A Decade of Influence: Five Studies from the 2015 Initiative That Redrew the Fertility Textbook

When archivists at HumanRep 2015 Archive began cataloging the initiative's published output in preparation for this anniversary, one question surfaced repeatedly in reader correspondence: which of the 2015 papers actually mattered? The answer, compiled from citation data, guideline revisions, and interviews with practicing reproductive endocrinologists across the United States, is presented below. Each of the five studies examined here has been cited more than 800 times, and each can be linked to a concrete change in how American clinics operate today.

1. Ovarian Reserve Testing and the Decline of Universal AMH Screening

The initiative's multicenter cohort on anti-Müllerian hormone (AMH) as a standalone predictor of natural fecundability remains the most consequential paper of the 2015 cycle. Drawing on more than 750 participants recruited through eight US academic medical centers, the study demonstrated that AMH values, while useful for counseling patients pursuing assisted reproduction, performed poorly as a predictor of time-to-pregnancy in the general population.

The finding rippled quickly. Within three years, the American Society for Reproductive Medicine (ASRM) and the American College of Obstetricians and Gynecologists (ACOG) had both issued statements cautioning against the use of AMH testing as a marker of future fertility in patients without infertility complaints. Clinicians we consulted for this retrospective describe the paper as the moment the field 'stopped selling false certainty.'

2. Elective Single Embryo Transfer Becomes the Standard

A second landmark contribution came from the initiative's working group on embryo transfer policy. Their analysis of perinatal outcomes, comparing elective single embryo transfer (eSET) against double embryo transfer across a decade of US registry data, provided the statistical weight that guideline committees had been waiting for.

The paper's central figure — a curve showing neonatal morbidity rising steeply with multiple gestation while cumulative live birth rates for eSET approached parity over sequential cycles — is now reproduced in nearly every reproductive endocrinology fellowship syllabus in the country. Its influence is visible in CDC-assisted reproduction technology reporting: the national shift toward single embryo transfer accelerated sharply after 2016, and today the practice is the default in most American IVF programs.

3. Endometrial Receptivity: A Sobering Null Result

Not every influential finding was positive. The initiative's blinded trial of endometrial receptivity arrays, which failed to demonstrate a significant improvement in implantation rates when transfer timing was guided by the assay, stands as a model of methodological rigor in a commercialized corner of the field.

Archivist commentary preserved in our collection notes that the paper was initially received coolly at industry-sponsored meetings. Yet its transparent reporting of subgroup analyses and its pre-registered protocol have made it a touchstone in later debates over laboratory-developed tests in reproductive medicine. Several US payors now cite it when adjudicating coverage for receptivity testing.

4. Preimplantation Genetic Testing and the Mosaicism Question

The fourth study, an observational analysis of embryo mosaicism rates and reproductive outcomes, helped reframe how US clinicians counsel patients after PGT-A results. Rather than treating mosaic embryos as uniformly nonviable, the initiative's data supported a graded approach, reserving transfer decisions for individualized discussion.

The paper's impact is codified in the 2018 PGD/PGS committee opinion from ASRM, which drew directly on the 2015 cohort's outcome tables. Genetic counselors interviewed for this retrospective describe it as 'the paper that gave us language' for conversations that had previously defaulted to discarding mosaic embryos outright.

5. Lifestyle Intervention Before IVF: Modest but Real

Finally, the initiative's randomized trial of structured preconception lifestyle intervention among patients preparing for IVF delivered a nuanced result: modest improvements in embryo quality markers, but no significant difference in live birth rates overall. The paper's careful separation of intermediate and final endpoints has been credited with tempering an overly enthusiastic wellness industry narrative while still justifying supportive counseling.

Why These Papers Endure

What unites the five studies, according to the archivists who curated our anniversary collection, is not headline-grabbing novelty but procedural transparency. Large cohorts, pre-specified analyses, and honest reporting of null or nuanced results made the 2015 output unusually durable. A decade on, US clinicians still reach for these papers — not because they settled every question, but because they modeled how reproductive science should be conducted.

The full citation records, original datasets, and archived correspondence related to each study are available through the HumanRep 2015 Archive reading room.