{ "article": { "format_version": 5, "presentation": "complete-card", "overview": "TTC means trying to conceive. A fertility evaluation asks about ovulation, sperm, the uterus and fallopian tubes, then connects the findings to care options. When trying with one's own eggs and no known concern, usually ask for evaluation after 12 months under 35 or six months at 35 and older; known concerns or age over 40 can justify asking sooner. Tests help answer particular questions, and treatment can help in selected circumstances, but neither a hormone number nor IVF guarantees a baby.", "sections": [ { "id": "understanding-fertility", "role": "explanation", "title": "Understand what fertility evaluation can answer", "intro": "TTC means trying to conceive. The useful first question is whether it is time to seek an assessment, then what the assessment needs to explain.", "items": [ { "label": "Follow the reproductive steps to understand the tests", "text": "A pregnancy requires more than one normal hormone number. An ovary releases an egg; sperm must fertilize it; the developing embryo must reach the uterus and implant in its lining. CDC explains that difficulty at one or several of these steps can contribute to infertility. That is why a workup considers ovulation, sperm, the uterus and fallopian tubes together. It is a search for information that changes care, rather than a competition to identify whose body is responsible. A prior pregnancy also does not prove that every step is working now.", "source_ids": [ "cdc-infertility", "who-infertility" ] }, { "label": "Use the definition to ask for care that fits your circumstances", "text": "Infertility describes difficulty achieving a successful pregnancy; it does not mean pregnancy is certainly impossible. WHO distinguishes primary infertility, when no pregnancy has been achieved, from secondary infertility after a previous pregnancy. ASRM's 2023 definition also includes people who need medical intervention to achieve pregnancy, including individual and donor-assisted pathways. This matters because someone should not have to fit a two-person trying timeline to receive a relevant assessment. The history and intended conception pathway establish which questions need answering; relationship status alone should not delay care.", "source_ids": [ "who-infertility", "asrm-definition" ] }, { "label": "Bring previous pregnancy losses into the medical conversation", "text": "Getting pregnant and carrying a pregnancy to delivery are related but different clinical questions. CDC notes that reproductive endocrinologists may also help with recurrent pregnancy loss, described there as two or more spontaneous miscarriages. Repeated losses deserve a clinician's assessment rather than automatically restarting the usual waiting clock for difficulty conceiving. Bring the dates, gestational stages and available records. A clinician can explain whether a fertility evaluation, a pregnancy-loss evaluation or both are appropriate; this article cannot diagnose the cause from a history of loss.", "source_ids": [ "cdc-infertility" ] } ] }, { "id": "when-to-seek-evaluation", "role": "application", "title": "Know when to start the conversation", "items": [ { "label": "Ask for evaluation after the usual age-and-duration threshold", "text": "For someone trying without a known fertility concern, ASRM uses 12 months when the person attempting pregnancy with their own eggs is under 35 and six months at 35 or older. These thresholds guide when to begin an assessment. They do not say that pregnancy before the deadline is guaranteed or that pregnancy after it is impossible. Age informs planning because reproductive potential changes with time, but a birthday is not an individual diagnosis. Write down the duration honestly, including pauses or uncertainty, so the clinician can apply the guidance to the actual history.\n\nConsider two invented referral notes. One says only 'We have been trying for a while.' The other gives the person's age, an approximate start date, any pauses and a known concern they want to discuss. The second supplies information a clinician can use to decide how the general timing guidance applies. It does not require the person to know which test or treatment will follow.\n\nIf there is uncertainty about the timeline, mark it rather than invent precision. If a known concern is present, include it instead of waiting solely to complete a calendar interval. The resulting appointment may clarify what to assess, which existing records are useful and who coordinates the next step. It cannot promise an explanation from one test or a pregnancy from evaluation. This example makes the threshold a route into assessment, rather than a verdict about an individual outcome.", "source_ids": [ "asrm-definition", "cdc-infertility" ] }, { "label": "Discuss known concerns before waiting for an anniversary", "text": "ASRM's evaluation opinion supports assessment without delay when a history suggests impaired fertility. Missing or irregular periods, suspected tubal or uterine disease, endometriosis, a known sperm problem and previous treatments that can damage reproductive function are examples. Over 40, a more immediate evaluation may be warranted. A referral request can name the concern directly: 'My periods have stopped' or 'I had chemotherapy and want to understand fertility.' The clinician decides the appropriate tests; the useful action is bringing the concern forward, rather than waiting simply because twelve months have not passed.", "source_ids": [ "asrm-evaluation" ] }, { "label": "Coordinate assessment of every relevant reproductive contributor", "text": "When a male partner provides sperm, evaluation should run alongside the assessment of the person who may carry the pregnancy. AUA/ASRM guidance makes reproductive history and semen analysis early parts of that workup. This can prevent months of testing one person before recognizing a contributor in the other, and more than one factor can coexist. For donor-assisted or individual care, ask what evaluation fits that pathway. 'Both partners' describes one common arrangement; it is not a universal entry requirement or a reason to deny assessment.", "source_ids": [ "male-evaluation", "asrm-definition" ] }, { "label": "Use the first visit to obtain a plan rather than a shopping list", "text": "A consultation does not obligate someone to IVF. ASRM's patient overview describes starting with histories and previous records, then deciding which tests or referrals are useful. A reproductive endocrinologist is an obstetrician-gynecologist with additional fertility training; a reproductive urologist evaluates male infertility. Some first steps can begin with an existing clinician. Ask who will coordinate the results, what each test would change and when the findings will be explained together. A clear first appointment should reduce uncertainty about the process even when it cannot settle the outcome.", "source_ids": [ "asrm-overview", "lobo-evaluation" ] } ] }, { "id": "what-first-tests-mean", "role": "findings", "title": "Understand the named first tests", "items": [ { "label": "Use cycle history to ask whether ovulation is occurring", "text": "Ovulation means releasing an egg from an ovary. Regular periods often supply useful evidence, while long gaps or absent periods can point toward an ovulation problem that needs an explanation. ASRM says