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The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities
BACKGROUND: Herein, we describe the consensus guideline methodology, summarize the evidence-based recommendations we provided to the World Health Organization (WHO) for their consideration in the development of global guidance and present a narrative review of the diagnosis of male infertility as re...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850791/ https://www.ncbi.nlm.nih.gov/pubmed/28981651 http://dx.doi.org/10.1093/humupd/dmx021 |
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author | Barratt, Christopher L R Björndahl, Lars De Jonge, Christopher J Lamb, Dolores J Osorio Martini, Francisco McLachlan, Robert Oates, Robert D van der Poel, Sheryl St John, Bianca Sigman, Mark Sokol, Rebecca Tournaye, Herman |
author_facet | Barratt, Christopher L R Björndahl, Lars De Jonge, Christopher J Lamb, Dolores J Osorio Martini, Francisco McLachlan, Robert Oates, Robert D van der Poel, Sheryl St John, Bianca Sigman, Mark Sokol, Rebecca Tournaye, Herman |
author_sort | Barratt, Christopher L R |
collection | PubMed |
description | BACKGROUND: Herein, we describe the consensus guideline methodology, summarize the evidence-based recommendations we provided to the World Health Organization (WHO) for their consideration in the development of global guidance and present a narrative review of the diagnosis of male infertility as related to the eight prioritized (problem or population (P), intervention (I), comparison (C) and outcome(s) (O) (PICO)) questions. Additionally, we discuss the challenges and research gaps identified during the synthesis of this evidence. OBJECTIVE AND RATIONALE: The aim of this paper is to present an evidence-based approach for the diagnosis of male infertility as related to the eight prioritized PICO questions. SEARCH METHODS: Collating the evidence to support providing recommendations involved a collaborative process as developed by WHO, namely: identification of priority questions and critical outcomes; retrieval of up-to-date evidence and existing guidelines; assessment and synthesis of the evidence; and the formulation of draft recommendations to be used for reaching consensus with a wide range of global stakeholders. For each draft recommendation the quality of the supporting evidence was then graded and assessed for consideration during a WHO consensus. OUTCOMES: Evidence was synthesized and recommendations were drafted to address the diagnosis of male infertility specifically encompassing the following: What is the prevalence of male infertility and what proportion of infertility is attributable to the male? Is it necessary for all infertile men to undergo a thorough evaluation? What is the clinical (ART/non ART) value of traditional semen parameters? What key male lifestyle factors impact on fertility (focusing on obesity, heat and tobacco smoking)? Do supplementary oral antioxidants or herbal therapies significantly influence fertility outcomes for infertile men? What are the evidence-based criteria for genetic screening of infertile men? How does a history of neoplasia and related treatments in the male impact on (his and his partner's) reproductive health and fertility options? And lastly, what is the impact of varicocele on male fertility and does correction of varicocele improve semen parameters and/or fertility? WIDER IMPLICATIONS: This evidence synthesis analysis has been conducted in a manner to be considered for global applicability for the diagnosis of male infertility. |
format | Online Article Text |
id | pubmed-5850791 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-58507912018-03-23 The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities Barratt, Christopher L R Björndahl, Lars De Jonge, Christopher J Lamb, Dolores J Osorio Martini, Francisco McLachlan, Robert Oates, Robert D van der Poel, Sheryl St John, Bianca Sigman, Mark Sokol, Rebecca Tournaye, Herman Hum Reprod Update Review BACKGROUND: Herein, we describe the consensus guideline methodology, summarize the evidence-based recommendations we provided to the World Health Organization (WHO) for their consideration in the development of global guidance and present a narrative review of the diagnosis of male infertility as related to the eight prioritized (problem or population (P), intervention (I), comparison (C) and outcome(s) (O) (PICO)) questions. Additionally, we discuss the challenges and research gaps identified during the synthesis of this evidence. OBJECTIVE AND RATIONALE: The aim of this paper is to present an evidence-based approach for the diagnosis of male infertility as related to the eight prioritized PICO questions. SEARCH METHODS: Collating the evidence to support providing recommendations involved a collaborative process as developed by WHO, namely: identification of priority questions and critical outcomes; retrieval of up-to-date evidence and existing guidelines; assessment and synthesis of the evidence; and the formulation of draft recommendations to be used for reaching consensus with a wide range of global stakeholders. For each draft recommendation the quality of the supporting evidence was then graded and assessed for consideration during a WHO consensus. OUTCOMES: Evidence was synthesized and recommendations were drafted to address the diagnosis of male infertility specifically encompassing the following: What is the prevalence of male infertility and what proportion of infertility is attributable to the male? Is it necessary for all infertile men to undergo a thorough evaluation? What is the clinical (ART/non ART) value of traditional semen parameters? What key male lifestyle factors impact on fertility (focusing on obesity, heat and tobacco smoking)? Do supplementary oral antioxidants or herbal therapies significantly influence fertility outcomes for infertile men? What are the evidence-based criteria for genetic screening of infertile men? How does a history of neoplasia and related treatments in the male impact on (his and his partner's) reproductive health and fertility options? And lastly, what is the impact of varicocele on male fertility and does correction of varicocele improve semen parameters and/or fertility? WIDER IMPLICATIONS: This evidence synthesis analysis has been conducted in a manner to be considered for global applicability for the diagnosis of male infertility. Oxford University Press 2017-11 2017-07-19 /pmc/articles/PMC5850791/ /pubmed/28981651 http://dx.doi.org/10.1093/humupd/dmx021 Text en © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited |
spellingShingle | Review Barratt, Christopher L R Björndahl, Lars De Jonge, Christopher J Lamb, Dolores J Osorio Martini, Francisco McLachlan, Robert Oates, Robert D van der Poel, Sheryl St John, Bianca Sigman, Mark Sokol, Rebecca Tournaye, Herman The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities |
title | The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities |
title_full | The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities |
title_fullStr | The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities |
title_full_unstemmed | The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities |
title_short | The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance—challenges and future research opportunities |
title_sort | diagnosis of male infertility: an analysis of the evidence to support the development of global who guidance—challenges and future research opportunities |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850791/ https://www.ncbi.nlm.nih.gov/pubmed/28981651 http://dx.doi.org/10.1093/humupd/dmx021 |
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