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Treating infertility with homeopathy. An update to the Liz Lalor Homoeopathy Fertility Program

Authors:
  • Aurum Project Australia
  • The Aurum Project

Abstract

This article is an update to the Liz Lalor Fertility Program developed in Australia in 1998. It was first created through the study and adaptation of Dr Leon Vannier's work and has evolved since then. A revised protocol is presented as well as the current and past success rate over the last twenty-two years. Results are shown through numbers of babies born and failures, and the outcomes are presented from 2003 to 2021 from treating over 500 patients, with a current success rate of 87%. The method used was literature review and Skype interview in which Liz Lalor discussed parts of the Fertility Program where advances have been made. Potency and posology have been adjusted. Pivotal strategies which still stem from ideas about the treatment of layers but have been improved. These are: to initiate treatment either Carcinosinum or Syphilinum will be prescribed. Folliculinum has been included as a fundamental remedy, additionally Natrum muriaticum will now be prescribed in almost all cases as a 'layer remedy', which relates to the patient's grief of constantly menstruating instead of the joy of conceiving. Changes to the exclusion criteria over the life of the program have contributed to the increased success rate. Two case studies are presented as examples.
12 #1 Volume 35 | June 2022 | The Australian Journal of Homoeopathic Medicine
Treating infertility
with homeopathy.
An update to the Liz Lalor
Homoeopathy Fertility Program
First author: Sarah Saunders
Co-author: Linlee Jordan
ABSTRACT
This article is an update to the Liz Lalor Fertility Program developed in Australia in 1998. It was first created through
the study and adaptation of Dr Leon Vannier’s work and has evolved since then. A revised protocol is presented as
well as the current and past success rate over the last twenty–two years. Results are shown through numbers of
babies born and failures, and the outcomes are presented from 2003 to 2021 from treating over 500 patients, with
a current success rate of 87%.
The method used was literature review and Skype interview in which Liz Lalor discussed parts of the Fertility
Program where advances have been made. Potency and posology have been adjusted. Pivotal strategies which
still stem from ideas about the treatment of layers but have been improved. These are: to initiate treatment either
Carcinosinum or Syphilinum will be prescribed. Folliculinum has been included as a fundamental remedy, additionally
Natrum muriaticum will now be prescribed in almost all cases as a ‘layer remedy’, which relates to the patient’s grief of
constantly menstruating instead of the joy of conceiving.
Changes to the exclusion criteria over the life of the program have contributed to the increased success rate. Two case
studies are presented as examples.
Introduction
Infertility refers to a couple’s inability to conceive after
12 months of unprotected sexual intercourse. Globally,
infertility affects 15% of couples of reproductive
ages. (1) In 2021, the Australian Longitudinal Study on
Women’s Health found that 6% of women aged 24–30
reported fertility issues. By the time women are 40–45
years old the percentage changed to 24%. (2, 3)
With these statistics in mind, an update on the
homoeopathic treatment of infertility by the Liz Lalor
Fertility Program is important to present because 20%
of patients presenting for homoeopathic treatment have
already unsuccessfully tried In Vitro Fertilisation (IVF),
and approximately twenty percent are treated with IVF
and homoeopathy at the same time. Also, homoeopathy
may be an important option and particularly useful for
those who are hesitant to try IVF.
Discussion from an interview with Lalor about updates
to the Program are outlined and the success rate of
the protocol in the last 22 years is presented from
2003 to 2021.
Background to the development of the
Liz Lalor Fertility Program
Liz Lalor is a homoeopath and integrative natural therapist
based in Melbourne. Although Lalor sees patients with a wide
variety of complaints and autoimmune disorders, she has
maintained a special interest in the treatment of infertility for
a large portion of her practice. Before studying homoeopathy,
she worked in somatic psychotherapy, counselling, massage,
and natural therapies, specifically vitamins and minerals, since
1980. The counselling is an essential skill to aid in supporting
the couples presenting for treatment, which becomes
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apparent in the interview when Lalor refers to the trauma that
couples experience during their infertility journey. The trauma
relates to the patient’s inability to conceive. There is constant
grief when their menses appear monthly, which can affect the
relationship between the couple, adding stress to an already
inconceivable level of distress.