that regular 21–35-day cycles usually do not require extra confirmation, with exceptions such as signs of excess androgen activity. If confirmation is needed, a progesterone blood test can show recent ovulation when timed about a week before the expected next period. A fixed 'day 21' test does not fit every cycle. One measurement also cannot grade the entire quality of the cycle.", "source_ids": [ "asrm-evaluation" ] }, { "label": "Read semen analysis as several measurements with context", "text": "Semen analysis measures features of a collected sample, including sperm concentration, movement and shape. AUA/ASRM explains that a value above or below a reference limit cannot, by itself, classify someone as fertile or infertile. Samples also vary, so an abnormal first result commonly needs repeat testing and a reproductive-urology review. Ask what was measured, whether collection conditions affected interpretation and what a repeat would clarify. The combined pattern and medical history matter more than treating one flagged number as a verdict; a normal sample does not answer every fertility question either.", "source_ids": [ "male-evaluation", "lobo-evaluation" ] }, { "label": "Ask which structural question an imaging test answers", "text": "HSG means hysterosalpingography: dye is introduced through the cervix and X-ray imaging follows it through the uterus and fallopian tubes. It can help assess the uterine cavity and whether the tubes appear open. NICHD also describes ultrasound and saline-based imaging for looking inside the uterus. These tests answer different questions, so one result need not replace every other assessment. Ask what the clinician is looking for and what an abnormal finding would lead to. 'The tubes appear open' does not prove every reproductive process is normal.", "source_ids": [ "nichd-diagnosis" ] }, { "label": "Use AMH and follicle counts to plan ovarian stimulation", "text": "Ovarian reserve refers mainly to the remaining egg supply; egg quantity and egg quality are different ideas. AMH, or anti-Müllerian hormone, is a hormone associated with small growing follicles. Antral follicle count is an ultrasound count of visible small follicles. ASRM finds these measures useful for anticipating response to medicines that stimulate the ovaries and expected egg yield. They cannot independently predict unassisted conception or guarantee a live birth. A very low AMH alone should not be used to deny IVF. Ask what decision the result changes, alongside age, diagnosis and any previous treatment response. ASRM discourages general reserve screening when fertility is untested.", "source_ids": [ "asrm-reserve" ] }, { "label": "Let a specific finding guide further testing or surgery", "text": "A larger test panel is not automatically a more useful evaluation. ESHRE's unexplained-infertility guideline identifies many additional tests with limited evidence and discourages routine testing that does not establish a useful cause. Surgery also needs a defined target and an expected benefit. ASRM does not recommend routine laparoscopy for infertility without a suspected pelvic problem or another indication. If a procedure is proposed, ask what it addresses, what less invasive alternatives exist and how recovery or delay affects the wider plan. Finding a difference in anatomy is the start of interpretation, not a treatment instruction.", "source_ids": [ "eshre-ui", "asrm-evaluation", "nichd-diagnosis" ] } ] }, { "id": "how-treatment-options-differ", "role": "findings", "title": "Connect treatment options to the findings", "items": [ { "label": "Match an ovulation medicine to a diagnosed ovulation problem", "text": "PCOS, or polycystic ovary syndrome, is a clinically assessed hormonal and metabolic condition that can disrupt ovulation. Anovulation means eggs are not being released; irregular cycles can have other causes too. Teede and colleagues' 2023 international guideline recommends letrozole as first-line medicine for infertility caused by anovulation in PCOS when other infertility factors are absent. That qualification matters: sperm or tubal findings may change care. Letrozole remains off-label for this use in many countries and requires clinician assessment, including excluding an existing pregnancy. The recommendation explains a pathway; it is not a prescription for every person with PCOS.", "source_ids": [ "pcos-guideline" ] }, { "label": "Read a treatment trial's actual population and outcome", "text": "Legro and colleagues randomly assigned 750 women with PCOS to letrozole or clomiphene for up to five cycles. Cumulative live birth occurred in 103 of 374 women receiving letrozole, about 28%, compared with 72 of 376, about 19%, receiving clomiphene. The difference was roughly eight additional live births per 100 participants in this selected trial population. It was not a chance per monthly cycle and did not establish a guarantee for an individual. NIH's explanation makes the practical point clear: knowing the cause of infertility can identify a treatment with better evidence for that cause.", "source_ids": [ "legro-trial", "nih-pcos" ] }, { "label": "Understand what IUI changes and what it still relies on", "text": "Intrauterine insemination, or IUI, places prepared sperm directly into the uterus. Fertilization still has to occur inside the body, so its usefulness depends on the relevant ovulation, sperm and tubal circumstances. HFEA explains that it is a different procedure from IVF, with different suitability and burdens; it should not be sold simply as a cheaper version of the same treatment. It may be combined with ovarian stimulation in selected circumstances. Ask why IUI fits the findings, what monitoring is needed and what would lead the team to reconsider it.", "source_ids": [ "hfea-iui", "male-treatment" ] }, { "label": "Follow the stages of IVF before interpreting its promise", "text": "In vitro fertilization, or IVF, involves collecting eggs and fertilizing them in a laboratory; a resulting embryo may then be transferred to the uterus. HFEA explains the separate stages because treatment can stop before transfer, and transfer does not ensure implantation, pregnancy or live birth. Medicines, scans, egg collection and possible later frozen transfers also create distinct burdens and costs. Ask which stages the estimate covers and what could alter or cancel the plan. IVF can bypass some problems and offer another route to pregnancy, but the name of the procedure does not settle the outcome. Discuss safety as well as success: transferring more embryos can increase multiple-pregnancy risk, and single-embryo-transfer research led by Van Voorhis helps explain why a safer outcome matters.", "source_ids": [ "hfea-ivf", "panel-van-voorhis" ] } ] }, { "id": "reading-treatment-outcomes", "role": "explanation", "title": "Make success rates understandable", "items": [ { "label": "Choose the outcome and denominator before comparing percentages", "text": "A live-birth rate is different from a positive pregnancy-test rate. Its denominator is the group of attempts or people being counted: started cycles, retrievals and transfers answer different questions. CDC's technical notes distinguish these measures and distinguish own-egg from donor-egg results. A per-transfer rate leaves out attempts that never reached transfer. Cumulative reporting can combine outcomes from linked transfers after a retrieval