Associate Professor Funda Göde announced that according to the newly updated NICE 2026 fertility guidelines, the evaluation timeframe for couples experiencing infertility should remain continuous despite a pregnancy loss.
Evaluating the landmark updates published by the UK-based National Institute for Health and Care Excellence (NICE), Gynecology, Obstetrics, and IVF Specialist Associate Professor Funda Göde, from the Bahçeci İzmir IVF Center, shared critical insights regarding modern reproductive medicine. Dr. Göde emphasized that a miscarriage or an ectopic pregnancy should no longer serve as a clinical justification to restart the standard observational waiting period required before initiating an infertility evaluation. She explained that this specific adjustment eliminates a major source of ambiguity in the patient’s care pathway, standardizing treatment access and significantly shortening the stressful delays that couples face while seeking clinical intervention.
OVARIAN STIMULATION ALONE NOT RECOMMENDED FOR UNEXPLAINED INFERTILITY
Dr. Göde noted that the NICE 2026 guidelines firmly establish that standalone ovarian stimulation is no longer an advised medical protocol for cases of unexplained infertility. For couples failing to conceive despite regular, unprotected intercourse, the updated framework recommends a cumulative two-year trial period before initiating active medical interventions. Following this timeline, clinicians are encouraged to design personalized strategies based on the couple’s unique clinical background, patient preferences, and potential risks. Rather than relying on simple ovarian stimulation, the guidelines suggest up to four cycles of artificial insemination paired with gonadotropins, or a direct progression to IVF depending on maternal age, semen metrics, and ovarian reserves.
CLARIFYING THE TRUE UTILITY OF OVARIAN RESERVE TESTS
Addressing common misconceptions regarding reproductive diagnostics, Dr. Göde explained that Anti-Müllerian Hormone (AMH) testing should not be misinterpreted as a definitive tool to gauge a woman’s capacity for natural conception. Aligning with current ESHRE recommendations, the updated guidelines clarify that AMH and antral follicle counts are strictly intended to forecast ovarian response during assisted reproductive technologies like IVF, enabling customized medication dosing. Similarly, Follicle-Stimulating Hormone (FSH) is no longer deemed a dependable marker for predicting overall treatment outcomes or specific cycle success, underscoring the critical importance of interpreting these diagnostic tests exclusively for their intended clinical parameters.
INDIVIDUALIZED STRATEGIES FOR ENDOMETRIOSIS AND MALE INFERTILITY FACTORS
Turning her attention to patients diagnosed with endometriosis, Dr. Göde highlighted that therapeutic pathways must be highly customized rather than solely dictated by the presence of the disease itself. Factors such as the duration of natural conception attempts, pain severity, tubal patency, and maternal age must be collectively evaluated to determine whether watchful waiting, surgical intervention, or advanced IVF treatment is most appropriate. Concluding her expert review on male infertility factors, Dr. Göde mentioned that the guidelines favor target-specific diagnostics while discouraging the routine use of generic supplements or antioxidants to improve sperm DNA integrity. Instead, resources are directed toward precise genetic testing, shielding patients from redundant procedures and building highly realistic, effective treatment timelines.
