Sexual and reproductive health

Global infertility guidelines:
Strategy for development and dissemination

Generating practice guidelines

The revision and updating of the “WHO global Guidelines for infertility diagnosis, management and interventions for treatment” (1992) and the WHO manual for the investigation and diagnosis of the infertile couple” (1993) was initiated in January 2012. A small Steering Committee with six Expert Working Group Chairs, local Swiss experts, as well as Presidents, Chairpersons and representatives of ASRM1, ESHRE2, FIGO3, GFMER4, ICMART5 and IFFS6 came to the table to share experiences, to present their current (or in-process) guidelines and to recommend a collaborative process for moving forward to generate global guidelines.

In addition to recently established WHO procedures for Guideline development, an innovate mechanism was planned and has been initiated to ensure developing country input throughout the process - from scoping and prioritization of the prioritized topics, to presentation of non-English language evidence for global consensus consultations. Through this process, gaps in knowledge and key areas of research required in developing countries and low resource settings will be identified.

Photo of the Infertility Guidelines Group

An on-line WHO infertility virtual consultation course includes a 5 module WHO evidence-based medicine course, as well as a 16 module ASRM eLearning course which reviews the evidence-base for the basic diagnosis of the infertile male and female, coupled with management and treatment. Opinion papers submitted by all participants will prioritize and address adaptation issues surrounding key questions which contribute to the consultations generating evidence-based WHO Guidelines.

Comprehensive infertility/subfertility global guidelines and identification of research gaps

External Review Group

Societies: ASRM (Current President or past President), ESHRE (Current President or past President), FIGO (Current President or past President) FIGO-RMC (Chair, David Adamson), GIERAF (President or past President, Ernestine Gwet Bell), ICMART (President, David Adamson), IFFS (President, Joe Leigh Simpson), ISMAAR (Geeta Nargund), Additional suggested Societies to be invited such as the International Society for Andrology, Asian society; ASPIRE, Society for Gynaecological Investigation (SGI).

Foundations: Friends of Low Cost/LCIVF Foundation (President, Alan Trounson or appointed representative), The Walking Egg (Willem Ombelet), Additional suggested Foundations/Trusts: Steptoe & Edwards Trust,

Patient groups and Representatives: Invited representatives from International or Regional Patient Groups, Developing Country End Users of the Recommended Guidelines, Invited representatives from the 6 WHO regional and interested country offices

Guideline Development Group (GDG) Steering Committee:

Co-Chairs: Paul Devroey (Belgium) & Bruce Dunphy (Australia): Male infertility; IVF-ICSI; IUI Bart Fauser (the Netherlands) & Basil Tarlatzis (Greece): Female infertility, PCOS, COS for ART Thomas D’Hooghe (Belgium): Endometriosis; Female infertility; IUI Felice Petraglia (Italy), Roger Lobo (USA): Prioritized topics to be determined.

Health economist: (to be determined - TBD) Methodologist: (TBD, if required)

Guideline Development Group (GDG) Sub-Committees

Chairs and Members

GDG SUB-Committees
  • Female subfertility work-up. ADVISORY: Hans Evers (the Netherlands), CO-CHAIRS: Cindy Farqhuar (New Zealand), Robert Rebar (USA), Johnny Awwad (Lebanon), William Catherino (USA), Elizabeth Stewart (USA), CR Tzeng (South Korea)
  • Male subfertility work-up. CHAIR: Christopher Barratt (UK); Members: Herman Tournaye (Belgium), Rob McLachlan (Australia), Christopher De Jonge (USA), Lars Björndahl (Sweden), Robert Oates (USA), Dorrie Lamb (USA)
  • Ovarian stimulation for ART. ADVISORY: Anders Nyboe Andersen (Denmark); CHAIR: Georg Griesinger (Germany), Members: Alan Penzias (USA), Frank Broekmans (Netherlands), Efstratios Kolibianakis (Greece); Julia Bosdou (Greece)
  • IVF, ICSI. ADVISORY: André van Steirteghem (Belgium); CO-CHAIRS: Laura Francesca Rienzi (Italy), Catherine Racowsky (USA); Members: John Collins (Canada), Arne Sunde (Norway), Andy LaBarbera (USA), Charles Bormann (USA), Roberta Maggiulli (Italy), Daniel Kaser (USA), Leslie Farland (USA)
  • IUI with or without ovarian stimulation. CHAIR: Ben Cohlen (the Netherlands) Members: Aartjan Bijkerk (Netherlands), Carin Huyser (South Africa), Aucky Hinting (Indonesia)
  • PCOS. CHAIR: Adam Balen (UK), Members: Maria Misso (Australia), Lara Morley (UK), Steve Franks (UK), Rick Legro (USA), Rob Norman (Australia), Chandrika Wijeyeratne (Sri Lanka)
In Planning GDG SUB-Committees
  • Endometriosis. CHAIR: TBD Members: TBD – in Discussion.
  • Fertility interventions for HIV- discordant couples. CHAIR: TBD Members: TBD - in Discussion
  • Environment and effects on fertility. CHAIR: TBD; Members: Okoema Mmeje (USA), Joelle Brown (USA)

  • American Society for Reproductive Medicine (ASRM)
  • European Society for Human Reproduction and Embryology (ESHRE)
  • International Federation of Obstetrics and Gynaecology (FIGO)
  • Graduate Foundation for Medical Education and Research (GFMER)
  • International Committee for Monitoring Assisted Reproductive Technologies (ICMART)
  • International Federation of Fertility Societies (IFFS)

Implementation of infertility guidelines at country level

Country assessment integration tool / research

Chair: Ian Cooke (UK), CO-CHAIR: David Adamson (US), Research P.I. and Support: Bruce Dunphy (IHBI, Australia), Co-PI, Support: Sheryl van der Poel (WHO) Members: Policy: Petra de Sutter (Belgium), Liz Sullivan (Australia); Systems: Jacky Boivin (Canada/UK)/Georgina Jones (UK), Ian Askew (Kenya) Services: Chris Herndon (USA, couple), Allan Pacey (UK, male, laboratory), Zi-Jian Chen (China) Unrestricted Educational Support through the Institute of Health and Innovations, Brisbane, Australia: Diego Ezcurra (USA)

ELSI (Ethics, Legal and Social Implications) for integration of infertility policy, practice guidelines and tools

Chair: Fernando Zegers-Hochschild (Chile), Co-Chairs: Francoise Shenfield (UK, France, suggested), Florencia Luna (Argentina, suggested), Guido Pennings (Belgium) Chairs: for specific and prioritized topics Members: (Teams to be determined, and funds to be secured for each prioritized topic for ELSI.)

GFMER-WHO-ASRM on line course and virtual consultation for building research and evidence-gathering capacity at country level

Coordinators: Aldo Campana (GFMER), Bruce Dunphy (University of Newcastle and IHBI, Australia), Karim Abawi (Pakistan, GFMER) and Sheryl van der Poel (WHO) Unrestricted Educational Support through the Graduate Foundation for Medical Education and Research: Julian Jenkins (Switzerland)

Fertility awareness and health care provider tools/research

Chair: (Jacky Boivin Canada/UK) Pilot studies for country level adaptation.Co-Chairs and Members: for specific and prioritized tools and specific country needs.