Assessment and treatment for people with fertility problems: NICE guideline

The National Institute of Health and Care Excellence (NICE) has published an updated clinical guideline on assessment and treatment for people with fertility problems.1 The guideline covers the pathway from advice and information for people concerned about fertility to assisted reproduction techniques. The guideline includes recommendations on medical and surgical management of male factor fertility problems, classification and treatment of ovulatory disorders, management of endometriosis, tubal and ovarian surgery, donor insemination, oocyte donation, and procedures during in vitro fertilisation (IVF). This summary will concentrate on initial advice and assessment and criteria for IVF treatment. ### Initial advice The guideline includes useful tables and figures which provide information about cumulative pregnancy rates (Table 1), and the effect of maternal age on IVF success rates (Table 2). Over 80% of couples will conceive within 1 year if the woman is <40 years, they do not use contraception and have regular sexual intercourse. Of those who do not conceive in the first year, about half will do so in the second year. Sexual intercourse every 2 to 3 days optimises the chance of pregnancy. A woman with regular menstrual cycles is likely to be ovulating. View this table: Table 1. Cumulative probability of conceiving a clinical pregnancy by the number of menstrual cycles View this table: Table 2. Cumulative probability of conceiving a clinical pregnancy by the number of cycles of insemination There is no change …