Guideline No. 446: Hysteroscopic Surgery in Fertility Therapy.

Objective: To evaluate the indications, benefits, and risks of hysteroscopy in the management of patients with infertility and provide guidance to gynaecologists who manage common conditions in these patients.

Target Population: Patients with infertility (inability to conceive after 12 months of unprotected intercourse) undergoing investigation and treatment.

Benefits, Harms, And Costs: Hysteroscopic surgery can be used to diagnose the etiology of infertility and improve fertility treatment outcomes.

Guideline No. 444: Hirsutism: Evaluation and Treatment.

Objective: This guideline reviews the etiology, diagnosis, evaluation, and treatment of hirsutism.

Target Population: Women with hirsutism.

Options: Three approaches to management include: 1) mechanical hair removal; 2) suppression of androgen production; and 3) androgen receptor blockade.

Assisted human reproduction and pregnancy outcomes in Alberta, 2009-2018: a population-based study.

Background: Assisted human reproduction (AHR) can be used to help individuals and couples overcome infertility issues. We sought to describe trends in pregnancies using AHR and to evaluate the impact of AHR on perinatal outcomes in a large population-based cohort in Alberta, Canada.

Methods: We linked maternal and child administrative data for all live births occurring July 1, 2009, to Dec.

Directive clinique n 435 : Chirurgie minimalement invasive dans les traitements de fertilité.

Objectif: Évaluer les risques et bénéfices de la chirurgie minimalement invasive dans la prise en charge des patientes atteintes d'infertilité et fournir des conseils aux gynécologues qui prennent en charge les problèmes les plus fréquents chez ces patientes.

Population Cible: Patientes atteintes d'infertilité (incapacité à concevoir après 12 mois de rapports sexuels non protégés) en processus diagnostique ou sous traitement. BéNéFICES, RISQUES ET COûTS: On peut recourir à la chirurgie de la reproduction minimalement invasive pour traiter l'infertilité, améliorer les résultats des traitements de fertilité ou préserver la fertilité.

Guideline No. 435: Minimally Invasive Surgery in Fertility Therapy.

Objective: To evaluate the benefits and risks of minimally invasive procedures in the management of patients with infertility and provide guidance to gynaecologists who manage common conditions in these patients.

Target Population: Patients with infertility (inability to conceive after 12 months of unprotected intercourse) undergoing investigation and treatment.

Benefits, Harms, And Costs: Minimally invasive reproductive surgery can be used to treat infertility, improve fertility treatment outcomes, or preserve fertility.

Predicting acute ovarian failure in female survivors of childhood cancer: a cohort study in the Childhood Cancer Survivor Study (CCSS) and the St Jude Lifetime Cohort (SJLIFE).

Background: Cancer treatment can cause gonadal impairment. Acute ovarian failure is defined as the permanent loss of ovarian function within 5 years of cancer diagnosis. We aimed to develop and validate risk prediction tools to provide accurate clinical guidance for paediatric patients with cancer.

Evolution of the Fetal Atrioventricular Interval from 6 to 40 Weeks of Gestation.

Doppler-based methods of estimating the atrioventricular interval are commonly used as a surrogate for the electrical PR in fetuses at risk of conduction abnormalities; however, to date, normal values for the fetal atrioventricular interval and an understanding of the evolution of its components in the late first trimester are lacking. We sought to investigate changes in the fetal atrioventricular interval from the first trimester to 40 weeks gestational age, and to explore functional and electrophysiological events that potentially impact its evolution. We prospectively examined healthy pregnancies by fetal echocardiography from 6 to 40 weeks' gestational age.

No. 350-Hirsutism: Evaluation and Treatment.

Objectives: To review the etiology, evaluation, and treatment of hirsutism.

Evaluation: A thorough history and physical examination plus selected laboratory evaluations will confirm the diagnosis and direct treatment.

Treatment: Pharmacologic interventions can suppress ovarian or adrenal androgen production and block androgen receptors in the hair follicle.

First-Trimester Fetal Echocardiography: Identification of Cardiac Structures for Screening from 6 to 13 Weeks' Gestational Age.

Background: Early fetal echocardiography (FE), performed at 12 to 16 weeks' gestational age (GA), can be used to screen for fetal heart disease akin to that routinely performed in the second trimester. The efficacy of FE at earlier GAs has not been as well explored, particularly with recent advances in ultrasound technology. The aim of this study was to evaluate the efficacy of early FE in assessing fetal heart structure, and the added benefit of color Doppler (CD), from as early as 6 weeks through to 13 weeks' GA.

Mature Oocyte Cryopreservation for Fertility Preservation.

In recent decades, advances in cancer treatment have led to a dramatic improvement in long term survival. This has led to an increasing focus on quality of life after surviving cancer treatment, with fertility being an important aspect. Given the known reproductive risks of cancer therapies, there has been a growing interest in the field of fertility preservation (also referred to as oncofertility).

DEFINING ELIGIBILITY CRITERIA FOR FUNDING POLICIES AROUND IN VITRO FERTILIZATION.

Objectives: This review aims to assess the state of the science around the potential impact of certain patient characteristics on the safety and effectiveness of in vitro fertilization (IVF).

Methods: Following Cochrane Collaboration guidelines and the PRISMA statement, a comprehensive systematic review of reviews and recent primary studies examining the impact of paternal age and maternal age, smoking, and body mass index (BMI) on the safety and effectiveness of IVF was performed. Papers, published between January 2007 and June 2014, were independently reviewed and critically appraised by two researchers using published quality assessment tools for reviews and primary studies.

Assisted Reproductive Technologies in Alberta: An Economic Analysis to Inform Policy Decision-Making.

Objective: Regulation and public funding of assisted reproductive technologies (ARTs) vary across the Canadian provinces. In Alberta, neither of these exists. We conducted this study to evaluate the cost effectiveness and budget impact of providing ARTs in Alberta under three different policy scenarios (a "restrictive" policy, a policy based on Quebec's model, and a "permissive" policy) in comparison with the status quo.

Assisted reproductive technologies (ARTs): evaluation of evidence to support public policy development.

Over the years, IVF/ICSI protocols have continued to evolve with efforts to improve outcomes. As a result, treatment success may be related to certain procedural factors, including number of embryos transferred and stage at which they are transferred. This review aims to assess the safety and effectiveness of IVF/ICSI in comparison to spontaneous conception and less invasive ARTs and the impact of procedure-related factors on the outcomes of IVF/ICSI in order to support the development of local clinical and policy guidance.

Antegrade late diastolic arterial blood flow in the fetus: insight into fetal atrial function.

Objective: The purpose of this study was to examine the presence and frequency of antegrade late diastolic arterial blood flow (ALDAF) in the fetus and to determine its contribution to cardiac output.

Study Design: We evaluated the presence of ALDAF in 457 fetal and 21 postnatal echocardiograms. The timing of ALDAF to the ventricular systolic Doppler recording (ALDAF-V) was compared with the mechanical atrioventricular interval and, in neonates, the electrical PR interval.

Gonadotropin-releasing hormone agonist in laparoscopic myomectomy: systematic review and meta-analysis of randomized controlled trials.

A systematic review and meta-analysis of randomized controlled trials was performed to estimate the effects on surgical outcomes of pretreatment with gonadotropin-releasing hormone (GnRH) agonist before laparoscopic myomectomy. The electronic bibliographic databases MEDLINE, EMBASE, Web of Knowledge, Scopus, and Cochrane Library, and reference lists from relevant articles were searched for English-language publications describing randomized controlled trials of GnRH agonist pretreatment vs placebo or no treatment before laparoscopic myomectomy. Three studies including 168 participants were identified.