[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-403418-105":59,"doc-detail-403418-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","fertility-solutions-infertility-medical-necessity-guideline-clinical-performance-guideline","Fertility Solutions - Infertility - Medical Necessity Guideline - Clinical Performance Guideline","","Clinical Performance Guideline for Fertility Solutions provides an evidence-based framework for understanding infertility treatment, infertility surgery considerations, and recommendations concerning single embryo transfer. It defines infertility, distinguishes it from recurrent pregnancy loss, and sets timing criteria for evaluation and treatment. The guideline outlines general indications and treatment criteria, including ovulation induction options (clomid, letrozole, tamoxifen, gonadotropins), intrauterine insemination approaches, and assisted reproductive technologies such as IVF and ICSI, as well as related interventions and key clinical considerations.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/fertility-solutions-infertility-medical-necessity-guideline-clinical-performance-guideline/403418/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/fertility-solutions-infertility-medical-necessity-guideline-clinical-performance-guideline/403418.png","ImageObject",300,407,{"name":92,"@type":93},"ahduag","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-27",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",16,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How does the guideline define infertility and when should evaluation begin?","Question",{"text":113,"@type":114},"Infertility is defined by the inability to achieve a successful pregnancy due to medical/sexual/reproductive history, or failure to achieve pregnancy after 12 months of regular unprotected intercourse when the female partner is under 35, or after 6 months when 35 or older. Earlier evaluation and treatment may be justified by medical history and physical findings, and evaluation is warranted after 6 months for women aged 35 years or older.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What are the main general indications and risk-related factors noted in the background?",{"text":118,"@type":114},"The guideline summarizes that infertility causes may be attributable to female factors (40%), male factors (40%), and combined male and female factors (10%), with 10–20% where the cause cannot be determined. It also notes that cigarette smoking adversely affects fertility and includes additional clinical statements related to fertility outcomes.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment pathway options are covered for infertility management?",{"text":122,"@type":114},"The guideline covers ovulation induction therapies (clomid, letrozole, tamoxifen, gonadotropins), intrauterine insemination options including natural cycle and stimulated IUI, and assisted reproductive technologies such as IVF and ICSI. It also includes guidance on concepts like elective single embryo transfer, multiple embryo transfer, and adjuncts such as preimplantation genetic testing and gestational carrier considerations.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},403418,1790649388,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},3985747870414,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Clinical Performance Guideline Fertility Solutions  \nInfertility  \nMedical Necessity Guideline  \nTABLE OF CONTENTS  \nPURPOSE AND GOAL 2 BACKGROUND 2 GENERAL INDICATIONS 9 TREATMENT CRITERIA 10  \nOVULATION INDUCTION 10 CLOMID 10 LETROZOLE 10 TAMOXIFEN 11 GONADOTROPINS 11 OVARIAN STIMULATION 12 CLOMID 12 LETROZOLE 12 TAMOXIFEN 12 GONADOTROPINS 12 THERAPEUTIC DONOR INSEMINATION 13 INTRAUTERINE INSEMINATION 14 NATURAL CYCLE 14 STIMULATED IUI 14 ASSISTED REPRODUCTIVE TECHNOLOGIES 15  \nIVF 16  \nNATURAL CYCLE IVF 16  \nICSI 16  \nIVF FRESH CYCLE NOT INDICATED 18  \nELECTIVE SINGLE EMBRYO TRANSFER 18  \nMULTIPLE EMBRYO TRANSFER 19  \nADJUNCTS TO TREATMENT 19  \nPREIMPLANTATION GENETIC TESTING 20  \nGESTATIONAL CARRIER 20  \nSURGERY 21  \nTUBAL 21 ENDOMETRIOSIS 22  \nUTERINE 22 MALE FACTOR INFERTILITY 23 DEFINITIONS 51 BIBLIOGRAPHY 53  \nPurpose: To provide an understanding of infertility treatment, issues surrounding infertility surgery, and issues surrounding multiple embryo transfers among individuals faced with the potential loss of fertility.  \nGoals: To provide an evidence-based approach to infertility management, infertility surgery, and the use of single embryo transfer in addition to describing the limitations of and recommendations for infertility treatment.  \n\n| Background | I.  