within a defined reporting window. Before comparing clinics, ask for the outcome, denominator, age group, egg source and timeframe. A larger percentage may describe a narrower group rather than better overall prospects.", "source_ids": [ "cdc-art-notes" ] }, { "label": "Use comparable group data to ask a better personal question", "text": "Imagine a hypothetical report with 100 started cycles, 80 transfers and 32 live births. The same results would be 32% per started cycle and 40% per transfer. This illustration is arithmetic, not a national or clinic statistic. CDC provides official clinic data and an IVF estimator, but a group estimate still needs a clinician's explanation of how the patient and proposed treatment resemble that group. A successful online story can offer support; it cannot replace comparable data. Ask why the estimate applies and which important uncertainties it leaves out.", "source_ids": [ "cdc-art-notes", "cdc-art-rates" ] } ] }, { "id": "where-care-choices-differ", "role": "perspectives", "title": "Understand where reasonable care choices differ", "items": [ { "label": "Ask what unexplained infertility means after the workup", "text": "Unexplained infertility is a diagnosis of exclusion: the standard evaluation has not identified a cause. ESHRE emphasizes that this category depends on completing the appropriate basic assessment. It does not prove every biological process is normal, and it does not mean the difficulty is imagined or that care has ended. It also does not make every extra test useful. Ask which questions have been answered and what remains unknown. That distinction lets the discussion move toward options and their evidence without turning uncertainty into an unlimited search for a hidden diagnosis.", "source_ids": [ "eshre-ui" ] }, { "label": "Agree on a treatment sequence and a point for reassessment", "text": "For unexplained infertility, ESHRE's 2023 guideline recommends stimulated IUI as a first-line treatment and uses prognosis to decide when to begin. NICE's 2026 England-focused guidance instead describes trying for a total of two years before treatment in its specified pathway. That is distinct from the earlier evaluation: tests and consultation can begin before active treatment. The differences concern prognosis, treatment timing and care systems, not whether the difficulty is real. Ask which current local guidance applies, how age and previous results affect waiting, and what would prompt reassessment rather than treating either timeline as universal.", "source_ids": [ "eshre-ui", "nice-ui" ] }, { "label": "Compare guideline approaches with their dates and populations", "text": "Treatment recommendations can differ over stimulation medicines as well as when to use IVF. NICE's 2026 pathway includes considering up to four gonadotropin-stimulated IUI cycles or offering IVF after discussion; ESHRE stresses low-dose regimens and monitoring to reduce multiple pregnancy and ovarian hyperstimulation syndrome, an excessive ovarian response. Historical ASRM guidance favored oral-agent IUI and discouraged gonadotropin-IUI, but its page lists a March 2024 expiration. These differences need a current clinician's interpretation. Ask why this regimen fits, what safeguards are used and when it will be reviewed; this article does not select medicines or doses.", "source_ids": [ "nice-ui", "eshre-ui", "asrm-ui-historical" ] }, { "label": "Ask whether an optional extra improves the outcome that matters", "text": "Treatment add-ons are extra tests or procedures offered alongside standard care. HFEA rates evidence by outcome and sometimes by patient group; lack of adequate evidence is different from trials showing no benefit. An improvement in a laboratory measure or a per-transfer statistic may not mean more live births across treatment. Ask which comparable patients were studied, the absolute benefit, possible harms and extra cost. A justified use for one condition does not make an add-on necessary for everyone. Forum disagreements about embryo testing prompted this question; the regulator's evidence, not the discussion's popularity, supports it.", "source_ids": [ "hfea-addons" ] }, { "label": "Ask which patients benefit from embryo chromosome screening", "text": "PGT-A tests a sample of embryo cells for an abnormal chromosome count before a possible transfer. The unresolved question is whether selection improves the total chance of a live birth for the particular patient, not simply whether a selected embryo has a favorable transfer outcome. ASRM's 2024 opinion says a routine benefit for all IVF patients has not been demonstrated and describes limitations in studies of selected groups. Ask about cumulative live birth, miscarriage, inconclusive results, costs and what happens to embryos with uncertain findings. Screening evidence should be discussed separately from testing for a known inherited disorder.", "source_ids": [ "asrm-pgta" ] }, { "label": "Balance health improvements with the cost of delaying care", "text": "Weight can affect ovulation, pregnancy health and the safety of fertility procedures, but improving a health measure does not automatically improve every fertility outcome. ASRM's obesity opinion reports that weight-loss interventions may improve ovulation in anovulatory women, while trials have not consistently shown better live birth after treatment in ovulatory women. The field must balance possible benefits, procedural safety and the reproductive cost of delay, especially with advancing age. Ask which outcome a proposed delay is intended to improve and what evidence supports it for this situation. This is a care discussion, not a blame assignment or a self-directed weight target.", "source_ids": [ "asrm-weight" ] } ] }, { "id": "keeping-care-manageable", "role": "application", "title": "Keep the workup useful and manageable", "items": [ { "label": "Keep one concise history and the existing reports", "text": "Bring trying duration, cycle patterns, previous pregnancies and losses, relevant surgery, infections, cancer treatment and current medicines or supplements. ASRM's patient overview explains that reviewing existing records can reduce waste from repeated evaluation. Record uncertain dates as uncertain. Keep the original reports beside the clinician's interpretation, rather than only a remembered label such as 'low hormones.' This gives the next clinician something concrete to review and makes it easier to explain why a repeat test is needed.", "source_ids": [ "asrm-overview", "nichd-diagnosis" ] }, { "label": "Keep the clinical question beside each result", "text": "A useful record has three parts: what was being investigated, what the test found and what happens next. For example, a structural image and a hormone test do not answer the same question. Lobo's public evaluation teaching connects the different tests before discussing a treatment plan. Use that approach when results arrive separately: ask how they fit together. Write down who will explain the combined findings and the follow-up date. This is a way to organize clinical conversations, not a method for diagnosing yourself from reference ranges.", "source_ids": [ "lobo-evaluation" ] }, { "label": "Discuss medicines and health support without assigning blame", "text": "WHO recommends practical support such as tobacco cessation, activity and a healthy diet alongside fertility care. These