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Guidelines & Resources > Recommendations - Choosing Wisely

Choosing Wisely Canada Recommendations

Fertility and Andrology: Nine Tests and Treatments to Question

The Canadian Fertility and Andrology Society (CFAS) Choosing Wisely National Working Group used a modified Delphi consensus approach, consisting of 5 rounds, to generate item ideas, review supporting evidence, assess clinical relevance, estimate recommendation impact and narrow the items for the original list. The Working Group was comprised of 11 diverse clinicians with experience in the field. Round 4 of the Delphi process consisted of a National CFAS Membership Survey to rank the remaining 13 items. The top 5 items were selected based on 4 qualities: prevalence, cost, potential for harm and impact on clinical practice (round 5). The CFAS Board of Directors provided feedback which was incorporated into the composition of the final list approved by the Board. The first 5 recommendations were released in January 2020. Additional recommendations were added to the list in March 2024. The CFAS Choosing Wisely Canada Working Group Lead and the Clinical Practice Guideline Committee created the new recommendations and annual revision of the list which was approved by the CFAS Board of Directors. 

The Choosing Wisely Recommendations For Fertility and Andrology by CFAS

  1. Don't routinely perform preimplantation genetic testing for aneuploidy screening on patients undergoing IVF.

  2. Don’t prescribe gonadotropins in doses of >450 units daily for controlled ovarian stimulation in IVF. 

  3. Don’t routinely perform assisted hatching on fresh embryos prior to transfer. 

  4. Don’t prescribe lymphocyte immunization therapy.

  5. Don’t routinely perform sperm DNA fragmentation testing.

  6. Don’t routinely perform hysteroscopy prior to IVF in women with a normal transvaginal ultrasound.

  7. Don’t perform endometrial receptivity testing.

  8. Don’t do repetitive hormone tests and ultrasounds in the work up of infertility.

  9. Don’t conduct in-person visits if a virtual visit is feasible, clinically appropriate and preferred by the patient.

    Source: Choosing Wisely Canada

 

Full Details: Recommendations & References

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CFAS stands with Choosing Wisely Canada in promoting climate-conscious healthcare.

(Recommendations 8 and 9)

We support their clinician-developed recommendations (Climate-Conscious Recommendations) that help reduce environmental harm without compromising patient care. By rethinking everyday practices, we can make a meaningful impact on planetary health—together.

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