29/04/2025
Dear Colleagues,
This is (Not Recommended) Guidelines of NICE Guidelines, ESHRE Guidelines, ASRM Guidelines, ACOG, RCOG
in Infertility
Part 1
(NOT RECOMMENDED in Infertility )
1- Any Infertility Investigation before one year of Unprotected Regular sexual In*******se in Patient less than 35 years with no significant History. (NICE Guidelines, 2013)
2- Hormonal Profile (FSH, LH, E2, TSH, Prolactin) in Regular Cycle. (NICE Guidelines, 2013)
3- Basal FSH, LH, E2 after withdrawal bleeding .
4- Induction of Ovulation in Ovulatory Woman.
5- Postcoital Test & Antisperm antibody test. (NICE Guidelines, ACOG)
6- Any Semen Analysis NOT according to WHO Parameters.
7- Basal body Temperature and Endometrial biopsy for Assessment of Ovulation. (NICE Guidelines 2013)
8- Routine Ovarian Reserve Tests (AMH, FSH) for a case of Infertility. (NICE Guidelines, 2013)
9- Any induction of Ovualtion before detection the cause of Anovulation.
10- Any induction of Ovulation or ICSI in cases of POI , Resistant o***y syndrome, Turners syndrome.
11- PRP for Cases of POI. (ESHRE, 2024)
12- AMH in Cases of POI.(ESHRE, 2024)
13- Egg donation in cases of POI (Prohibited by Religion & Low) (Egyptian Guidelines, 2024)
14- Any treatment of Hyperprolactinemia before detection the cause .
15- Any treatment of Galactorhea in Ovulatory woman unless Galactorhea cause psychological issues.
16- Any induction of Ovulation in cases of Hypo Hypo before detection the cause.
17- Routine MRI for a case of Hyperprolactinemia before detection the cause and level of serum Prolactin.
18- Routine AMH for cases of PCOS especially All of us having Ultrasound. (Eshre Guidelines, 2023)
19- Routine Laparoscopic Ovarian drilling in PCOS patient. (Eshre ,2023)
20- Induction of Ovulation in case of PCOS before doing HSG in patient with suspected Tubal factor of Infertility.
(Eshre 2023)
21- LH: FSH Ratio for diagnosis a case of PCOS. (Eshre 2023)
22- Routine hCG trigger for cases of Infertility. (Eshre 2023)
23- More than 6 cycle of induction of Ovualtion by Oral induction drugs or Gonadotropins in Cases of PCOS.
24- AMH in diagnosis of Adolescent PCOS. (Eshre 2018)
25- Use of US in the diagnosis of Adolescent PCOS less than 8 years after menarche. (Eshre 2018)
26- Use more than 150 mg of CC daily or use more than 7.5 mg of Letrozole daily for induction of Ovulation in patient with PCOS. (Eshre 2023)
27- Triggering of Ovulation by hCG when use Gonadotropins for induction of ovulation in cases of PCOS when there is more than two mature follicles.
(Eshre 2023)
28- Triggering of Ovulation by hCG when E2 more than 1700 pg/ml . (Textbook of ARTs by Gardener 2018)
29- Use of COCs for Treatment of Functional Ovarian cysts. (Cochrane Meta- anylysis)
30- Use of Antibiotics and medical treatment for a case of Hydrosalpinex.
(RCOG Guidelines)
31- Routine use of Laparoscopy and Hysteroscopy for a case of Unexplained Infertility. (Eshre Guidelines 2023)
32- Tubal Surgery for a case of Severe distal or Proximal Tubal obstruction or adhesion.
33- HSG in a case with Active PID until treated or in bleeding episodes (Contraindicated)
34- HSG in Patient with T.B.(Contraindicated)
35- Use of Hysteroscopy or MRI as primary investigation for diagnosis of Uterine factor of Infertility.
36- Hysteroscopic Surgery of Asherman syndrome unless you are Hysteroscopy Expert and well trained.
37- Myomectomy for myoma NOT Touch the Endometrium in patient complain of Infertility. (Figo Guidelines)
38- Uterine artery Embolization for a patient complaint of Infertility.
39- Uterine artery Torniquet during myomectomy in patient complain of Infertility.
40- Routine use of Laparoscopy for diagnosis of Endometriosis. (Eshre Guidelines 2022)
41- Laparoscopic Surgery of deep and severe cases of Endometriosis unless you are expert and well trained. (Eshre Guidelines 2022)
42- Treatment with (COCs, Danazol, GnRH agonist and Medroxyprogesterone acetate) in Patient with Endometriosis desire Fertility. (Eshre Guidelines 2022)
46- Medical or Surgical Treatment for a patient with Endometriosis with poor Ovarian Reserve and desire fertility. (Refer to IVF) , (Eshre Guidelines 2022)
47- Routine Surgical or Laparoscopic removal of Endometrioma in a patient desire Fertility. (Eshre Guidelines 2022)
48- MRI as the first line to confirm normal Uterine Structure in patient with Unexplained Infertility. (Eshre Guidelines 2023)
49- Postcoital test or Antisperm antibody tests in patient with Unexplained Infertility. (Eshre Guidelines 2023)
50- Testing of thyroid antibodies in cases of Unexplained Infertility. (Eshre Guidelines 2023)
51- DNA fragmentation Test in a patient with Unexplained Infertility. (Eshre Guidelines 2023)
52- Testing for Thrombophilia , Vitamin D , Prolactin level in cases of Unexplained Infertility. (Eshre Guidelines 2023)
53- Genetic Study for patient with Unexplained Infertility. (Eshre Guidelines 2023)
54- ICSI as first line treatment for a patient with Unexplained Infertility.
(Eshre Guidelines 2023)