steps do not identify the cause of one unsuccessful cycle or guarantee conception. Medication review also matters for sperm: AUA/ASRM explains that external testosterone can suppress sperm production, even when used for another health goal. Bring prescribed medicines, hormones and supplements to the clinician rather than changing them on your own. Ask what support is appropriate now and which changes have evidence for the outcome being discussed.", "source_ids": [ "who-care", "male-treatment" ] }, { "label": "Include emotional support as part of care", "text": "Waiting, tests and uncertain outcomes can affect daily life, work and finances. WHO's guideline release calls for ongoing psychosocial support, and Cardiff researchers Boivin and Gameiro develop tools and guidance addressing fertility-related well-being and care needs. Counseling is support for someone living through a difficult process; needing it is not evidence that distress caused the infertility. Ask about counseling, peer support or social-work help and whether it is independent of treatment sales. Support can be useful whether care continues, changes or pauses.", "source_ids": [ "who-care", "boivin-profile", "gameiro-profile" ] }, { "label": "Keep total burden and the review point in the decision", "text": "A treatment decision includes appointments, monitoring, medicines, procedures, travel, work disruption and possible further attempts. WHO recognizes financial barriers, while Gameiro's research addresses how people experience treatment burden and decisions about continuation. Ask for a written estimate of what the proposed step includes and excludes, and verify local coverage directly. NICE's England-focused guidance is not US insurance entitlement; its 2026 NG257 replaced CG156, but detailed access rules need current local confirmation. A pause or second opinion can be discussed without treating it as a failure of commitment.", "source_ids": [ "who-care", "gameiro-profile", "hfea-ivf", "nice-ng257" ] } ] }, { "id": "checking-fertility-claims", "role": "perspectives", "title": "Check a fertility claim against the evidence", "intro": "These short judgments connect to the fuller explanations above. A verdict applies to the wording of the claim, not to a person's prognosis.", "items": [ { "label": "Use the usual clocks with their exceptions", "text": "Claim: 'Evaluation usually starts at 12 months under 35 or six months at 35 and older.' Verdict: established. ASRM provides these thresholds when no earlier concern is known. Known risks can justify earlier assessment; the clocks do not predict an individual outcome.", "source_ids": [ "asrm-definition", "asrm-evaluation" ] }, { "label": "Include sperm assessment when sperm is part of the plan", "text": "Claim: 'A workup can routinely skip semen analysis.' Verdict: not. AUA/ASRM includes semen assessment early when applicable. Individual and donor-assisted pathways are adapted to their circumstances.", "source_ids": [ "male-evaluation" ] }, { "label": "Use AMH for a defined planning question", "text": "Claim: 'An online AMH kit tells me whether I can conceive.' Verdict: not. AMH can inform expected ovarian response; it cannot independently answer natural-conception potential. Keep the report for clinical interpretation.", "source_ids": [ "asrm-reserve" ] }, { "label": "Ask about live birth with every IVF estimate", "text": "Claim: 'IVF guarantees a baby.' Verdict: not. IVF has stages that may not reach transfer, pregnancy or live birth. An estimate needs its outcome and denominator.", "source_ids": [ "hfea-ivf", "cdc-art-notes" ] }, { "label": "Connect PCOS care to the demonstrated ovulation problem", "text": "Claim: 'A clinician can evaluate PCOS as an ovulatory contributor.' Verdict: established. The international guideline identifies a clinical pathway, while keeping other infertility contributors in view.", "source_ids": [ "pcos-guideline" ] }, { "label": "Seek help using the history rather than folklore", "text": "Claim: 'People should wait many years before asking for evaluation.' Verdict: talk. Professional evaluation thresholds and earlier-risk exceptions provide a better starting point. A conversation does not settle the prognosis.", "source_ids": [ "asrm-definition" ] }, { "label": "Use an unexplained result to discuss the remaining options", "text": "Claim: 'Unexplained infertility means nothing can be done.' Verdict: not. It describes what the standard evaluation has not explained. ESHRE provides further care options while acknowledging substantial uncertainty.", "source_ids": [ "eshre-ui" ] } ] }, { "id": "clinical-boundaries", "role": "cautions", "title": "Use this understanding with qualified care", "items": [ { "label": "Bring persistent difficulty and known disease to a clinician", "text": "This is a reading companion, not a diagnosis, not a fertility-clinic visit, and not an intimacy or dating guide. Persistent inability to conceive, repeated miscarriage, or known reproductive disease belongs with a qualified clinician. This page does not promise a pregnancy. Named sources. Honest paraphrase of the finding. Not medical, legal, or financial advice. The sources explain populations and clinical pathways; a clinician still needs the individual's history, examination and results before selecting tests or treatment.", "source_ids": [ "cdc-infertility", "asrm-definition" ] } ] }, { "id": "your-next-step", "role": "next_steps", "title": "Leave the next conversation with a clear question", "items": [ { "label": "Arrange an assessment when the history calls for one", "text": "The next move is to contact an appropriate clinician when the usual age-and-duration threshold has been reached, or sooner for a known concern. Give your age, how long pregnancy has been attempted, the intended conception pathway and any concern that may justify earlier assessment. If sperm assessment is relevant, ask how it will be coordinated. The goal of this first contact is an evaluation plan with named questions and a follow-up point, rather than choosing a treatment from an online success story.", "source_ids": [ "asrm-definition", "male-evaluation" ] }, { "label": "Prepare a short history before the visit", "text": "Try-step one: gather existing reproductive records and make a brief timeline of attempts, cycles, previous pregnancies or losses, relevant operations or treatments and medicines. ASRM's overview explains why access to previous records can reduce unnecessary repetition. Add the question you most need answered, such as whether earlier assessment is appropriate or why a particular test is proposed. You do not need a perfectly documented calendar or a purchased hormone panel before asking for help.", "source_ids": [ "asrm-overview" ] }, { "label": "Ask for the result-to-decision link", "text": "Write down: 'What does this test answer, and what decision will change when we have the result?' For a treatment discussion, add 'What live-birth outcome, risks, total burden and review point apply to people with similar findings?' Lobo's evaluation explanation and WHO's care framework both connect assessment to a plan. Keep the answers with the reports so the next appointment builds on what has already been learned.", "source_ids": [ "lobo-evaluation", "who-care" ] } ] } ], "related": [ "sleep", "nutrition", "meaning" ] }, "sources": [ { "id": "asrm-definition", "title": "Definition of infertility: