One Year Fellowship in Reproductive Medicine

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Overview of the Program
Duration: 1 Year (12 months)

Course Intake: 01

Eligibility: M.D/MS/ DGO/FCPS in Obstetrics & Gynaecology in MCI approved
place or D.N.B. in Obstetrics & Gynaecology in NBE approved place.

Criteria of Selection: Merit based Interview by the panel of teachers who are nominated for the course.

Program Highlights :

• This is a one-year fellowship program that will be available for qualified gynaecologists desiring additional training in reproductive medicine and In-Vitro Fertilization.
• The fellows will be trained in Embryo transfer and OPU by the end of the course
• Opportunity to conduct at least one original research study during the course duration
• Opportunity to present their research work at state/national/international conferences.
• Training under Fertility experts and Embryologists at India IVF Fertility centres.
• Demonstration of Lab and OT procedures for training purposes, Structured course layout for comprehensive training.
• Limited students per batch for individual attention

Course Objectives :

• To acquire competence in evaluation and work up of patients with fertility problems.
• To achieve competence in formulation of strategies to manage patients with subfertility.
• To develop competence in performing IUI.
• To gain in-depth knowledge of stimulation protocols.
• To learn preventive steps, Diagnosis and Management of ovarian hyper stimulation syndrome.
• To assist in performing ovum pick-ups (OPUs) and fresh/ frozen embryo transfers (ETs)
• To observe laboratory procedures in IVF lab such as semen preparation for IUI, IVF, ICSI
• To achieve competence in managing donor egg /donor sperm programs.
• To understand the procedure of sperm and embryo cryopreservation and thawing.

Syllabus for Certificate Course in Reproductive Medicine
Expectations at the end of the course, the trainee should be able to:-
FEMALE INFERTILITY:

• Take an appropriate history and examine the woman.
• Evaluate, describe, diagnosis and plan therapy for: ovulatory disorders: including use of basal body temperature, plasma progesterone and endometrial biopsy; diagnosis of causes of anovulation: syndromes of inappropriate prolactin secretion, CNS hypothalamic- pituitary syndromes and other causes.
• Selection of ovulation induction utilizing antioestrogens, gonadotrophins, dopamine agonists, GNRH, GNRH analogues and other agents;
• Tubal disorders: including correct use of and interpretation of studies of tubal function (e.g., ultrasound, hysterosalpingography and laparoscopy); indications for tubal reparative procedures including micro-surgery/ or laparoscopic surgery, versus assisted conception;
• Endometriosis and other peritoneal disorders: including diagnosis and staging of endometriosis and other peritoneal causes of infertility; knowledge of the medical management of endometriosis;
• Cervical factors: including tests for sperm/cervical mucus interaction and possible therapy; artificial insemination including the indications and contra-indications;
• Adoption: including the indications for adoption; knowledge of appropriate counselling methods;
• Familiarity with various local agencies and legal implications dealing with adoption.
• Surrogacy: indications, knowledge of appropriate counselling methods.

MALE INFERTILITY:
The trainee should be able to take an

• Appropriate history and examine the man, including detailed genital examination and arrange /perform appropriate investigations and treatment.
• The trainee should understand and be able to discuss:- the formation and content as well as examination of the seminal fluid;
• The cycle of spermatogenesis, including endocrinological control mechanisms, its abnormalities and the effects of drugs;
• The physiology and Pathophysiology of sexual function; causes of azoospermia and aspermia; the biosynthesis of oestrogens, androgens and progestogens by the human testis and the biological action of testosterone in man;
• Investigation, diagnosis and therapy of infection of the male reproductive system;
• cryobiology of semen, counselling of donors and recipients of DI, sperm banking;
• In vitro and laboratory tests of sperm function e.g., mucus penetration, biochemistry etc.;
• The value and limitations of testicular biopsy and endocrine assessment such as plasma FSH;
• The physiology of endocrine and gametogenic function of the testes and accessory glands.
• Indications and methods of assisted fertilization, including intracytoplasmic sperm injection ;
• Methods of surgical sperm retrieval.

Psychosexual Aspects of Reproductive Medicine Objectives:

• The trainee should understand and be able to discuss:-
• The psychodynamics of growth and development, puberty and the establishment of the gender role.
• The psychological changes associated with treatment of infertility.

In-Vitro Fertilisation (IVF) and other Assisted Reproduction Techniques Objectives:
The trainee should be competent for independent clinical practice in:

• Conditions for which IVF and related techniques of assisted reproduction are appropriate.
• Determination of the menstrual cycle to plan synchronization.
• Follicular stimulation and monitoring by ultrasound, steroid and peptide assays.
• The timing of oocyte aspiration, laparoscopic, and ultrasound based procedures.
• In-vitro gamete transport, maturation and fertilization.
• Surgical and non-surgical methods of sperm retrieval and their use in assisted fertilization.
• Timing and methods of embryo transfer.
• Monitoring of implantation.
• Assessment of genetic abnormalities and their potential treatment.
• Relevant aspects of cryobiology.
• Psychological assessment and management of gamete donors and recipients.
• Ethical and Legal Aspects of ART

The trainee should be able to discuss the ethical and legal aspects of the clinical practice of their Subspecialty and should have particular knowledge of the relevant areas listed below:-

• Legislation, particularly recent, relevant to their subspecialty practice.
• Ethics of health care provision and resource allocation.
• Medical confidentiality.
• Consent.

QC, QA and Record keeping in ART –

• Setting up of an ART Lab
• Equipment required for setting an ART Lab
• Quality Assurance & quality control in ART laboratory

Recommended books and Journals:

1. Journals
2. Fertility and sterility
3. Human reproduction
4. Human reproduction update
5. Reprod Biomed outline.

2. ART
3. David Garden
4. Vergese
5. Pankaj Talwar
6. Altus
7. Frozen Life
8. Infertility Management
9. Kamini Rao
10. Ultrasound
11. Endoscopy
12. ICMR guidelines