Page 49 - Shared Guideline Development Experiences in Fertility Care

Methods
Setting
e Dutch Organization for Health Research and Development (ZonMw) funded our project, which took place within the Dutch program of Knowledge Quality and Curative Care. e program’s objective was to improve the development of multidisciplinary CPGs in terms of innovation, collaboration, and e ciency.
Fertility care
Infertility is commonly de ned as ‘any form of reduced fertility with prolonged 3 time of unwanted non-conception’, and it a ects approximately 80 million couples
worldwide [15,16]. Dutch fertility care takes place on three levels. Physicians
provide primary care that includes an initial fertility assessment. A physician
can refer couples to a gynaecologist in a general hospital (secondary care) or a university hospital (tertiary care). e gynaecologist completes the fertility assessment, determines the cause of infertility, and de nes a treatment plan. If a relevant male factor is found, the couple may be referred to an urologist. Clinical chemists and embryologists are also involved in assessments and preparation for the use of medically assisted reproductive techniques, one of which is in vitro fertilization (IVF). Because infertility has a high emotional and psychological impact that can interfere with work, psychologists and occupational physicians are regularly involved with the clinical course of the infertility problem.
e network
Our steering committee, which included ve guideline experts, one implementation expert, and one project coordinator, initiated and coordinated the patient-centred network approach to MuG development. A group of gynaecologists, physicians, urologists, clinical embryologists, clinical chemists, a medical psychologist, an occupational physician, and two patient representatives from Freya (the Dutch association for people with fertility problems) assembled to collaborate in developing the guidelines in February 2008. Four MoG groups, including participants mainly from single disciplines, and one MuG group convened to develop the guidelines.
An overlap of participants from the same discipline across the groups and the project coordinator facilitated guideline harmonization. e project coordinator
Patient-centred network approach
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