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FIGO CONGRESS NEWS: Facilitating the achievement of universal access to reproductive health
Rome, October 9th, 2012 – Helping infertile women become pregnant and helping fertile women avoid unintended pregnancies are two sides of the same coin: reproductive health. As defined by the World Health Organization (WHO): “Reproductive health implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so”.
The International Federation of Gynecology and Obstetrics (FIGO) is very much involved in both the areas of infertility and contraception. The FIGO2012 World Congress in Rome, Italy, staged two major occurrences: the presentation of “The FIGO Fertility Tool Box™” and the third edition of the “Emergency Contraceptive Pills: Medical and Service Delivery Guidelines”.
“The emergency contraception guidelines were created by a group of experts working with the International Consortium for Emergency Contraception. The first release appeared in 2000, and the 2012 edition is endorsed by FIGO, whose representatives participated in reviewing the document,” Professor Ian Fraser, Honorary Secretary of FIGO, explained.
The FIGO Fertility Tool Box™
- http://www.figo.org/news/resources/FIGO_Fertility_Tool_Box - is a new instrument, focused on alleviating the burden of infertility, developed by the FIGO Committee for Reproductive Medicine, chaired by Professor David Adamson. “When thinking about it, we decided to focus not on sophisticated infertility treatments, such as in vitro fertilisation or other assisted reproductive technologies, but to work within the range of generalist obstetricians and gynecologists and down to lower level healthcare providers, including midwives and the public,” he said.
The Tool Box is simple, usable, and evidence-linked; a very flexible tool for adaptation in different environments and countries. “It is hoped that this tool will be used by many providers of women’s healthcare to increase access to quality, cost-effective infertility prevention and management. We have taken into account the international sensitivities with respect to culture, religion, politics and economics,” Professor Adamson continued.
It consists of 6 components dealing with overcoming personal and societal barriers to infertility care, prevention, diagnosis, treatment, referral and resolution, plus the FIGO Fertility Daisy™. The Fertility Daisy™ deals with why one should care about infertility. “Infertility, specifically in low resource settings, is important and its management is justified by the positive impact on quality of life, burden of disease, political commitments, non-discrimination, family planning, prevention of sexually-transmitted infections, affordability and protection of resources - each item symbolised by a petal of the daisy,” Professor Adamson said. “Though the tool is intended primarily for women’s healthcare providers, we hope it will also be used by policy makers,” he added.
Professor Ian Fraser is one of the FIGO experts involved in the review of the emergency contraception guidelines. “Despite the availability of highly effective methods of contraception, many pregnancies are mistimed or unwanted and may carry a high risk of morbidity and mortality, particularly in settings where safe abortion is not accessible. Many of these unintended pregnancies can be avoided using emergency contraception. Furthermore, emergency contraception provides a sense of security for those women who have experienced the life-changing trauma of sexual assault,” he said.
Emergency contraceptive pills, the most commonly used and most convenient form of emergency contraception, should be easily and widely available. Providers can be trained easily in the correct use, counselling, and follow-up related to them. “The guidelines produced by the International Consortium for Emergency Contraception reflect the latest available evidence and are intended to assist family planning programmes and providers in assuring that the women they serve can use these regimens effectively and safely,” he added.
Professor Ian Fraser also chairs the FIGO Working Group on Menstrual Disorders, which developed and released the “FIGO Classification of Causes of Abnormal Uterine Bleeding”. “Its purpose is to provide a structured context for clinical research, medical education, and the provision of clinical care for women with abnormal uterine bleeding. It has been designed to be flexible, suitable for regular review and revision and adaptable for use at the primary care, specialist and clinical investigator levels. The system eliminates the use of vague and undefined diagnostic and symptomatic terms like ‘dysfunctional uterine bleeding’ and ‘menorrhagia’, therefore allowing improved communication about menstrual symptoms, coordinated research planning and improved diagnostic precision, critical elements of any strategy designed to enhance the standard of care for women with this condition,” he concluded.
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