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.
Objectives: 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.
Methods: This guideline will be 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 will be followed. A protocol was formulated and a Guideline Development Group was formed in Oct 2016 with specialists of reproductive medicine, methodologists from Chinese GRADE working group and aged infertile women. During Nov and Dec 2016, questions regarding the ART strategies for aged infertility were formulated and the 12 most important ones were chosen to be structured in PICO format (Population, Intervention, Comparison, Outcomes). Comprehensive search and review of the literature will be performed since Feb 2017. The quality of the evidence will be assessed and rated based on certain criteria and be categorised as high, moderate, low or very low, and decision-making tables will be generated and reviewed.
Recommendations will be then 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 strength of recommendations will be rated as either strong or conditional. The final recommendations will be agreed on by consensus during a face-to-face meeting in Jul 2017 and then sent to external auditors.
Results: The guideline is scheduled to be published in Sep 2017.
Conclusion: This will be the first practice guideline in reproductive medicine developed following a standard scientific method.