Infertility\u003Cbr>• Infertility is defined as:\u003Cbr>o The inability to achieve a successful pregnancy due to an individual’s medical, sexual, or reproductive history, OR\u003Cbr>o Failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse when the female partner is less than\u003Cbr>35 years, OR\u003Cbr>o Failure to achieve a pregnancy after 6 months or more of regular unprotected sexual intercourse when the female partner is 35 years or older.\u003Cbr>Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women aged 35 years or older. The presence of an identified infertility factor should allow for immediate treatment, obviating the need for the waiting period to meet the definition of infertility when an individual is actively attempting to achieve a conception.\u003Cbr>Recurrent pregnancy loss is a disease distinct from infertility, defined by two or more failed pregnancies. When the cause is unknown, each pregnancy loss merits careful review to determine whether specific evaluation may be appropriate. (ASRM) For purposes of determining when evaluation and treatment for infertility or recurrent pregnancy loss are appropriate, pregnancy is defined as a clinical pregnancy documented by ultrasonography or histopathologic examination. (ASRM)\u003Cbr>Artificial donor insemination may (refer to specific benefit language) be considered diagnostic in terms of meeting the definition of infertility for females without a male partner who do not otherwise have an identified infertility factor. Such artificial insemination is limited to not more than 12 inseminations for females \u003C35 years of age and not more than 6 inseminations for females 35 years of age and older. In this context, ovarian stimulation is not indicated as the insemination is being performed in a natural cycle. (The above does not apply to any individual with an infertility diagnosis as such individual would be subject to the medical necessity infertility clinical guidelines when medical necessity review is part of the infertility benefit.)\u003Cbr>• The causes of infertility may be attributable to the female in 40% of cases, to the male in 40% of cases and to a combination of both male and female factors in 10% of cases.\u003Cbr>• The cause of infertility cannot be determined in up to 10-20% of couples.\u003Cbr>• Female factors can further be divided into tubal (40%), ovulatory (40%), uterine (10%) and cervical (10%) .\u003Cbr>• Cigarette smoking adversely affects fertility. |\n| --- | --- |\n\n\n|  | • Endometriosis is associated with infertility; however, the mechanism of impaired fertility in the presence of minimal disease has not been clearl","cbCaiuZNHmNUAeL0","https://ap.wps.com/l/cbCaiuZNHmNUAeL0","pdf",847879,76,"English","# Purpose and Goal\n## Background\n## General Indications\n## Treatment Criteria\n## Ovulation Induction\n## Intrauterine Insemination\n## Assisted Reproductive Technologies (ART)\n## IV F and Related Procedures\n## Adjuncts to Treatment\n## Definitions\n## Bibliography","[{\"question\":\"How does the guideline define infertility and when should evaluation begin?\",\"answer\":\"Infertility is defined by the inability to achieve a successful pregnancy due to medical/sexual/reproductive history, or failure to achieve pregnancy after 12 months of regular unprotected intercourse when the female partner is under 35, or after 6 months when 35 or older. Earlier evaluation and treatment may be justified by medical history and physical findings, and evaluation is warranted after 6 months for women aged 35 years or older.\"},{\"question\":\"What are the main general indications and risk-related factors noted in the background?\",\"answer\":\"The guideline summarizes that infertility causes may be attributable to female factors (40%), male factors (40%), and combined male and female factors (10%), with 10–20% where the cause cannot be determined. It also notes that cigarette smoking adversely affects fertility and includes additional clinical statements related to fertility outcomes.\"},{\"question\":\"What treatment pathway options are covered for infertility management?\",\"answer\":\"The guideline covers ovulation induction therapies (clomid, letrozole, tamoxifen, gonadotropins), intrauterine insemination options including natural cycle and stimulated IUI, and assisted reproductive technologies such as IVF and ICSI. It also includes guidance on concepts like elective single embryo transfer, multiple embryo transfer, and adjuncts such as preimplantation genetic testing and gestational carrier considerations.\"}]","Fertility Solutions - Infertility - Medical Necessity Guideline - Clinical Performance Guideline | PDF",1790540285,192]