Fertility woes: top 10 priorities for future research

People affected by fertility problems have called for better-targeted research for a condition that brings heartbreak to over 48 million couples worldwide.

Their calls emerged from a large international consultation which identified the top ten priorities for future research across four key areas: male infertility, female and unexplained infertility, in vitro fertilisation (IVF) and other treatments including IVF add-ons, and the organisation of care.

About one in seven couples seek advice at some time in their lives about difficulties in getting pregnant. Unfortunately, for up to a quarter of people, no reason can be found for their fertility problems. Success rates for different infertility treatments range from 13 to 43 percent, depending on the person’s age and the treatment.

“There’s been an escalation in research into infertility, yet many fundamental questions about the treatment of infertility remain unanswered,” says co-chair Dr James Duffy from the Nuffield Department of Primary Care Health Sciences at the University of Oxford.

“The frustration is that we’re drowning in research which is utterly lacking in impact.”

The project, a collaboration between the Cochrane Gynaecology and Fertility Group, the University of Auckland, and the University of Oxford, was launched to identify the most pressing research questions as perceived by people with fertility problems, patient organisations, and professionals. More than 700 people from 52 countries participated, including more than 330 people with fertility problems and their partners.

For a woman aged 35 years old, one cycle of treatment with IVF using all the available embryos (fresh and frozen) is only likely to be successful about one third of the time

Professor Cindy Farquhar University of Auckland

People with fertility problems, patient organisations, and professionals suggested more than 423 different research questions, which were further prioritised in a second international survey, and finally refined to the top ten at an international consultation meeting. The results will be launched today (25 June 12:00pm GMT) at a large international meeting of fertility experts, the European Society of Human Reproduction and Embryology.

Professor Cindy Farquhar, from the Faculty of Medical and Health Sciences at the University of Auckland, Aotearoa New Zealand, is the project’s other co-chair.

“It comes as a shock to many couples seeking to have a baby that the treatments such as IVF are not universally successful. For a woman aged 35 years old, one cycle of treatment with IVF using all the available embryos (fresh and frozen) is only likely to be successful about one third of the time,” she says.

“We expect that this list will help both funders and researchers set their future priorities. The ultimate goal is infertility research with the reach and relevance to help as many people as possible in ways that are safe, timely, compassionate and effective.”

Among the top ten fertility questions:

  • Do environmental factors cause male infertility? 
  • Does treating specific causes of male infertility improve outcomes?
  • Can age-related infertility be prevented? 
  • What causes unexplained infertility?
  • What is the emotional and psychological impact of repeated fertility treatment failure?
  • How can the cost of infertility treatment be reduced?

The full list can be downloaded from the project website.

The project was funded by the Catalyst Fund, Royal Society Te Apārangi; Auckland Medical Research Fund; and Maurice and Phyllis Paykel Trust.

The full report, ‘Priority Setting Partnership for Infertility: What should infertility research focus on next?’, can also be downloaded from the website

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