a committee opinion (2023)", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/definition-of-infertility/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Inclusive definition; usual 12/6-month evaluation clocks; circumstances requiring intervention; no delay solely by relationship status.", "limitations": "Definition and professional opinion, not insurance entitlement." }, { "id": "asrm-evaluation", "title": "Fertility evaluation of infertile women: a committee opinion (2021)", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Earlier evaluation indications; ovulation assessment; test selection; HSG limitations; targeted surgery.", "limitations": "US specialist guidance, not an individualized workup." }, { "id": "asrm-reserve", "title": "Testing and interpreting measures of ovarian reserve: a committee opinion (2020)", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/testing-and-interpreting-measures-of-ovarian-reserve-a-committee-opinion-2020/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "AMH/AFC predict stimulation response better than unassisted pregnancy; low values alone should not deny IVF.", "limitations": "Older committee opinion; egg quantity and egg quality are distinct. Relevant sections, rather than a new clinical assessment, support this explanation." }, { "id": "cdc-infertility", "title": "Infertility: Frequently Asked Questions", "url": "https://www.cdc.gov/reproductive-health/infertility-faq/", "kind": "official", "accessed_at": "2026-10-01", "supports": "Public-health definition, reproductive steps, age, recurrent pregnancy loss and major contributors.", "limitations": "Public definitions explicitly do not determine access to individual services." }, { "id": "who-infertility", "title": "Infertility", "url": "https://www.who.int/news-room/fact-sheets/detail/infertility", "kind": "official", "accessed_at": "2026-10-01", "supports": "Primary/secondary infertility; male/female contributors; social and access burdens.", "limitations": "Global overview; prevalence and risk factors do not identify a personal cause." }, { "id": "who-care", "title": "WHO issues first global guideline on infertility", "url": "https://www.who.int/news/item/28-11-2025-who-issues-first-global-guideline-on-infertility", "kind": "official", "accessed_at": "2026-10-01", "supports": "November 2025 guideline release: progressively selected care, lifestyle support, patient preferences and psychosocial support.", "limitations": "Guideline release, not a review of the full WHO guideline. No specific treatment algorithm is inferred." }, { "id": "male-evaluation", "title": "Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020)", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-auaasrm-guideline-part-i-2020/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Parallel assessment, variable semen measurements, repeat abnormal samples, specialist review.", "limitations": "Based on the 2020 text; the 2024 amendment was unavailable for review. No amended genetic thresholds are used." }, { "id": "male-treatment", "title": "Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-aua-asrm-guideline-part2/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "External testosterone can suppress sperm production; supplements have uncertain value; IUI definition.", "limitations": "Older guideline text; clinician-directed treatment; no doses or protocols reproduced." }, { "id": "pcos-guideline", "title": "Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome", "url": "https://integration.asrm.org/globalassets/_asrm/practice-guidance/practice-guidelines/pdf/recommendations_from_the_2023_int_evidence-based_guideline_on_pcos.pdf", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Teede and colleagues: letrozole first-line for anovulatory PCOS infertility without other factors; off-label status and pregnancy exclusion.", "limitations": "Official 26-page guideline summary, not the complete Monash guideline. The recommendation applies to the specified population." }, { "id": "legro-trial", "title": "Letrozole versus clomiphene for infertility in the polycystic ovary syndrome", "url": "https://pubmed.ncbi.nlm.nih.gov/25006718/", "kind": "study", "accessed_at": "2026-10-01", "supports": "Randomized 750-woman trial, up to five cycles; cumulative live birth 27.5% versus 19.1%.", "limitations": "Primary abstract; selected PCOS population, not all infertility or per-cycle probabilities." }, { "id": "nih-pcos", "title": "New treatment increases pregnancy rate for women with infertility disorder", "url": "https://www.nichd.nih.gov/newsroom/releases/070914-PCOS", "kind": "official", "accessed_at": "2026-10-01", "supports": "NIH explanation of the 2014 trial, eligible PCOS population and live-birth outcome.", "limitations": "Historical institutional explanation, not updated prescribing guidance." }, { "id": "eshre-ui", "title": "Unexplained Infertility guideline (2023)", "url": "https://www.eshre.eu/-/media/sitecore-files/Guidelines/UI/UI-guideline_-Final.pdf", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Diagnosis of exclusion; limited evidence for extras; stimulated IUI as first-line, individualized IVF, monitored low-dose gonadotropins.", "limitations": "Relevant recommendations from the full European guideline; much of its evidence is low quality." }, { "id": "asrm-ui-historical", "title": "Evidence-based treatments for couples with unexplained infertility: a guideline (2020)", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-treatments-for-couples-with-unexplained-infertility-a-guideline-2020/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Historical US comparison: oral-agent IUI before IVF; cautions about gonadotropin IUI and multiple pregnancy.", "limitations": "The source lists a March 2024 expiration. Used only for a labeled historical comparison, not a current U.S. treatment algorithm." }, { "id": "hfea-ivf", "title": "In vitro fertilisation (IVF)", "url": "https://www.hfea.gov.uk/treatments/explore-all-treatments/in-vitro-fertilisation-ivf/", "kind": "official", "accessed_at": "2026-10-01", "supports": "IVF stages, laboratory fertilization, transfer and treatment risks.", "limitations": "UK regulator education; UK funding rules not generalized." }, { "id": "hfea-iui", "title": "Intrauterine insemination (IUI)", "url": "https://www.hfea.gov.uk/treatments/explore-all-treatments/intrauterine-insemination-iui", "kind": "official", "accessed_at": "2026-10-01", "supports": "Prepared sperm placed in uterus; IUI and IVF differ in procedure and suitability.", "limitations": "The source retains legacy NICE wording; only its procedure explanation is used, not funding or referral rules." }, { "id": "cdc-art-notes", "title": "NASS Technical Notes", "url": "https://www.cdc.gov/art/php/nass/technical-notes.html", "kind": "official", "accessed_at": "2026-10-01", "supports": "Cycle-, retrieval- and transfer-based rates; own/donor eggs; cumulative versus noncumulative reporting.", "limitations": "Surveillance definitions; clinic groups and reporting lag limit individual prediction." }, { "id": "cdc-art-rates", "title": "ART Success Rates", "url": "https://www.cdc.gov/art/success-rates/index.html", "kind": "official", "accessed_at": "2026-10-01", "supports": "Official clinic-data access and IVF success estimator; estimates tied to patient characteristics.", "limitations": "Data-access landing page, not a review of individual clinics or current national numerical rates." }, { "id": "hfea-addons", "title": "Treatment add-ons with limited evidence", "url": "https://www.hfea.gov.uk/treatments/treatment-add-ons/?wp-linkindex=1", "kind": "official", "accessed_at": "2026-10-01", "supports": "Optional extras; outcome/population-specific ratings; insufficient evidence differs from evidence of no benefit; page reviewed September 28, 2026.", "limitations": "UK regulator ratings; individual indications and safety require discussion; no universal ban inferred." }, { "id": "nichd-diagnosis", "title": "How is infertility diagnosed?", "url": "https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/diagnosed", "kind": "official", "accessed_at": "2026-10-01", "supports": "History, ultrasound, HSG procedure and different structural tests.", "limitations": "General overview contains fixed-day progesterone language; ASRM individualized timing governs this article." }, { "id": "asrm-overview", "title": "Infertility: an Overview (booklet)", "url": "https://integration.