Page 59 - Shared Guideline Development Experiences in Fertility Care

Patient-centred network approach Table 4: Examples of recommendations integrated into the multidisciplinary guideline
Medical-technical recommendations
e physician should only physically examine the man if his semen analysis is irregular. LOE C
e gynaecologist should not test ovarian reserve capacity to predict probability of pregnancy (with or without treatment). LOE A
Organizational recommendations
e physician should order a semen analysis from an accredited laboratory (ISO15189) or from a referral hospital. LOE D
In accordance with the Dutch IVF planning decree, every licensed IVF centre and their corresponding transport and satellite centres must provide annual reports on treatment outcomes for uniform national IVF registration. LOE D
Patient-centred recommendations
Both partners of the couple should be involved in the assessment and management of infertility because it is a joint problem. LOE C
e gynaecologist should o er couples with fertility problems psychological support throughout all phases of fertility care. LOE D
Patient recommendations
Patients want their gynaecologist to inform them about the di erent phases of treatment and their expected time spans. LOE P
Patients want their physician to make a referral immediately a er they have been trying to conceive for 1 year. LOE P
Origin or guideline
General infertility for physicians
Unexplained infertility
MuG MuG
MuG MuG
MuG MuG
Chapter of the MuG
Family physician (physical examination)
Gynaecologist (assessments)
Organization of fertility care
Organization 3 of fertility care
(registration)
Physician, gynaecologist, and urologist (basic principles)
Gynaecologist (information provision)
Gynaecologist (information provision)
Physician (referral)
MuG = Multidisciplinary Guideline, IVF = in vitro fertilization, LOE = level of evidence
Time investments
e median number of two-hour regular group meetings was 10 (range: 5 to 11). e median participation rate was 88% (range: 77 to 94%). ree additional two- hour meetings were necessary for adjustment between guidelines. e steering committee needed 11 two-hour meetings for organizing the project. Seven participants (20%) were involved in the preparation phase, for which they needed 471 h in total. In the development phase, the participants spent time on meeting preparation, two-hour face-to-face meetings, and minutes of meetings; and extra time on reviewing literature, writing guidelines, and commenting on dra versions. e time all participants spent in the development phase totalled 4,497 hours, including the 281 hours the steering committee members spent organizing this phase (Table 5).
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