Table 31.1 Grading of recommendations Grade Recommendation A Requires at least one randomised controlled trial as part of the body of literature of overall good quality and consistency addressing the specific recommendation. B Requires availability of well-conducted clinical studies but no randomised clinical trials on the topic of recommendation. Indicates absence of directly applicable studies of good quality. A. Recommendations for health policy 1. This national service framework should draw on evidence about clinical efficacy and cost-effectiveness.
More attention needs to be paid to the prevention of infertility.
In particular, programmes of screening for the known causes of infertility should be introduced and rigorously evaluated. A clear distinction should be made to patients, practitioners and health authorities between treatments of established efficacy and experimental treatments. The latter should be provided only in the context of research studies funded from appropriate research sources. Professional bodies advocating the introduction of new treatments should be explicit about the implications and the costs involved. In general, new treatments should be introduced into clinical practice on a time scale that allows for the identification of appropriate resources.