with fertility problems, and others will help funding organisations and researchers to set their future research priorities. We are drowning in research that is singularly lacking in impact. Our approach should ensure future research has the necessary reach and relevance to inform future clinical practice and improve patient outcomes. Dr James M. N. Duffy Balliol College, University of Oxford, United Kingdom Prof. Cindy Farquhar Cochrane Gynaecology and Fertility, University of Auckland, New Zealand
4 Priority Setting Partnership for Infertility Our consensus building methods 01. Gathering research questions 02. Prioritising research questions We conducted an initial survey asking healthcare professionals, people with We conducted an interim prioritisation survey asking healthcare fertility problems, and others what questions they wanted future research professionals, people with fertility problems, and others to prioritise a to answer. We promoted the survey across our partner organisations and rationalised list of 231 research questions. The survey was promoted across social media to ensure we reached a diverse range of people with different our partner organisations and social media. perspectives. Survey respondents were asked to select their top fjve research questions 179 healthcare professionals, 153 people with fertility problems, and 56 for male infertility, female and unexplained infertility, medically assisted others, from 40 countries, responded to the initial survey and submitted 423 reproduction, and ethics, access, and organisation of care. potential research questions. 143 healthcare professionals, 119 people with fertility problems, and 55 We also reviewed 14 clinical practice guidelines and 162 Cochrane others, from 43 countries, responded to the interim prioritisation survey. systematic reviews and identifjed a further 236 potential research questions. Based on their feedback, 15 research questions were prioritised for male infertility, female and unexplained infertility, medically assisted reproduction, and ethics, access, and organisation of care. 179 healthcare professionals 143 healthcare professionals 153 people with fertility problems 119 people with fertility problems 56 others 55 others 40 countries 43 countries
5 Priority Setting Partnership for Infertility Our consensus building methods 03. Consensus development conference Prioritised research questions were discussed in a consensus development conference held in Auckland, New Zealand. Using the formal consensus development methods, 19 healthcare professionals, 14 people with fertility problems, and eight others, from 11 countries, prioritised the top ten research uncertainties for male infertility, female and unexplained infertility, medically assisted reproduction, and ethics, access, and organisation of care. 19 healthcare professionals 14 people with fertility problems 8 others 11 countries
6 Priority Setting Partnership for Infertility Our international reach • Argentina • Denmark • India • Montenegro • Romania • Switzerland • Australia • Ecuador • Iran • New Zealand • Russia • Thailand • Belgium • Egypt • Ireland • Nigeria • Saudi Arabia • The Netherlands • Bosnia and Herzegovina • Finland • Israel • Norway • Serbia • Turkey • Brazil • France • Italy • Peru • South Africa • Tuvalu • Bulgaria • Germany • Japan • Poland • South Korea • United Kingdom • Canada • Greece • Malaysia • Portugal • Spain • United States of America • Chile • Hong Kong • Malta • Qatar • Suriname • Vietnam • China • Hungary • Mexico • Republic of Korea • Sweden
7 Priority Setting Partnership for Infertility Top ten male infertility research uncertainties 03 09 05 01 Do environmental Does treating Can we improve Are sperm tests factors cause male co-morbidities surgical sperm other than the World infertility? improve outcomes? extraction outcomes Health Organization 07 by using endocrine parameters useful stimulatory protocols? Does treating in evaluating male modifjable risk factors fertility? improve outcomes? 02 06 10 04 What is the emotional What modifjable risk Are nutraceuticals and psychological factors cause male useful in improving Does treating specifjc 08 impacts of male infertility? male reproductive causes of male infertility? Can potential? If so, infertility improve What co-morbidities addressing them which? outcomes? are associated with improve outcomes? infertility?
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