After qualifying as a homoeopath, Lalor decided to work in
infertility. She had suffered from reproductive issues and used
homoeopathic treatment with positive results. This inspired
her to explore ways to use homoeopathy to help others with
similar reproductive dilemmas.
Causes of infertility - female
1. Polycystic Ovary Syndrome (PCOS) affected 8.7% of
women of reproductive age in 2010. (4)
2. Problems with fallopian tubes or uterus may have
arisen after previous pelvic inflammatory disease,
caesarean, pregnancy termination or chlamydia infection. (5)
3. Endometriosis is manifested by extra-uterine
endometrial tissue and cyclical pain and is seen in 25 to
50% of infertile women. (6)
4. Fibroids. Keyhole surgery is often suggested to remove
large fibroids which are causing obstructions within the
reproductive organs. (7)
5. Age of patient. The ability to become pregnant and
deliver a live birth reduces with age in all populations. (8)
Causes of infertility - male
Sperm has to be a certain shape to be able to penetrate an
egg. Sperm morphology may have occurred after damage
to testes, or causes can be unknown. Gerhard states
that homoeopathy can help with low sperm counts and
sometimes motility of sperm. (9)
The work of Dr Leon Vannier
Lalor’s early research led her to the work of Dr Leon Vannier
(1880–1963), and over time and after the treatment of many
patients, she has built on those foundations. Vannier’s work
was based on his practical experience over 38 years from
1912 to 1950. (10) He was able to study the health history of
generations of families at the time and see patterns emerge
because people were not as mobile as they are today ‘…
tending to live and die generation after generation in the
same neighbourhood. So, it was possible to see miasmatic
symptoms and signs evolve.’ (10 p.65)
Remedy descriptions according to Vannier:
1. Fundamental remedy (the simillimum) has a profound,
long-lasting effect. If it is given in high potency without
preparatory remedies, then an aggravation may occur. It
is given in 200C or 1M in single doses at intervals of 12 to
20 days. A practical interval would seem to be every two
weeks. 30C should be used once a day, in chronic cases.
2. Drainage remedies prevent aggravation. These
remedies are concerned with the function of the organ.
Drainage is the elimination of toxins. The remedy has to
be individualised, based on the materia medica which
corresponds most closely to the patient’s functional
symptoms. For example, Borax venata has the symptom:
menses comes too soon, profuse with griping nausea and
pain in stomach, extending to small of back. A drainage
remedy is given in 30C for 5 days before the fundamental
remedy or miasmatic remedy is introduced.
3. Lesional remedies are used in low potencies 6x to 6C in
chronic cases where there are anatomical changes within
the organ with the functional symptoms stemming from
structural disturbances. For example, Sepia officinalis
has the symptoms: menses too late and scanty, irregular,
early and profuse, leucorrhoea yellow, greenish with much
itching coming from venous stasis and prolapse.
4. Miasmatic (nosode) remedy chosen according to the
patient’s family health history. One dose of 200C on the
17th night of the month.
Vannier called the fundamental remedy (similimum) ‘regulation
treatment’, which is used to re-establish the equilibrium of an
individual. He advised that regulation and drainage are two
methods which must not be separated because together they
form the complete homoeopathic treatment of the individual. (10)
Points about the use and timing of remedies in the Lalor
program derived from the Vannier prescribing method:
1. all four remedies must be compatible - not able
to antidote each other (all four remedies are viewed
as one remedy)
2. systematic regulation of treatment to avoid
aggravations
3. the Drainage remedy is prescribed for the first
5 days - mornings
4. the Lesional remedy is prescribed for the first
5 days - nightly
5. the Fundamental remedy is introduced on
the 5th and 19th night
6. the Miasmatic remedy is introduced on
the 17th night.
Vannier’s work became entirely applicable and relevant to
Lalor when she realised early on that treating with a similimum
(fundamental remedy) which requires finding ‘the peculiar, queer,
rare or strange (PQRS)’ did not apply to the modern–day control
of menstrual cycle by the oral contraceptive pill (OCP).