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/infertility-an-overview-booklet/", "kind": "professional", "accessed_at": "2026-10-01", "supports": "Types of specialists, records, histories, reducing repeated tests.", "limitations": "Patient booklet includes older practices; no unsupported success promise or obsolete reserve-test advice carried over." }, { "id": "lobo-evaluation", "title": "Basic Infertility Evaluation", "url": "https://www.reproductivefacts.org/browse-resources/videos/basic-infertility-evaluation-vid/", "kind": "professional", "accessed_at": "2026-10-01", "supports": "Roger Lobo’s public teaching explains the core evaluation and specialist referrals.", "limitations": "Based on the transcript, not video review. Its egg-quality shorthand is qualified here using ASRM’s more precise ovarian-reserve opinion." }, { "id": "gameiro-profile", "title": "Dr Sofia Gameiro", "url": "https://profiles.cardiff.ac.uk/staff/gameiros", "kind": "professional", "accessed_at": "2026-10-01", "supports": "Official role, patient-support tools, ESHRE psychosocial guideline contribution and research on treatment burden.", "limitations": "Role/research page, not proof that support improves live birth." }, { "id": "boivin-profile", "title": "Professor Jacky Boivin", "url": "https://profiles.cardiff.ac.uk/staff/boivin", "kind": "professional", "accessed_at": "2026-10-01", "supports": "Official psychology role; fertility quality-of-life and coping-support work; public media role.", "limitations": "Role and contribution verification, not a medical treatment recommendation." }, { "id": "question-addons", "title": "Thoughts on the New Research on IVF Add-Ons??", "url": "https://www.reddit.com/r/IVF/comments/16zqzq6/thoughts_on_the_new_research_on_ivf_addons/", "kind": "question_signal", "accessed_at": "2026-10-01", "supports": "Discussion illustrates confusion over PGT-A, per-transfer versus cumulative live birth and regulator ratings.", "limitations": "Community questions only; no anecdotes, statistics or recommendations used as factual authority." }, { "id": "nice-ng257", "title": "Fertility problems: assessment and treatment (NG257)", "url": "https://www.nice.org.uk/guidance/ng257", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Published March 31, 2026, replacing CG156. The overview and initial-assessment chapter describe one-year assessment and earlier referral at 36 or known risk. Chapter 1.38 describes two years of trying before treatment, followed by discussion of stimulated IUI or IVF.", "limitations": "Only the cited chapters were reviewed. England-focused pathway, not U.S. insurance entitlement or an instruction to postpone evaluation." }, { "id": "nice-ui", "title": "Unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse", "url": "https://www.nice.org.uk/guidance/ng257/chapter/unexplained-fertility-problems-in-people-trying-to-conceive-through-unprotected-vaginal-sexual-intercourse", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Recommendations 1.38.1–1.38.3: total two-year trying period before treatment; no standalone stimulation; consider up to four gonadotropin-stimulated IUI cycles or offer IVF after discussion.", "limitations": "Based on the official chapter, not the full guideline or local commissioning criteria." }, { "id": "asrm-pgta", "title": "The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/the-use-of-preimplantation-genetic-testing-for-aneuploidy-a-committee-opinion-2024/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Routine PGT-A benefit for all IVF patients not demonstrated; trial populations and denominators matter; miscarriage benefit uncertain.", "limitations": "Subgroup benefit and values remain individual counseling questions; chromosome screening is not all genetic testing." }, { "id": "asrm-weight", "title": "Obesity and reproduction: a committee opinion (2021)", "url": "https://www.asrm.org/practice-guidance/practice-committee-documents/obesity-and-reproduction-a-committee-opinion-2021/", "kind": "guideline", "accessed_at": "2026-10-01", "supports": "Weight-related associations, procedural safety, effects of weight-loss interventions on ovulation versus IVF/live birth and costs of delay.", "limitations": "Older opinion; weight is one contributor and care thresholds require individual safety assessment." }, { "id": "panel-cedars", "title": "Marcelle Cedars | UCSF Profiles", "url": "https://profiles.ucsf.edu/marcelle.cedars", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; UCSF professor of Obstetrics, Gynecology and Reproductive Sciences. Ovarian-aging research helps distinguish age, egg supply and treatment response. Public UCSF profile links ovarian-aging research, clinical care and institutional news for patients seeking context.", "limitations": "An investigator profile establishes expertise; it does not supply a personal pregnancy forecast." }, { "id": "panel-legro", "title": "Richard Legro | College of Medicine | Penn State", "url": "https://med.psu.edu/departments-faculty/directory/richard-legro", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; Penn State professor and chair; reproductive endocrinology and infertility specialist. Lead author of the randomized letrozole–clomiphene PCOS trial used here. NIH publicly explains his PCOS trial and its live-birth outcome.", "limitations": "Selected anovulatory-PCOS trial results cannot be generalized to all TTC." }, { "id": "panel-dokras", "title": "Anuja Dokras, MD, MHCI, PhD | Penn DBEI", "url": "https://dbei.med.upenn.edu/staff/anuja-dokras-md-mhci-phd/", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD, MHCI, PhD; Penn professor and director of Penn PCOS Center. PCOS can require whole-health evaluation as well as an ovulation discussion. Official description of the multidisciplinary PCOS center shows reproductive, metabolic and psychological care in one pathway.", "limitations": "PCOS expertise does not establish that every irregular cycle or infertility problem is PCOS." }, { "id": "panel-schlegel", "title": "Dr. Schlegel Named Acting Chairman of Urology", "url": "https://news.weill.cornell.edu/news/2001/09/dr-schlegel-named-acting-chairman-of-urology", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; urologist and male-infertility researcher; Weill Cornell institutional biography and AUA/ASRM guideline contributor. Male