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These opinion papers are produced by the Scientific Advisory Committee.

Below, you can browse Scientific Impact Papers by title or year published.

For any enquiries about the Scientific Impact Papers, please contact Laura Dean-Osgood, Assistant Editor

If you would like to propose a new Scientific Impact Paper, please complete the Topic Proposal Form and email it to

The use of expanded carrier screening in reproductive medicine (Scientific Impact Paper No. 73)

This Scientific Impact Paper discusses the current context of use of expanded carrier screening (ECS), as well as the clinical and technical considerations of performing ECS and the ethics to be considered.

Management of Impacted Fetal Head at Caesarean Birth (Scientific Impact Paper No. 73)

This Scientific Impact Paper reviews the current evidence on the prediction, prevention and management of impacted fetal head at caesarean birth.

Laser treatment for genitourinary syndrome of menopause (Scientific Impact Paper No. 72)

This Scientific Impact Paper outlines the level of evidence available for the use of laser in the treatment of genitourinary syndrome of menopause (GSM), as well as highlighting areas of uncertainty and debate.

Published 27/7/2022

Robotic Surgery in Gynaecology (Scientific Impact Paper No. 71)

This Scientific Impact Paper looks at the use of robotics in different fields of gynaecological surgery, including cancers and endometriosis. It considers impact on surgical performance and complications, and discusses safety and effectiveness compared with conventional keyhole surgery.

Published 18/7/2022

Subclinical hypothyroidism and antithyroid autoantibodies in women with subfertility or recurrent pregnancy loss (Scientific Impact Paper No. 70)

This Scientific Impact Paper uses the latest evidence to provide information on thyroid testing and the management of mild thyroid problems and thyroid antibodies in women with a history of subfertility or recurrent miscarriages.

Published 29/06/2022

The Use of Biomarkers to Stratify Surgical Care in Women with Ovarian Cancer (Scientific Impact Paper No. 69)

This Scientific Impact Paper highlights research that may pave the way towards bespoke surgery according to the biological characteristics of a tumour and aid gynaecological oncologists to provide surgical treatment according to individual need, rather than a blanket approach for all.

Published 25/05/2022

Evaluating misoprostol and mechanical methods for induction of labour (Scientific Impact Paper No. 68)

This Scientific Impact Paper reviews the use of the drug misoprostol for the induction of labour as well as ‘mechanical’ induction using a balloon catheter. The paper examines the evidence that suggests these methods are both at least as safe and effective as using the standard drug, dinoprostone. The effects of these methods on birth outcomes and number of caesarean births is discussed, along with suitability for outpatient or home induction and the advantages for specific patient groups.

Published 28/04/2022

Understanding the Relationship Between Social Determinants of Health and Maternal Mortality (Scientific Impact Paper No. 67)

This is the first edition of this paper. Its aim is to inform those involved in the care of pregnant women in the UK about the relationship between social determinants of health and the risk of maternal death.

Published 10/02/2022

Risk-Reducing Salpingo-Oophorectomy and the Use of Hormone Replacement Therapy Below the Age of Natural Menopause (Scientific Impact Paper No. 66)

This Scientific Impact Paper details the risk factors for ovarian cancer which determine the indications for and timing of risk-reducing salpingo-oophorectomy. It also outlines the subsequent consequences of premature surgical menopause and the role of hormone replacement therapy – its benefits, risks and limitations.

Published 21/10/2021

Uterine Transplantation (Scientific Impact Paper No. 65)

The purpose of this Scientific Impact Paper is to summarise the pertinent published literature on uterine transplantation (UTx) and to propose a framework for establishing a sustainable UTx programme in the UK. Potential recipients and donors are discussed, as well as the surgical, immunological, fertility, obstetric, psychological and ethical considerations associated with this procedure.

Published 29/04/2021

Evidence to Support the Clinical Utility of Prenatal Exome Sequencing in the Evaluation of the Fetus with Congenital Anomalies (Scientific Impact Paper No. 64)

This Scientific Impact Paper examines past and more recent evidence on the use of prenatal exome sequencing and outlines what this test adds to current practice in identifying congenital anomalies.

Published 16/02/2021

Elective Egg Freezing for Non-Medical Reasons (Scientific Impact Paper No. 63)

This Scientific Impact Paper examines the reasons behind the increasing numbers of women choosing to freeze their eggs (cryopreservation of oocytes) in the absence of a medical condition, the efficacy and safety of the technique, the ethical considerations, and the importance of improved and continuing fertility education to optimise success rates.

