We recommend strict follow-up of infertility units to ensure adherence to the recommendation of performing AOA and implementing an electronic database system to facilitate monitoring and adherence to the above recommendation. Practitioners should provide a clear justification and state the reason if they recommend AOA outside of the aforementioned recommendations.

▪️ Update of guideline

This guideline will be updated whenever new evidence is available.

▪️ Research gaps

Research in AOA reveals significant gaps that warrant further investigation. The field lacks high-quality evidence on AOA's effectiveness and safety across various patient groups, with a particular dearth of long-term safety data for children born after the procedure. There's limited understanding of AOA's impact on embryo quality and development, and the biological mechanisms underlying these effects remain unclear. The efficacy of rescue AOA and its optimal timing are poorly understood. The field would benefit from larger, well-designed studies with appropriate control groups to address these knowledge gaps.