Method
On March 4th, 2021, a list of proposed questions was sent
by email to Lalor prior to the Skype interview to be conducted
by Sarah Saunders. It was then decided that the question-
and-answer interview style which had been planned, would
be redundant given previous publications. So instead, the
interview was conducted in a homoeopathic consultation style
where open questioning is the major technique used. (11)
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Results of the interview and updates to the
Lalor Fertility Program
During the interview, Lalor estimated that it can take between
one to two years to fall pregnant after taking the OCP for
several years, but she sees that homoeopathy has helped
to reduce this length of time, which is particularly useful for
those who are hesitant to try IVF. Lalor explained that the
symptoms of a woman having been on OCP and unable to
fall pregnant are that they are not ovulating, they have a lack
of vaginal mucus, and no sexual urge, ‘… all these symptoms
described the suppressant drug profile …’, therefore,
constitutional prescribing was not appropriate. The Vannier
system of Drainage and Lesional treatment is appropriate
for the suppressive effects on ovulation by the OCP. In her
experience she sees that women are pregnant within two
cycles, even when they have not had a consistent menstrual
cycle or have not ovulated for several years.
To achieve this success, Lalor has made changes to the
Program. For example, over time she increased the frequency
of remedies, particularly in cases of patients who were not
ovulating, yielding success. The remedy Folliculinum 200C
follows on from initiating treatment first by prescribing either
Carcinosinum or Syphilinum. Folliculinum was included
because it covers disturbance of the whole function of the
patient in terms of emotional, mental and physical symptoms.
If the patient is not ovulating, their Follicle Stimulating
Hormone (FSH) is too high or progesterone is too low, then
Folliculinum 200C is prescribed once weekly.
Following this she will prescribe either Thuja occidentalis
200C or Medorrhinum 200C, once weekly, depending upon
the patient’s symptoms. The homoeopath must decide which
remedy to use based on individual Functional, Drainage and
Lesional symptoms.
The remedy Natrum muriaticum 200C is prescribed once
weekly as well. This remedy re-establishes periodicity of
the menses. Although not all of the women treated are
constitutionally Natrum muriaticum, Lalor has found that these
women are ‘in a layer’ of Natrum muriaticum and suffering
from the trauma of repeatedly being unable to conceive.
The trauma is compounded by underlying conditions such
as endometriosis and PCOS and, worse still, many women
in the community with PCOS remain undiagnosed. (12) Lalor
has found that PCOS and endometriosis are successfully
treated with her approach. PCOS is treated with miasmatic
remedies and endometriosis responds to Folliculinum, Thuja
occidentalis, Medorrhinum, Natrum muriaticum, Sepia
officinalis and Borax venata.
Lalor says, ‘Consistently, my experience has been that a
woman with fibroids, endometriosis or a history of Polycystic
Ovarian Disorder will consult me, and I will get her pregnant
within two cycles, even if she has not been having a menstrual
cycle or has not ovulated for several years. Until I formulated
this program it took up to one year to achieve ovulation in
women who had been on the OCP’.
Updated success rates
The statistics from Lalor’s Program with 416 babies born,
shows an inspiring success rate:
2003 – 21 couples and 16 babies born, 77% success rate (13)
2005 – 44 babies from 54 women, 81% success rate (14)
2011 – 252 babies born, 38 failures
2021 – 416 babies born, 56 failures, 87% success rate
The true value of this homoeopathic approach is apparent
when even the women who do not become pregnant show
improvements in other ways both emotionally and physically.
To quote Lalor, ‘Every woman I have worked with is far
healthier at the end of the Program, than at the start.’ To
evaluate this, a patient reported outcome measure would
be a useful addition to the Program for future research (15).
Exclusion criteria:
The exclusion criteria for entering the Program have
become tighter:
Lalor will tell women to research all of the issues
which can affect themselves or the foetus when over
the age of 43. Lalor does not treat women over the
age of 43 years anymore.
Patients are treated for no longer than four of their
menstrual cycles, but most will fall pregnant within
two months.