Published 27/02/2020

Reproductive Implications and Management of Congenital Uterine Anomalies (Scientific Impact Paper No. 62)

The task of counselling and caring for women diagnosed with congenital uterine anomalies (CUAs) is complex because of four issues: inconsistent classifications, the use of diverse diagnostic modalities, the challenges associated with determining the reproductive impact of each anomaly using published data, and the absence of a single randomised controlled trial to address surgical management of CUAs. The aim of this Scientific Impact Paper is to address these issues and make recommendations.

Published 21/11/2019

Prenatal Management of Pregnancies at Risk of Fetal Neonatal Alloimmune Thrombocytopenia (FNAIT) (Scientific Impact Paper No. 61)

This Scientific Impact Paper considers the latest evidence in relation to treatment options in the prenatal management of pregnancies at risk of FNAIT; specifically, the role of screening, immunoglobulins, steroids, fetal blood sampling and intrauterine platelet transfusion.

Published 10/04/2019

The Combined Use of Ultrasound and Fetal Magnetic Resonance Imaging for a Comprehensive Fetal Neurological Assessment in Fetal Congenital Cardiac Defects (Scientific Impact Paper No. 60)

This Scientific Impact Paper summarises the available evidence for the combined use of ultrasound and fetal magnetic resonance imaging to comprehensively assess the brain in fetuses with congenital cardiac defects.

Published 27/03/2019

Antenatal and Postnatal Analgesia (Scientific Impact Paper No. 59)

The purpose of this Scientific Impact Paper is to clarify advice regarding pain relief in the antenatal and postnatal periods reviewing evidence from the Medicines and Healthcare products Regulatory Agency and European Medicines Agency.

Published 13/12/2018

Diagnostic Biomarkers for Predicting Adverse Early Pregnancy Outcomes (Scientific Impact Paper No. 58)

This Scientific Impact Paper discusses the controversies surrounding the current use of biomarkers and their potential future use.

Published 07/11/2018

Epigenetics and Reproductive Medicine (Scientific Impact Paper No. 57)

This Scientific Impact Paper summarises current viewpoints on our understanding of epigenetics and the relevance of these findings to reproductive medicine.

Published 25/09/2018

Multiple Pregnancy Following Assisted Reproduction (Scientific Impact Paper No. 22)

This paper discusses the increase in the multiple pregnancy rate as a result of assisted reproduction and the implications.

Published 02/02/2018


Congenital Cytomegalovirus Infection: Update on Treatment (Scientific Impact Paper No. 56)

This Scientific Impact Paper summarises the issues around screening, diagnosis and treatment of CMV in pregnancy, utilising the best available evidence and highlighting recent advances.

Published 15/11/2017

The Effect of Surgery for Endometriomas on Fertility (Scientific Impact Paper No. 55)

This paper will review the current evidence for management of endometriomas within the context of infertility treatment.

Published 25/09/2017

Metformin Therapy for the Management of Infertility in Women with Polycystic Ovary Syndrome (Scientific Impact Paper No. 13)

This paper discusses the use of metformin as an infertility treatment for women with PCOS.

Published 23/08/2017

Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates (Scientific Impact Paper No. 54)

This Scientific Impact Paper discusses the evidence for endometrial trauma and improved implantation rates, the mechanisms by which implantation may improve, timing and technique for inducing endometrial trauma and who may benefit.

Published 28/11/2016

The Role of Natural Killer Cells in Human Fertility (Scientific Impact Paper No. 53)

In this Scientific Impact Paper, the data relating to NK cell function will be reviewed and recommendations made regarding the measurement of NK cells in women with reproductive failure.

Published 28/11/2016

Management of Female Malignant Ovarian Germ Cell Tumours (Scientific Impact Paper No.52)

This Scientific Impact Paper studies the management of female malignant ovarian germ cell tumours (MOGCTs).

Published 25/11/2016

Sentinel Lymph Node Biopsy in Endometrial Cancer (Scientific Impact Paper No.51)

This Scientific Impact Paper discusses the potential benefits of SLNB, those women with endometrial cancer who may be most suitable for SLNB, and detection and analysis techniques.

Published 19/07/2016

Reproductive Outcomes after Local Treatment for Preinvasive Cervical Disease (Scientific Impact Paper No.21)

This Scientific Impact Paper attempts to present the current evidence and future research required, with particular focus on UK practice.

Published 19/07/2016

Progress in Cervical Screening in the UK (Scientific Impact Paper No. 7)

This paper reviews the challenges and developments associated with cervical screening programmes.

Published 16/03/2016

Bariatric Surgery in Improving Reproductive Health, The Role of (Scientific Impact Paper No. 17)

This paper reviews the most recent evidence on the safety and efficacy of bariatric surgery as an intervention to improve female fertility and reproductive outcomes in obese women.