evaluation, sperm retrieval and the interface with assisted reproduction. Institutional public explanation of male-factor treatment and professional guideline work make male assessment visible.", "limitations": "Biography is historical; no current leadership title or personal success probability claimed." }, { "id": "panel-pfeifer", "title": "Samantha M. Pfeifer, M.D. | Patient Care", "url": "https://weillcornell.org/spfeifer", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; board-certified reproductive endocrinologist; Weill Cornell professor of clinical reproductive medicine. Uterine-anomaly classification and reproductive surgery illustrate why structural findings need specific interpretation. Official bio documents provider/patient MAC2021 educational tool and frequent professional teaching.", "limitations": "Surgical expertise does not imply surgery improves every infertility outcome." }, { "id": "panel-gracia", "title": "Clarisa R. Gracia, MD, MSCE | Penn Medicine", "url": "https://www.pennmedicine.org/providers/clarisa-gracia", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD, MSCE; Penn reproductive endocrinologist, division chief and fertility-preservation director. Connects medical history, reproductive aging and an inclusive assessment pathway. Patient-facing profile explains fertility-preservation and reproductive-aging interests; named contributor to ASRM's 2023 definition.", "limitations": "Fertility-preservation decisions require individual medical risks and timing; no preservation guarantee." }, { "id": "panel-falcone", "title": "Tommaso Falcone, MD | Cleveland Clinic", "url": "https://providers.clevelandclinic.org/provider/tommaso-falcone/4270552", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; reproductive endocrinology-trained Cleveland Clinic physician and professor. Structural disease and minimally invasive reproductive surgery inform questions about indications and alternatives. Official provider biography, education and public provider-video link explain his reproductive and surgical scope.", "limitations": "Provider biography establishes the clinical field, not treatment outcomes." }, { "id": "panel-van-voorhis", "title": "2019 Award for Achievement: Bradley Van Voorhis, MD", "url": "https://alumni.medicine.uiowa.edu/news/2020/03/2019-award-achievement-bradley-van-voorhis-md", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; University of Iowa reproductive endocrinologist and IVF safety researcher. Single embryo transfer can reduce multiple-birth burden; outcome literacy includes safety as well as pregnancy. University's public feature explains his single-embryo-transfer work and why IVF safety matters.", "limitations": "2020 feature verifies contribution; its administrative title is not claimed current." }, { "id": "panel-fauser", "title": "Catalogus professorum | Fauser B.C.J.M.", "url": "https://profs.library.uu.nl/hoogleraar/fauser-b-c-j-m/", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD, PhD; Utrecht professor emeritus of reproductive medicine. Ovarian-response and AMH scholarship helps separate biological measures from broad fertility predictions. Public university record documents reproductive-medicine scholarship and retirement lecture; Glasgow lists his AMH collaboration with Nelson.", "limitations": "Retired Utrecht appointment; the profile does not establish a present clinic role or findings from every listed paper." }, { "id": "panel-nelson", "title": "Professor Scott Nelson | University of Glasgow", "url": "https://www.gla.ac.uk/schools/medicine/staff/scottnelson/", "kind": "professional", "accessed_at": "2026-10-01", "supports": "Professor; Muirhead Chair of Reproductive and Maternal Medicine, University of Glasgow. AMH biomarker research and quantitative prediction support careful measurement literacy. Public faculty page lists fertility research and AMH interpretation papers, giving a route to specialist evidence.", "limitations": "Publication listing verifies contribution; it does not mean every listed paper was read." }, { "id": "panel-teede", "title": "Helena Teede | Monash University", "url": "https://research.monash.edu/en/persons/helena-teede/", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MBBS, PhD, FRACP; Monash professor and Monash Health endocrinologist. 2023 PCOS guideline specifies the population for first-line letrozole and wider health assessment. Official biography verifies community involvement, patient resources and media education; led international PCOS guideline synthesis.", "limitations": "Guideline recommendations have eligibility limits; no individual prescription is offered." }, { "id": "panel-lobo", "title": "Rogerio Arnaldo Lobo, MD | Obstetrics & Gynecology", "url": "https://www.obgyn.columbia.edu/profile/rogerio-lobo-md", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; Columbia professor of Obstetrics and Gynecology and reproductive endocrinology fellowship director. Explains how ovulation, semen and uterine/tubal evaluation fit together and which specialists help. ASRM’s Basic Infertility Evaluation transcript offers patient-facing teaching.", "limitations": "Ovarian reserve concerns egg supply and response; this teaching should be read with ASRM’s distinction between egg quantity and quality." }, { "id": "panel-eisenberg", "title": "People | Eisenberg Lab | Stanford Medicine", "url": "https://med.stanford.edu/eisenberglab/People.html", "kind": "professional", "accessed_at": "2026-10-01", "supports": "MD; Stanford urologic surgeon-scientist and male reproductive medicine program leader. Male fertility and general-health research supports including reproductive urology in the workup. Public lab biography and institutional care-team pages explain specialist male-infertility care.", "limitations": "Experimental work listed by the lab is not an endorsed add-on or established treatment." } ], "professional_panel": [ { "name": "Marcelle Cedars", "credential": "MD; UCSF professor of Obstetrics, Gynecology and Reproductive Sciences", "official_url": "https://profiles.ucsf.edu/marcelle.cedars", "public_usefulness": "Public UCSF profile links ovarian-aging research, clinical care and institutional news for patients seeking context.", "contribution": "Ovarian-aging research helps distinguish age, egg supply and treatment response.", "boundary": "An investigator profile establishes expertise; it does not supply a personal pregnancy forecast.", "reviewed_at": "2026-10-01" }, { "name": "Richard Legro", "credential": "MD; Penn State professor and chair; reproductive endocrinology and infertility specialist", "official_url": "https://med.psu.edu/departments-faculty/directory/richard-legro", "public_usefulness": "NIH publicly explains his PCOS trial and its live-birth outcome.", "contribution": "Lead author of the randomized letrozole–clomiphene PCOS trial used here.", "boundary": "Selected anovulatory-PCOS trial results cannot be generalized to all TTC.", "reviewed_at": "2026-10-01" }, { "name": "Anuja Dokras", "credential": "MD, MHCI, PhD; Penn professor and director of Penn PCOS Center", "official_url": "https://dbei.med.upenn.edu/staff/anuja-dokras-md-mhci-phd/", "public_usefulness": "Official description of the multidisciplinary PCOS center shows reproductive, metabolic and psychological care in one pathway.", "contribution": "PCOS can require whole-health evaluation as well as an ovulation