Deep Dive into Reproduction with LIFE by Dr. Pat
Send us Fan Mail [https://www.buzzsprout.com/2434547/fan_mail/new] WHO 2025 INFERTILITY GUIDELINE — KEY TAKEAWAYS Infertility = no pregnancy after 12 months of regular unprotected intercourse. It affects 1 in 6 people worldwide, regardless of country income level. 🔹 Why this matters * Infertility is a health and human rights issue. * People deserve accurate information, access to diagnosis/treatment, and support without stigma. * WHO emphasizes cost-effective, evidence-based care that avoids unnecessary testing. 🔵 1. PREVENTION * Educate the public early about fertility, age-related decline, and when to seek help. * Lifestyle actions: quit smoking, reduce alcohol, maintain healthy weight, exercise. * Prevent and promptly treat STIs, a major global cause of tubal disease. 🔵 2. DIAGNOSIS Female * If cycles are regular → confirm ovulation with mid-luteal progesterone, not routine ultrasound. * Assess hormones only if clinically indicated: FSH, LH, E2, PRL, TSH. * Check tubal patency with HSG or HyCoSy. * Evaluate the uterine cavity with SIS (preferred) or 3D ultrasound. Male * Semen analysis: * Abnormal → repeat after ≥11 weeks * Normal → no need to repeat Unexplained Infertility * Normal exam, normal ovulation + tubes, and normal semen → classify as unexplained. 🔵 3. TREATMENT Female * PCOS: * First-line: Letrozole * If unsuccessful → Gonadotropins → IVF * Tubal disease: * Age <35 + mild/moderate disease → Surgery first * Severe or age ≥35 → IVF preferred * Hydrosalpinx: * Salpingectomy or tubal occlusion before IVF improves outcomes Male * Varicocele: * Treat surgically or radiologically rather than observation * Microsurgical repair preferred when available Unexplained infertility 1. Begin with expectant management (3–6 months) 2. If unsuccessful → Stimulated IUI (S-IUI) with letrozole or clomiphene 3. If unsuccessful → IVF 4. Use IVF alone, not routine ICSI, unless true male factor exists 🔵 4. WHO EMPHASIZES * Listening to patients, addressing psychological stress, and offering support * Using systematic, not excessive, diagnostic testing * Choosing treatments based on effectiveness, feasibility, and cost * Documenting treatment outcomes for continuous quality improvement
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