Published 15/10/2015

Developing New Pharmaceutical Treatments for Obstetric Conditions (Scientific Impact Paper No. 50)

This paper discusses the challenges in developing therapeutics in obstetrics and identifying best practice.

Published 13/05/2015

Ultrasound from Conception to 10+0 Weeks of Gestation (Scientific Impact Paper No. 49)

This paper addresses the issues of ultrasound in the embryonic period. It will consider both medical and non-medical use of the commonly used ultrasound modes in the embryonic stage of human development (up to 10 weeks of gestation). 

Published 13/03/2015

Clamping of the Umbilical Cord and Placental Transfusion (Scientific Impact Paper No. 14)

This paper summarises the physiology of cord clamping and reviews the evidence related to timing of clamping.

Published 27/02/2015

Genetic Predisposition to Gynaecological Cancers, Management of Women with a (Scientific Impact Paper No. 48)

This paper considers the risks related to gene mutations and the options for reducing or managing the risk of gynaecological cancer.

Published 04/02/2015

Chronic Pelvic Pain Relief, Therapies Targeting the Nervous System for (Scientific Impact Paper No. 46)

This paper describes the options for treating women with chronic pelvic pain that target the nervous system.

Published 28/01/2015

Fetal Scalp Lactate as an Alternative to Scalp pH, Is it Time for UK Obstetricians to Accept (Scientific Impact Paper No. 47)

This Scientific Impact Paper has been archived.

Published 28/01/2015

High-grade Serous Carcinomas, The Distal Fallopian Tube as the Origin of Non-uterine Pelvic (Scientific Impact Paper No. 44)

This paper reviews the understanding of ovarian carcinogenesis, especially HGSOC because it has the potential to significantly change clinical preventive strategies in ovarian cancer.

Published 19/11/2014

Ascites in Ovarian Cancer Patients, Management of (Scientific Impact Paper No. 45)

This paper describes the aetiology, therapeutic options and research needs for the management of malignant ascites secondary to ovarian cancer.

Published 19/11/2014

Vitamin D in Pregnancy (Scientific Impact Paper No.43)

This paper investigates the effects of vitamin D on the placento-fetal unit and the mother.

Published 26/06/2014

Non-invasive Prenatal Testing for Chromosomal Abnormality using Maternal Plasma DNA (Scientific Impact Paper No. 15)

This paper summarises current evidence and issues surrounding non-invasive prenatal testing, with particular emphasis on the detection of chromosomal abnormalities.

Published 04/03/2014

Perinatal Management of Pregnant Women at the Threshold of Infant Viability– the Obstetric Perspective (Scientific Impact Paper No. 41)

This paper reviews the evidence and provides an opinion on the management of women in preterm labour at the extreme of infant viability.

Published 11/02/2014

Botulinum Toxin for an Overactive Bladder (Scientific Impact Paper No. 42)

This guideline provides guidance on the use of botulinum toxin for the treatment of detrusor overactivity and overactive blladder.

Published 05/02/2014

Targeted Therapies for the Management of Ovarian Cancer (Scientific Impact Paper No. 12)

This paper discusses treatment options for ovarian cancer.

Published 06/09/2013

Sex Steroid Treatment for Pubertal Induction and Replacement in the Adolescent Girl (Scientific Impact Paper No. 40)

This paper discusses the timing of sex steroid treatments to induce puberty and the research conducted in this area.

Published 02/08/2013

Adhesion Prevention Agents in Obstetrics and Gynaecology, The Use of (Scientific Impact Paper No. 39)

This paper provides guidance for clinicians and policy makers on the use of effective adhesion prevention agents.

Published 05/06/2013

Chemical Exposures During Pregnancy (Scientific Impact Paper No. 37)

This paper provides advice on the sources and routes of chemical exposure during pregnancy or while breastfeeding, to allow women to minimise harm to their child.

Published 05/06/2013

Air Travel and Pregnancy (Scientific Impact Paper No. 1)

This paper provides guidance for obstetricians on how to advise women on whether it is suitable for them to fly during pregnancy.

Published 22/05/2013

Stem Cell Therapies in Obstetrics and Gynaecology (Scientific Impact Paper No. 38)

This paper discusses the female genital tract and the fetus as sources and targets for molecular and regenerative medicine.

Published 22/05/2013

Enhanced Recovery in Gynaecology (Scientific Impact Paper No. 36)

This paper discusses enhanced recovery (also known as ‘fast track’, ‘rapid’ or ‘accelerated’ recovery) in gynaecology.

Published 08/02/2013

Preterm Labour, Antibiotics and Cerebral Palsy (Scientific Impact Paper No. 33)

This paper examines the evidence for giving antibiotics to women in preterm labour.

