The Human Fertility and Embryology Authority (HFEA) in the UK, has recently published the priorities for infertility research. This clearly maps out how we can hope to solve infertility issues in the future.
‘If there’s a place you gotta go
I’m the one you need to know
I’m the Map!
I’m the Map, I’m the Map!’
Dora The Explorer has a valid point. If you want to get somewhere, it’s useful to have a map! Most people think that limited resources are restricting solutions to medical problems. However, it’s not always lack of funding that is the problem. Research can only proceed in small steps and is limited by current scientific knowledge.
It is imperative to focus efforts on areas where researchers are likely see the best results and the best return on investment. This applies as much to fertility research as it does to any other type of research into human disease.
As one expert researcher puts it, “We are drowning in research that is singularly lacking in impact. Our approach should ensure future research has the necessary reach and relevance to inform future clinical practice and improve patient outcomes.”
So what is on the HFEA map for us?
An HFEA spokesman said, “We hope to identify the most pressing research questions. Whether on male infertility, unexplained infertility or so-called add-on treatments. This will provide a much-needed focus to help researchers and funders to tackle the most pressing problems that we are seeing in infertility. There have been many advances in the development of fertility treatment since the birth of Louise Brown over 40 years ago. Yet, as identified by this project, the IVF sector, both in the UK and elsewhere, still lacks a culture of high-quality evidence-based research with the right reach and relevance to improve outcomes for patients.”
The questions, 40 in all, were compiled from over 700 experts in 53 countries in order to prioritise the top 10 research questions in four distinct areas:
– Male infertility
– Female and unexplained fertility
– Medically assisted reproduction
– Ethics, access and organisation of care
Let’s take a look at some of these areas
Does treating modifiable risk factors improve outcomes in male infertility?
It seems obvious, doesn’t it? Can a man modify his behaviour in such a way that he becomes more fertile? Probably! But that is ALL we can say. Current research does not tell us how much the man should modify his behaviours in order to expect an improvement. Nor does it tell us what combination of different behaviours he should modify. What difference does giving up smoking make as opposed to taking up exercise and decreasing/increasing intake of red meat and vegetables?
In short, the EVIDENCE BASE is lacking. And this is what the HFEA map hopes to address in coming years.
In women with otherwise unexplained infertility does hysteroscopic removal of an endometrial polyp increase live birth rates?
Despite all the thousands of research papers on endometriosis and pregnancy/fertility, we don’t have an evidence-based answer!
This 40-question map of research indicators will shape the future of infertility for the next three decades. The outcomes of this research will affect both the patients and providers of treatments.
You can take a look at the four areas, and the 40 questions here.