Background: 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 sufficient evidence. The Society of Reproductive Medicine, Chinese Medical Association is going to develop a Chinese practice guideline of ART strategies for age-related infertility.

Objectives: We would like to formulate the most high-profile clinical questions in reproductive medicine which will be answered in this guideline.

Methods: We performed two rounds of questionnaire-investigation. An open-ended questionnaire was firstly distributed to the members of the Guideline Development Group, including specialists in reproductive medicine, methodologists from Chinese GRADE working group and aged infertile women. Based on the results, we develop a scale questionnaire regarding the importance of the addressed clinical questions and administrated it to reproductive medicine physicians throughout China in Dec 2016. Quantitative scores were assigned to every question based on the proportion of each options and a ranking of the clinical questions were then made.

Results: In the first-round survey, eleven experts from Beijing, Shanghai and seven other provinces (male 18.18%, female 81.82%) came up with 78 clinical questions which they believed to be of the biggest concerns regarding ART strategies for age-related infertility. After deduplication and combination, we obtained 36 questions while 21 of them qualified for the second-round survey. At the end of Dec 2016, we received 336 copies of questionnaire from all over mainland China, covering all the 32 provinces (municipalities and autonomous regions). Two of the questionnaires were duplicated and 1 was blank (excluded), and 333 were included in the next-step analysis. 90.4% of the respondents are female, 82.3% with graduate degrees. Twelve most important clinical questions are included in this practice guideline and will be further refined and structured.