discussion.", "boundary": "PCOS expertise does not establish that every irregular cycle or infertility problem is PCOS.", "reviewed_at": "2026-10-01" }, { "name": "Peter Schlegel", "credential": "MD; urologist and male-infertility researcher; Weill Cornell institutional biography and AUA/ASRM guideline contributor", "official_url": "https://news.weill.cornell.edu/news/2001/09/dr-schlegel-named-acting-chairman-of-urology", "public_usefulness": "Institutional public explanation of male-factor treatment and professional guideline work make male assessment visible.", "contribution": "Male evaluation, sperm retrieval and the interface with assisted reproduction.", "boundary": "Biography is historical; no current leadership title or personal success probability claimed.", "reviewed_at": "2026-10-01" }, { "name": "Samantha Pfeifer", "credential": "MD; board-certified reproductive endocrinologist; Weill Cornell professor of clinical reproductive medicine", "official_url": "https://weillcornell.org/spfeifer", "public_usefulness": "Official bio documents provider/patient MAC2021 educational tool and frequent professional teaching.", "contribution": "Uterine-anomaly classification and reproductive surgery illustrate why structural findings need specific interpretation.", "boundary": "Surgical expertise does not imply surgery improves every infertility outcome.", "reviewed_at": "2026-10-01" }, { "name": "Clarisa Gracia", "credential": "MD, MSCE; Penn reproductive endocrinologist, division chief and fertility-preservation director", "official_url": "https://www.pennmedicine.org/providers/clarisa-gracia", "public_usefulness": "Patient-facing profile explains fertility-preservation and reproductive-aging interests; named contributor to ASRM's 2023 definition.", "contribution": "Connects medical history, reproductive aging and an inclusive assessment pathway.", "boundary": "Fertility-preservation decisions require individual medical risks and timing; no preservation guarantee.", "reviewed_at": "2026-10-01" }, { "name": "Tommaso Falcone", "credential": "MD; reproductive endocrinology-trained Cleveland Clinic physician and professor", "official_url": "https://providers.clevelandclinic.org/provider/tommaso-falcone/4270552", "public_usefulness": "Official provider biography, education and public provider-video link explain his reproductive and surgical scope.", "contribution": "Structural disease and minimally invasive reproductive surgery inform questions about indications and alternatives.", "boundary": "Provider biography establishes the clinical field, not treatment outcomes.", "reviewed_at": "2026-10-01" }, { "name": "Bradley Van Voorhis", "credential": "MD; University of Iowa reproductive endocrinologist and IVF safety researcher", "official_url": "https://alumni.medicine.uiowa.edu/news/2020/03/2019-award-achievement-bradley-van-voorhis-md", "public_usefulness": "University's public feature explains his single-embryo-transfer work and why IVF safety matters.", "contribution": "Single embryo transfer can reduce multiple-birth burden; outcome literacy includes safety as well as pregnancy.", "boundary": "2020 feature verifies contribution; its administrative title is not claimed current.", "reviewed_at": "2026-10-01" }, { "name": "Bart Fauser", "credential": "MD, PhD; Utrecht professor emeritus of reproductive medicine", "official_url": "https://profs.library.uu.nl/hoogleraar/fauser-b-c-j-m/", "public_usefulness": "Public university record documents reproductive-medicine scholarship and retirement lecture; Glasgow lists his AMH collaboration with Nelson.", "contribution": "Ovarian-response and AMH scholarship helps separate biological measures from broad fertility predictions.", "boundary": "Retired Utrecht appointment; the profile does not establish a present clinic role or findings from every listed paper.", "reviewed_at": "2026-10-01" }, { "name": "Scott Nelson", "credential": "Professor; Muirhead Chair of Reproductive and Maternal Medicine, University of Glasgow", "official_url": "https://www.gla.ac.uk/schools/medicine/staff/scottnelson/", "public_usefulness": "Public faculty page lists fertility research and AMH interpretation papers, giving a route to specialist evidence.", "contribution": "AMH biomarker research and quantitative prediction support careful measurement literacy.", "boundary": "Publication listing verifies contribution; it does not mean every listed paper was read.", "reviewed_at": "2026-10-01" }, { "name": "Helena Teede", "credential": "MBBS, PhD, FRACP; Monash professor and Monash Health endocrinologist", "official_url": "https://research.monash.edu/en/persons/helena-teede/", "public_usefulness": "Official biography verifies community involvement, patient resources and media education; led international PCOS guideline synthesis.", "contribution": "2023 PCOS guideline specifies the population for first-line letrozole and wider health assessment.", "boundary": "Guideline recommendations have eligibility limits; no individual prescription is offered.", "reviewed_at": "2026-10-01" }, { "name": "Rogerio (Roger) Lobo", "credential": "MD; Columbia professor of Obstetrics and Gynecology and reproductive endocrinology fellowship director", "official_url": "https://www.obgyn.columbia.edu/profile/rogerio-lobo-md", "public_usefulness": "ASRM's opened Basic Infertility Evaluation transcript is a direct public teaching resource.", "contribution": "Explains how ovulation, semen and uterine/tubal evaluation fit together and which specialists help.", "boundary": "Ovarian reserve concerns egg supply and response; this teaching should be read with ASRM’s distinction between egg quantity and quality.", "reviewed_at": "2026-10-01" }, { "name": "Jacky Boivin", "credential": "PhD; Cardiff professor and Chair in the School of Psychology", "official_url": "https://profiles.cardiff.ac.uk/staff/boivin", "public_usefulness": "Official profile identifies media commentary and tools supporting people trying to conceive, including fertility quality-of-life work.", "contribution": "Psychosocial research keeps emotional burden and accessible support inside fertility care.", "boundary": "Support is valuable for well-being; it is not a proven fertility cure.", "reviewed_at": "2026-10-01" }, { "name": "Sofia Gameiro", "credential": "PhD in health psychology; Cardiff Reader in the School of Psychology", "official_url": "https://profiles.cardiff.ac.uk/staff/gameiros", "public_usefulness": "Official profile links patient-support tools and ESHRE psychosocial-care guidance she co-developed.", "contribution": "Research on treatment burden, care preferences and continuation/discontinuation informs review-point discussions.", "boundary": "Psychological research does not determine the biological cause or prescribe a treatment sequence.", "reviewed_at": "2026-10-01" }, { "name": "Michael Eisenberg", "credential": "MD; Stanford urologic surgeon-scientist and male reproductive medicine program leader", "official_url": "https://med.stanford.edu/eisenberglab/People.html", "public_usefulness": "Public lab biography and institutional care-team pages explain specialist male-infertility care.", "contribution": "Male fertility and general-health research supports including reproductive urology in the workup.", "boundary": "Experimental work listed by the lab is not an endorsed add-on or established treatment.", "reviewed_at": "2026-10-01" } ] }