title: Subfertility guidelines in Europe: the quantity and quality of intrauterine insemination guidelines.
abstract: BACKGROUND
  International collaboration could facilitate systematic development of guidelines to regulate and improve clinical practice. To promote European collaboration in guideline development in reproductive medicine, insight into existing subfertility guidelines in Europe is essential. The study aim was to explore the number and quality of clinical practice guidelines on homologous intrauterine insemination (IUI) in Europe.
  
  
  METHODS
  To identify IUI guidelines in Europe, electronic databases and Internet were systematically searched and key experts on assisted reproduction in 25 European countries were questioned. The quality of IUI guidelines was systematically assessed with the internationally validated Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. Qualitative methods were used to appraise IUI guideline recommendations and references.
  
  
  RESULTS
  National guidelines on IUI are available in four of 25 European countries. The quality of IUI guidelines in Europe is moderate to high, but the recommendations and references differ considerably.
  
  
  CONCLUSIONS
  The number of IUI guidelines in Europe is surprisingly small, and differences in their recommendations and references are considerable. To overcome these deficiencies in clinical guidance on IUI care in Europe, a central body with expertise in up-to-date guideline development methodology and sufficient resources could be established in Europe for central selection and international exchange of evidence to support guideline recommendations.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Ther Netherlands.
authors.forename: E C
authors.initials: EC
authors.lastname: Haagen
authors.forename: R P M G
authors.initials: RP
authors.lastname: Hermens
authors.forename: W L D M
authors.initials: WL
authors.lastname: Nelen
authors.forename: D D M
authors.initials: DD
authors.lastname: Braat
authors.forename: R P T M
authors.initials: RP
authors.lastname: Grol
authors.forename: J A M
authors.initials: JA
authors.lastname: Kremer
mesh_terms: D005060:Europe; D005260:Female; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007315:Insemination, Artificial / Q000592:standards*; D017410:Practice Guidelines as Topic