Patient tailored infertility care is the way forward

Ernesto Bosch
Reproductive BioMedicine Online. Available online 23 June 2022 In press Journal pre-proof. 2022 doi:


As in any other healthcare discipline, the debate around standardization of practice vs individualized care is also present in the field of infertility. While the former looks for the efficiency of diagnostic and therapeutic processes in average population supported by Evidence Based Medicine (EBM), the later looks for a patient centered care, integrating individual clinical expertise and patients’ rights and preferences. Both approaches have been purposed in a few randomized controlled trials (RCT) having as endpoints live birth rates and adverse effects incidences. However, the available evidence is arguable and too weak to clearly proclaim one better than the other. Indeed, it’s been suggested that RCT, the keystone for EBM, are not the best tool to evaluate the efficacy of a personalized care. A different design named “No of 1” trails has been purposed as the most appropriate methodology to this end. Infertile patients are still undertreated worldwide. Poor outcomes, fear to adverse events, and financial reasons are behind. In this context, a more personalized approach, aiming to optimize outcome while fulfilling patient’s preferences is necessary to overcome these barriers.