Male patients with sperm morphology, such as
a large or misshapen head or crooked or double
tail defect of the sperm cannot be helped with
homoeopathy. Sperm abnormalities are treated with
herbs and nutritional advice.
Depending upon the size and location of fibroids,
Lalor has found that these structural problems are
hard to treat and may result in being excluded from
treatment.
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Another update is in the area of testing (see the
addendum)
It is important to ask if the patient is testing when they are
ovulating, so that they are aware of their cycle. If not, Lalor
recommends Clear Blue LH test strips. Other tests are listed
in the addendum.
An example of the current Program and remedies used:
To initiate treatment, Syphilinum or Carcinosinum.
Syphilinum – when there is a history of autoimmune
disease, sexually transmitted disease, repeated miscarriage,
endometriosis or history of taking the OCP. For patients who
believe that they miscarry as they have ‘irreparable damage’.
Carcinosinum – when there is a history of glandular fever,
chronic fatigue, anorexia nervosa or absent menses. For
patients who believe that they will not fall pregnant and
that they are personally responsible, feel guilty delaying
conception.
Folliculinum 200C – one dose two days before ovulation. If
the patient is not ovulating, then one dose of Folliculinum is
given weekly.
Thuja occidentalis 200C or Medorrhinum 200C or both
– one dose weekly based on individual medical history. Thuja
is applicable for repeated abortion, vaginal dryness and
absent menses. Medorrhinum is applicable for symptoms of
inflammation and dark, clotted, heavy menses.
Natrum muriaticum 200C – one dose weekly. This remedy is
repeated more frequently depending upon the patient’s history.
Borax venata 30C – one dose every morning as a drainage
remedy, it increases the mucus quality because it increases
levels of oestradiol. Increase the potency to 200C in cases of
suppressed mucus from Day 5 to Day 14 mornings only.
Sepia officinalis 6C or 30C – one dose nightly. This is a
lesional and drainage remedy and helps with the suppression
of sexual energy from the OCP.
Pulsatilla pratensis 30C – one dose every morning or
weekly. This is used, if after starting the Program the patient
has miscarried. It is also used weekly to address emotional
distress.
Calcarea carbonica 30C – one dose every morning. This
is given due to miscarriage after starting the Program, and
relevant due to menses brought on from anxiety, or early
menses due to emotional trauma or physical exertion.
Diet, nutritional and herbal supplements being used
Anti-candida diet for every woman for six weeks
Folate 500 mcg per day
Fish oils
Coenzyme Q10 preferably Ubiqinol
• Lysine
Calcium, magnesium, zinc and iron
Selenium for those who have had repeated
miscarriages
In the full program, Lalor always prescribes herbal
supplements on an individual basis, depending upon their
symptoms. She may prescribe Homoeobotanical Formula F.
Supplements and herbs for men
Zinc and selenium
Coenzyme Q10; preferably Ubiquinol
• Lysine
Tribulus herb
Two illustrative successful cases
Case 1
Age of patient: 32
- Has used OCP for 13 years
- tried to conceive for 2 years
- progesterone range 2.1 (range 5.0 – 9.0)
- oestradiol 10 (range 30 - 400)
- candida
- anorexia in the past, wheat allergy and hypoglycaemia;
now good weight, but exercises excessively
- repeated urinary tract infections with extensive
antibiotic use
- insomnia
- menses too scanty, lasting one day and is quite often
just spotting: too early, 25-day cycle.
Advice: Candida diet. No exercise other than moderately
paced walking.
Remedies given:
- Natrum muriaticum 200C weekly
- Thuja occidentalis 200C weekly
- Borax venata 30C in the morning
- Sepia officinalis 6C nightly
- Folliculinum 200C monthly on day 10
- Added Carcinosinum 30C weekly. (This was added
due to anorexia, low progesterone, and as a drainage
remedy for the OCP). In retrospect, Lalor would have
given Carcinosinum 200C before starting the Program.
Supplements given: Zinc; Folate; Lysine; Tribulus;
Homoeobotanical Formula F.