Published 08/02/2013

Induction of Labour at Term in Older Mothers (Scientific Impact Paper No. 34)

This paper discusses the induction of labour in women of advanced maternal age (40+ years) and the possible benefits of inducing at an earlier stage of gestation (39–40 weeks).

Published 01/02/2013

Fertility-sparing Treatments in Gynaecological Cancers (Scientific Impact Paper No. 35)

This paper discusses gynaecological cancers and the different fertility-sparing treatments available to women.

Published 01/02/2013

Perinatal Risks Associated with IVF (Scientific Impact Paper No. 8)

This paper examines the evidence regarding the outcomes of pregnancy, delivery and early childhood associated with conception by IVF and associated procedures.

Published 06/06/2012

Endometrial Cancer in Obese Women (Scientific Impact Paper No. 32)

This paper reviews the evidence for the treatment of endometrial cancer in light of the increasing proportion of obese women with this disease.

Published 06/06/2012

Patient-reported Outcome Measures in Gynaecology (Scientific Impact Paper No. 31)

This Scientific Impact Paper has been archived.

Published 02/05/2012

Acupuncture and Chinese Herbal Medicine for Women with Chronic Pelvic Pain (Scientific Impact Paper No. 30)

This Scientific Impact Paper has been archived

Published 20/03/2012

Life Course Approach to Women’s Health Care, Why Should we Consider a (Scientific Impact Paper No. 27)

This Scientific Impact Paper has been archived.

Published 14/10/2011

Magnesium Sulphate to Prevent Cerebral Palsy following Preterm Birth (Scientific Impact Paper No. 29)

This Scientific Impact Paper has been archived

Published 28/09/2011

Evidence Can Influence Clinical Practice, How (Scientific Impact Paper No. 28)

This Scientific Impact Paper has been archived.

Published 28/09/2011

Antithrombotics in the Prevention of Recurrent Pregnancy Loss, The Use of (Scientific Impact Paper No. 26)

This Scientific Impact Paper has been archived.

Published 24/06/2011

Ovarian Cancer, Optimum Surgery in Advanced-stage (Scientific Impact Paper No. 25)

This paper discusses the role and value of optimum surgery in the management of advanced-stage ovarian cancer.

Published 24/06/2011

Diagnosis and Treatment of Gestational Diabetes (Scientific Impact Paper No. 23)

This Scientific Impact Paper has been archived.

Published 26/01/2011

Reproductive Ageing (Scientific Impact Paper No. 24)

This paper discusses various issues related to reproductive ageing and strategies to ameliorate their impact on fertility.

Published 26/01/2011

Alternatives to HRT for the Management of Symptoms of the Menopause (Scientific Impact Paper No. 6)

This paper provides guidance on alternatives to hormone replacement therapy for the management of menopausal symptoms.

Published 01/09/2010

Nutrition in Pregnancy (Scientific Impact Paper No. 18)

This Scientific Impact Paper has been archived.

Published 13/05/2010

Evaluating New Screening Methodologies (Scientific Impact Paper No. 20)

This Scientific Impact Paper has been archived.

Published 13/05/2010

Mesh in Gynaecological Surgery, The Use of (Scientific Impact Paper No. 19)

This Scientific Impact Paper has been archived.

Published 13/05/2010

Vaccination Against Cervical Cancer (Scientific Impact Paper No. 9)

This Scientific Impact Paper has been archived. Please refer to the Department of Health for up-to-date information.

Published 20/11/2009

Vitamin Supplementation in Pregnancy (Scientific Impact Paper No. 16)

This Scientific Impact Paper has been archived.

Published 19/10/2009


Reproductive Trends and Assisted Reproduction Technologies (Scientific Impact Paper No. 11)

This Scientific Impact Paper has been archived.

Published 01/06/2008

Immunological Testing and Interventions for Reproductive Failure (Scientific Impact Paper No. 5)

This Scientific Impact Paper has been archived. Please see Scientific Impact Paper no. 53 The Role of Natural Killer Cells in Human Fertility and no. 54 Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates.

Published 01/06/2008

Changing Role of the Gynaecologist in the Management of Women with Cancer (Scientific Impact Paper No. 10)

This Scientific Impact Paper has been archived.

Published 01/11/2007

Intrauterine Infection and Perinatal Brain Injury (Scientific Impact Paper No. 3)

This Scientific Impact Paper has been archived.

Published 01/10/2007


Umbilical Cord Blood Banking (Scientific Impact Paper No. 2)

This paper provides advice on various issues related to cord blood banking, including the science, clinical use, safety and legal issues.

Published 01/06/2006

Clinical content hub

We have developed a hub of audio versions, bitesize video summaries and infographics based on our Green-top Guidelines and Scientific Impact Papers.