Page 50 - Shared Guideline Development Experiences in Fertility Care

Chapter 3
was a member of all ve groups and gave feedback to the steering committee. e implementation expert assured attention to the future implementation and anticipated any potential barriers to guideline implementation during all development phases. An independent researcher (MS) evaluated the project.
e network structure consisted of three organized layers comprising seven groups: the centrally located infertile patients and the steering committee, the MuG group, and four MoG groups. For our purposes, this network was to produce one patient-centred MuG on infertility and four related, mainly monodisciplinary owned guidelines. ese four included a guideline on general infertility for physicians, a guideline on unexplained infertility for gynaecologists, a guideline on male infertility for urologists and gynaecologists, and a guideline on semen analysis for clinical embryologists.
Guideline development
Managing con icts of interest (COIs)
Before starting the guideline development, all members of the groups had to declare any COIs and be o cially mandated by their societies. e steering committee discussed all COIs. Participants with signi cant COIs were excluded from discussions or voting on recommendations for which they had COIs.
De ning the scope and key questions
We explored the care aspects in the clinical pathways of infertile patients. We paid particular attention to improvements that the patients and professionals found necessary. Various methods were used to collect data about the most relevant aspects.
We conducted 12 exploratory interviews with couples facing the spectrum of issues in the main phases of the clinical pathways in fertility care. ese phases may include a physician’s initial fertility assessment, a gynaecologist’s fertility assessment, treatment with ovulation induction, intrauterine insemination, IVF, and/or intracytoplasmic sperm injection by a gynaecologist, a urologist’s care, and a ercare (whether pregnancy occurred or not). e couples were consecutively invited to participate by means of an information letter that they received when they saw a gynaecologic resident in a fertility clinic in Nijmegen or Amsterdam. We phoned potential participants—Dutch-speaking couples with fertility problems who reacted positively to the information letter. e selection of couples
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