Follow-up:
- progesterone reading 10 (range 5.0 – 9.0)
- mucus Day 20
- changed Folliculinum to day 18 i.e., 2 days before to
stimulate ovulation
- has not lost weight on anti-Candida diet – gained 1kg
- anxious about weight gain
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- very anxious about not exercising – no emotional outlet
- mucus at intercourse noticeably more lubricated
- no increase in sexual energy
- menses heavier and longer: 3 days, cycle 32 days.
Changed Sepia officinalis to 30C nightly as lesional remedy to
match functional disturbance, low sexual energy, reflection of
progesterone imbalance.
Follow-up:
- pregnant
- progesterone on day 21 the following cycle was 45
(range in first trimester of pregnancy 11.2 – 90)
- day 35 progesterone 105
She held the pregnancy
Case 2
Age of patient: 40
- OCP for 19 years
- not ovulating, recommended LH test strips
and blood test
- menses lasts one day moderate bleed, 2 days spotting
- no sexual energy
- not lubricated during sex.
Remedies given:
- Natrum muriaticum 200C weekly
- Sepia officinalis 6C one dose nightly
- Borax venata 30C one dose in the morning
- Folliculinum 200C one dose day 14
- Thuja occidentalis 200c weekly.
Follow-up:
- good flow for 3 days
- sexual energy good at ovulation and prior to menses
- lubrication noticeably profuse
- positive LH strip day 20, sex days 19/20
- progesterone not tested
- pregnant 1st cycle
- outcome cot death at 12 months
- pregnant again after two cycles of Lalor’s Program
- currently trying for number three.
Unsuccessful cases
Lalor has never successfully treated a woman who has no
viable egg production. Also, in 2011, after studying her
statistical success rate with women over 42 years of age she
decided it was no longer ethically responsible to treat women
in this age group. The success rate is 2% in women over 43
years of age.
Discussion
In 2018, a meta-analysis conducted by Girim and Waise
included 14,884 women who had discontinued contraception
to become pregnant. (3) The study included 11,636
women who had used the OCP and the study found that
contraceptive use, regardless of its duration and type, doesn’t
significantly delay fertility other than in women who used OCP
for a longer duration. This could be the effect of age, in which
fertility decreases as age advances. The authors discount
previous studies where impaired fertility was reported as
resulting from OCP and say those studies refer to the use of
the high-dose oral contraceptive pill in the past.
Despite the results of the meta–analysis, Lalor estimates that
50% of her patients have had problems falling pregnant after
taking the OCP, as well as those using the Mirena (hormonal
intrauterine device), or Implanon (contraceptive implant). Lalor
sees that the OCP has created problems in her patients using
her observations about suppression. She also assesses that
if treatment with Folliculinum resolves an ovulation problem,
then the OCP is likely to have caused it. Jansen and Assilem
share a similar perspective. (15,16). This consistency of
observations about using Folliculinum across different authors
in homoeopathy warrants further research.
Concluding notes
After interviewing Lalor an updated fertility program is
presented. The key aspects include the use of a number of
remedies in repetition to clear layers that seem to prevent
conception. Refined exclusion criteria make the program more
reliable for potential clients. Use of Folliculinum promotes
a return of ovulation after OCP use, which is at odds with
meta–analysis studies showing no correlation. It would be
of benefit to conduct further research into how ovulation is
re–established after OCP use and failed fertility treatments.
Analysis of patient’s data in 2021 shows the Lalor Program
success rate to be 87% with 416 babies born.
The statistical success stands in its own right and has been
validated by hundreds of homoeopaths all around the world
who are using this method.
Sarah Saunders has been inspired by the success of the
Program to set up a homoeopathy infertility clinic which will
host a research program. Homoeopaths who have been
treating infertility cases will be invited to share their findings.
For more information, please email sarah@saunders.com.au
To study the complete Lalor Homoeopathy Fertility Program
please email Liz Lalor on lalor@ozonline.com.au.
Lalor offers mentoring to homoeopaths in the use of the
entire Program which she has taught around the world.
She is the author of A Homoeopathic Guide to Partnership
and Compatibility and Homoeopathic Psychiatry, and A
Psychological Analysis of the Delusion Rubrics which later
became a repertorisation program for Radaropus (no longer in
production.)
