A Chinese practice guideline of the assisted reproductive technology strategies for women with advanced age

Li Jiang; Yaolong Chen; Qi Wang; Xiaoqin Wang; Xufei Luo; Junqiao Chen; Hongjing Han; Yingpu Sun; Huan Shen; Chinese Society of Reproductive Medicine (CSRM)

doi:10.1111/jebm.12346

A Chinese practice guideline of the assisted reproductive technology strategies for women with advanced age

J Evid Based Med. 2019 May;12(2):167-184. doi: 10.1111/jebm.12346.

Authors

Li Jiang¹, Yaolong Chen^{2

3

4}, Qi Wang^{5

6}, Xiaoqin Wang^{2

3

4}, Xufei Luo^{2

3

4}, Junqiao Chen⁷, Hongjing Han¹, Yingpu Sun⁸, Huan Shen¹; Chinese Society of Reproductive Medicine (CSRM)

Affiliations

¹ Reproductive Medicine Center, Peking University People's Hospital, Beijing, China.
² Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
³ Chinese GRADE Center, Lanzhou, China.
⁴ WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.
⁵ Health Policy PhD Program, Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
⁶ McMaster Health Forum, McMaster University, Hamilton, Canada.
⁷ Faculty of Science, University of Lisbon, Lisbon, Portugal.
⁸ Reproductive Medicine Center, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China.

PMID: 31144467
DOI: 10.1111/jebm.12346

Abstract

More women postpone childbearing nowadays while female fertility begins to decline with advancing age. Furthermore, with the rolling out of the two-child policy, there is a huge demand for a second child for Chinese aged women. There are various assisted reproductive technology (ART) strategies applied for age-related infertility without solid evidence. On behalf of the Society of Reproductive Medicine, Chinese Medical Association, we would like to develop a Chinese guideline of ART strategies for age-related infertility. This guideline was produced following the recommendations for standard guidelines described in the 2012 WHO Handbook for guideline development. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was also followed. A protocol was formulated and a Guideline Development Group was formed with specialists of reproductive medicine, methodologists from Chinese GRADE working group, and patient representative. Questions regarding the ART strategies for aged infertility were formulated and 8 most important ones were chosen to be structured in PICO format (Population, Intervention, Comparison, Outcomes). Comprehensive search and review of the literature were performed and the quality of the evidence was assessed and rated based on certain criteria and be categorized as high, moderate, low, or very low. Twenty-five recommendations were formulated among members of the Guidelines Development Group (Delphi method) basing on the overall quality of the evidence, in addition to the balance between benefits and harms, values and preferences, and resource implications. The final recommendations were agreed on by consensus during face-to-face meetings. This is the first Chinese practice guideline in reproductive medicine developed following the standard and scientific method.

Keywords: advanced maternal age; assisted reproductive technology; evidence-based clinical practice guideline; infertility.

Publication types

Practice Guideline

MeSH terms

China
Female
Humans
Infertility, Female / therapy*
Maternal Age*
Reproductive Techniques, Assisted / standards*