Guidelines informing counseling on female age-related fertility decline: a systematic review
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Authors
Trawick, Emma
Pecoriello, Jillian
Quinn, Gwendolyn
Goldman, Kara N
Issue Date
2021-01
Type
Article
Language
en_US
Keywords
Counseling , Guidelines , Reproductive Aging , Systematic Review
Alternative Title
Abstract
Purpose: To identify, appraise, and assess clinical practice guidelines informing patient counseling on female age-related fertility decline.
Methods: Searched electronic database records from January 1, 2006, to September 10, 2018, and professional society websites. The search terms included iterations of "guideline," "counseling," "preconception," "age-related fertility decline," and "reproductive life planning." English-language professional organization guidelines addressing patient counseling on age-specific reproductive health topics were included. Assessed the methodological quality of included guidelines using the AGREE II instrument. Guidelines were categorized as high quality or low quality based on AGREE II scores. Extracted age-specific reproductive health recommendations of high-quality guidelines.
Results: The search identified 2918 records. Nineteen records addressed counseling on age-related fertility decline; only 6 focused only on reproductive aging, with the remaining 13 covering related topics. Eleven met criteria for high quality. All high-quality guidelines had high "rigor of development" scores on AGREE II. Ten high-quality guidelines stated an age at which female fertility declines, ranging from 30 to "late 30s." One recommended a specific age at which patients should be counseled. Five of eleven high-quality guidelines did not discuss the obstetric and perinatal risks of advanced maternal age.
Conclusions: Few high-quality guidelines address counseling on female age-related fertility decline, and existing guidance on reproductive aging counseling is inconsistent and incomplete. Greater rigor of development and incorporation of age-specific counseling recommendations into clinical practice guidelines could lead to improved patient anticipatory guidance and more informed reproductive choices.
Description
Citation
Trawick E, Pecoriello J, Quinn G, Goldman KN. Guidelines informing counseling on female age-related fertility decline: a systematic review. J Assist Reprod Genet. 2021 Jan;38(1):41-53. doi: 10.1007/s10815-020-01967-4. Epub 2020 Nov 14. PMID: 33188440; PMCID: PMC7822973.
Publisher
Journal of assisted reproduction and genetics