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Declaration
Sarah Saunders and Linlee Jordan have no pecuniary or
personal interest to declare in writing this article.
Acknowledgments
Much gratitude to Liz Lalor for her research efforts over
the years of using homoeopathy for infertility and for her
generosity of time spent helping this article come together.
Thank you to The Aurum Project for providing collegial
support while thinking about conducting research in Australia.
References
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infertility in 195 countries and territories. 1990–2017: results from a global
burden of disease study, 2017. Aging. 2019. Dec;11:23
2. Loxton D, Byles J, Tooth L, Barnes I, Byrnes E, Cavenagh D et al. Report
prepared for the Australian Government Department of Health, May 2021.
3. Girum T, Wasie A. Return of fertility after discontinuation of contraception:
a systematic review and meta-analysis. Contraception and reproductive
medicine. 2018. Jul;3(9).
4. March W. The prevalence of polycystic ovary syndrome in a community sample
assessed under contrasting diagnostic criteria. Human reproduction. 2009.
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5. Rebar R. Tubal dysfunction and pelvic lesions. [Internet] MSD Manual. Merck
Sharp & Dohme Corp. [updated 2020 Sep; cited 2021 Jun 15]. Available
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infertility/tubal-dysfunction-and-pelvic-lesions.
6. Bulletti C, Coccia M, Battistonie S, Borini A. Endometriosis and infertility. J
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7. Guo X, Segars J. The impact and management of fibroids for fertility: An
evidence-based approach. Obstet Gynecol Clin North Am. 2012. Dec;39(4):
521-533.
8. Deatsman S, Vasilopoulos T, Rhoton-Vlasak A. Age and fertility: A study on patient
awareness. JBRA Assist Reprod. 2016. Aug;20(3):99 p.
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Homoeopathy. 2002. Apr;91(3):133 p.
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theories on the paratuberculous and paracancerous States. Swan Hill: Eder Pty
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11. Prousky JE. Repositioning individualized homoeopathy as a psychotherapeutic
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13. Lalor L. Fertility success using Homoeopathy: Clinical notes. Similia. 2003.
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14. Lalor L. Fertility success using Homoeopathy and the Vannier method.
Homoeopathic Links. 2005. Spring;18:9-12 p.
15. Churruca K. Patient-reported outcome measures (PROMs): A review of generic
and condition-specific measures and a discussion of trends and issues. Health
Expect. 2021. 24(4):1015-1024 p.
16. Jansen T. Human chemistry, integrated therapy from a homoeopathic
perspective. Den Hoorn: Ton Jansen; 2021. 107 p.
17. Assilem M. Matridonal remedies of the humanum family. Tunbridge Wells: Helios
Pharmacy; 2009. 34 p.
Sarah Saunders Practitioner Advanced
Diploma in Homoeopathy
Sarah originally qualified as a homoeopath in 1999 and
was drawn to homoeopathy because of her daughter’s
health problems. Fertility is something Sarah has
researched in depth and she has set up a fertility program
to help those that wish to have assistance in conceiving.
Linlee Jordan BHom DipNutr MHlthScEd RN
Linlee is a Recognised Provider of the Autism Support
Project. She has been recognised because of her
experience and training, through a process of peer review
and case presentation about developmental problems in
children.
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Article
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Background Patient‐reported outcome measures (PROMs) are questionnaires that collect health outcomes directly from the people who experience them. This review critically synthesizes information on generic and selected condition‐specific PROMs to describe trends and contemporary issues regarding their development, validation and application. Methods We reviewed academic and grey literature on validated PROMs by searching databases, prominent websites, Google Scholar and Google Search. The identification of condition‐specific PROMs was limited to common conditions and those with a high burden of disease (eg cancers, cardiovascular disorders). Trends and contemporary issues in the development, validation and application of PROMs were critically evaluated. Results The search yielded 315 generic and condition‐specific PROMs. The largest numbers of measures were identified for generic PROMs, musculoskeletal conditions and cancers. The earliest published PROMs were in mental health‐related conditions. The number of PROMs grew substantially between 1980s and 2000s but slowed more recently. The number of publications discussing PROMs continues to increase. Issues identified include the use of computer‐adaptive testing and increasing concerns about the appropriateness of using PROMs developed and validated for specific purposes (eg research) for other reasons (eg clinical decision making). Conclusions The term PROM is a relatively new designation for a range of measures that have existed since at least the 1960s. Although literature on PROMs continues to expand, challenges remain in selecting reliable and valid tools that are fit‐for‐purpose from the many existing instruments. Patient or public contribution Consumers were not directly involved in this review; however, its outcome will be used in programmes that engage and partner with consumers.
