Overbehandeling bij onverklaarde subfertiliteit

Translated title of the contribution: Overtreatment in couples with unexplained infertility

Fleur A.M. Kersten, Rosella P.G.M. Hermens, Didi D.M. Braat, Annemieke Hoek, Ben Willem J. Mol, Mariëtte Goddijn, Willianne Nelen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To assess adherence to expectant management of 6-12 months in couples with unexplained subfertility, as recommended by the Dutch Networkguideline Subfertility. Design: A retrospective cohort study in 25 clinics. Method: Couples were eligible to participate if they were diagnosed with unexplained subfertility and had a good prognosis of natural conception within one year (>30%), for these couples the networkguideline recommends an expectant management. Outcomes measures are overtreatment, i.e. couples that started treatment within six months, and three quality indicators: 1) prognosis not calculated, 2) no correct expectant management advised, 3) starting treatment too soon despite a correct advise. Data collection was obtained from medical records. Multilevel regression analyses were performed to investigate associations of overtreatment with patient and clinic characteristics. Results: We included 544 couples. Overtreatment occurred in 36% (N=198). In 34% (N=186) of all couples no prognosis was calculated (1), and in 42% (N=230) of all couples expectant management was not advised correctly (2). When a correct expectant management of six to twelve months was advised, 16% (N=51) started treatment too soon anyway. Overtreatment occurred more frequently in childless couples, a higher female age, and a longer duration of infertility. Conclusion: Our findings show that developing and publishing guideline recommendations on expectant management is not enough and that overtreatment still occurs frequently. To improve future care the next step is to evaluate a tailored implementation strategy to improve adherence to the recommendations on expectant management by the Dutch Networkguideline Subfertility.

Translated title of the contributionOvertreatment in couples with unexplained infertility
Original languageDutch
Article numberA8689
JournalNederlands tijdschrift voor geneeskunde
Issue number19
Publication statusPublished - 2015


Dive into the research topics of 'Overtreatment in couples with unexplained infertility'. Together they form a unique fingerprint.

Cite this