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Introduction Along with increasing availability and utilization of contraception, It is also important to confirm that the effects of contraception use on resumption of fertility after discontinuation However currently evidences on resumption of fertility after contraception use are inconclusive and practically fertility after termination of contraception remains a big concern for women who are using contraception. This fear poses a negative impact on utilization and continuation of contraception. Therefore, Estimating the rate of pregnancy resumption after contraceptive use from the available reports and identifying the associating factors are important for designing a strategy to overcome the problem. Methods The review was conducted through a systematic literature search of articles published between 1985 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of conception was estimated with a random-effects model. Heterogeneity was assessed by the I² and publication bias through funnel plot. Results Twenty two studies that enrolled a total of 14,884 women who discontinued contraception were retained for final analysis. The pooled rate of pregnancy was 83.1% (95% CI = 78.2-88%) within the first 12 months of contraceptive discontinuation. It was not significantly different for hormonal methods and IUD users. Similarly the type of progesterone in specific contraception option and duration of oral-contraceptive use do not significantly influence the return of fertility following cessation of contraception. However the effect of parity in the resumption of pregnancy following cessation of contraception was inconclusive. Conclusion and recommendation Contraceptive use regardless of its duration and type does not have a negative effect on the ability of women to conceive following termination of use and it doesn’t significantly delay fertility. Therefore, appropriate counseling is important to assure the women to use the methods as to their interest.
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Endometriosis is a debilitating condition characterized by high recurrence rates. The etiology and pathogenesis remain unclear. Typically, endometriosis causes pain and infertility, although 20-25% of patients are asymptomatic. The principal aims of therapy include relief of symptoms, resolution of existing endometriotic implants, and prevention of new foci of ectopic endometrial tissue. Current therapeutic approaches are far from being curative; they focus on managing the clinical symptoms of the disease rather than fighting the disease. Specific combinations of medical, surgical, and psychological treatments can ameliorate the quality of life of women with endometriosis. The benefits of these treatments have not been entirely demonstrated, particularly in terms of expectations that women hold for their own lives. Although theoretically advantageous, there is no evidence that a combination medical-surgical treatment significantly enhances fertility, and it may unnecessarily delay further fertility therapy. Randomized controlled trials are required to demonstrate the efficacy of different treatments.
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Fibroids affect 35% to 77% of reproductive-age women. When selecting a treatment plan for symptomatic fibroids, the fibroid location, size, and number must be considered. Myomectomy remains the preferred method for women with fibroid-related infertility who wish to have children or maintain fertility. Currently available medical therapies reduce symptoms in the short term but may involve side effects when used long term. Initial fertility studies are encouraging but trials are needed. Recent medical advances have led to minimally invasive approaches for women with fibroid disease, but there is a strong demand for additional treatment options.
Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories. 1990-2017: results from a global burden of disease study
Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories. 1990-2017: results from a global burden of disease study, 2017. Aging. 2019. Dec;11:23
Report prepared for the Australian Government Department of Health
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Loxton D, Byles J, Tooth L, Barnes I, Byrnes E, Cavenagh D et al. Report prepared for the Australian Government Department of Health, May 2021.
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Rebar R. Tubal dysfunction and pelvic lesions. [Internet] MSD Manual. Merck Sharp & Dohme Corp. [updated 2020 Sep; cited 2021 Jun 15]. Available from: https://www.msdmanuals.com/professional/gynecology-and-obstetrics/ infertility/tubal-dysfunction-and-pelvic-lesions.